Acute Arterial Thrombosis of Lower Extremities in COVID-19 Patients

Abstract

Clinical signs and symptoms of COVID-19 varied from asymptomatic forms to severe, life-threatening conditions that required treatment in intensive care units. These severe forms of illness are connected with a hypercoagulable state due to excessive inflammation, hypoxia, immobilisation, and altered angiotensin-converting enzyme 2 (ACE-2). In total, 17 COVID-19 positive patients were diagnosed with peripheral arterial thrombosis (AT), 13 of them had COVID-19 pneumonia. Laboratory findings in patients with X-ray confirmed pneumonia showed a four times higher neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and three times higher lactate dehydrogenase level (LDH) than patients without confirmed pneumonia. Patients with pneumonia had significantly more bilateral occlusions of the lower extremities and a significantly higher percentage with complete occlusion of the arteries than patients without pneumonia. The rate of limb loss was 35.3%. They were all from the group with COVID-19 pneumonia. Ten out of thirteen patients with pneumonia died due to acute respiratory distress syndrome (ARDS). All patients without pneumonia were discharged from the hospital. The aim of this retrospective study was to report the incidence of arterial thrombosis of lower extremities and their complications in the acute phase of the infection among COVID-19 patients admitted to the hospital for treatment.

Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients

“…The pandemic caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has affected, until the present day (26 August 2022), a total of 604,392,189 cases and caused 6,483,256 deaths [ 1 ], having a negative impact on medical activities [ 2 , 3 ]. Patients’ symptoms range from minor (headache, loss of taste and smell) to severe (major lung damage, admission to critical care units, the necessity of invasive mechanical ventilation, sepsis, and, more recently, thromboembolic events) [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

A Clinical Case of Critical Ischemia of the Lower Limb Due to Antiphospholipid Syndrome in a Patient With Newly Diagnosed Systemic Lupus Erythematosus

“…Відомо, що коронавірусна хвороба (COVID-19) пов'язана з підвищеним ризиком розвитку венозної тромбоемболії [3]. Описаний також і тромбоз артерій нижніх кінцівок при COVID-19, який, за даними літератури, асоціюється з розвитком пневмонії, тяжким перебігом, що потребує госпіталізації [4]. Окрім того, проведені дослідження на підставі яких вважається, що інфекцією SARS-CoV2 ініціюється утворення АФЛ.…”

Revacularization in limb arterial thrombosis

“…(между 61 и 90 г. ), 11 мъже и шест жени, с COVID-19 в хода на ретроспективно проучване през периода между 19.III.2020 г. и 11.XII.2021 г. в Хърватска (7). При дванадесет от тринадесетте болни с пневмония, свързана с COVID-19, и при четирите случая без пневмония, се установява двустранно запушване на артериите.…”