Concomitant calciphylaxis and COVID-19 associated thrombotic retiform purpura

Rotman, J; Dean, Kathryn E.; Magro, Cynthia M.; Nuovo, Gerard J.; Bartolotta, Roger J.

doi:10.1007/s00256-020-03579-6

Cited by 16 publications

(22 citation statements)

References 31 publications

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“…There is an increased risk of venous and arterial complications related to COVID‐19, including deep vein thrombosis, pulmonary embolism, ischemic stroke, myocardial infarction, and acute kidney injury. To date, calciphylaxis has been observed in two COVID‐19 patients, one with end‐stage renal disease and the other being treated with warfarin 4,5 . Our patient was nonuremic and did not receive warfarin.…”

Section: Figurementioning

confidence: 77%

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Nonuremic calciphylaxis in a COVID‐19 patient

et al. 2021

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Section: Figurementioning

confidence: 77%

“…To date, calciphylaxis has been observed in two COVID-19 patients, one with end-stage renal disease and the other being treated with warfarin. 4,5 Our patient was nonuremic and did not receive warfarin.…”

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confidence: 86%

Nonuremic calciphylaxis in a COVID‐19 patient

et al. 2021

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“…(Rotman et al, 2020) report a case of a rare syndrome of calciphylaxis and COVID-19 in which calcium was deposited in the vasculature and associated in this case with ischaemic dermopathy. In retrospective cohort study in a tertiary-care hospital (Di Filippo et al, 2020) found hypocalcaemia in 82% of 531 patients with COVID-19.…”

Section: Resultsmentioning

confidence: 99%

Characterising COVID-19 as a Viral Clotting Fever: A Mixed Methods Scoping Review

Marley

2020

Preprint

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BackgroundThe COVID-19 pandemic has claimed over 1 million lives globally and results from the SARS-COV2 virus. COVID-19 is associated with a coagulopathy. In this mixed-methods PRISMA-compliant scoping review, we set out to determine if ARDS, sepsis and DIC could account for the coagulopathy and if there were any other features of the coagulopathy we could determine so as to inform future research. Methods: We used a search strategy to identify papers with clinically relevant thromboembolic events in COVID-19. We then developed a technique referred to as an Abridged Thematic Analysis (ATA) to quickly identify themes in the papers so as to increase the yield of clinically relevant information. We further developed Validated Abridged Thematic Analysis (VATA) to validate the resulting taxonomy of themes. Finally we developed a number of methods that can be used by other researchers to take forwards this work. Results: We identified 56 studies with 10,523 patients, 456 patients with COVID-19 and thromboembolic events (TBE’s) and 586 thrombembolic events. There were an average of 1.3 TBE’s per patient. There were five main arterial territories with corresponding clinical sequelae: Acute limb ischaemia, myocardial infarcts, strokes, mesenteric ischaemia and pulmonary embolism. We also identified DVT’s. There were two further groups: medical-device-related coagulopathy and dermal lesions. In a subgroup of 119 patients we found mortality ranged from 26% in DVT to 79% in acute limb ischaemia although there was evidence of selection bias in the latter group. All patients were hospitalised and the average age of survivors was 63 versus 73 for those who died. 91/150 patients with TE’s had fever. From the ATA, we identified 16 characteristics of the clotting pathology in COVID-19. From the VATA, we identified 34 mechanisms leading to coagulopathy and grouped them according to Virchow’s triad of vascular damage, stasis and hypercoagulability. Coagulopathy occurred with and without each of ARDS, Sepsis and DIC. We conclude that COVID-19 leads to the syndrome of a viral clotting fever in a subgroup of patients and that the presentation of coagulopathy and fever should raise the possibility of COVID-19 as a differential. We make recommendations for future research studies.

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“…30 The more recent reports documenting laboratory-confirmed SARS-CoV-2 infection can be seen in Table 5. [30][31][32][33][34][35][36][37][38][39][40][41][42] Although more reports have emerged, there is still limited evidence-based reports regarding the predictive prognosis and significance of timeline of these dermatologic signs.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of dermatologic manifestations among adult patients with COVID‐19 diagnosis

Schwartzberg

Advani

Clancy

et al. 2021

Skin Health and Disease

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Background: Infection with COVID-19 is characterized by respiratory, gastrointestinalandneurologicsymptoms.However,limitedevidenceexistsof the involvement of the integumentary system among COVID-19 patients and evidence suggests that these symptoms may even be the first presenting sign. Objective: To systematically evaluate the literature published on dermatologic signs of COVID-19 in order to educate doctors about the dermatologic signs of COVID-19 infection. Methods: Lit COVID, World Health Organization COVID-19 database and PubMed were searched using terminology to identify adult patients with confirmed COVID-19 infection and dermatologic manifestations of disease. The last search was completed on 13 July 2020. Results: There were 802 reports found. After exclusion, 20 articles were found with 347 patients with confirmed COVID-19 infection. Within these articles, 27 different skin signs were reported. Limitations: Limitations of this review include the recency of COVID-19 infection; so, there are limited published reports and that many reports are not by dermatologists, and so, the cutaneous signs may be misdiagnosed or misdescribed. Conclusion: Dermatologic manifestations of COVID-19 may be the first presenting sign of infection; so, dermatologists and doctors examining the skin should be aware of the virus's influence on the integumentary system in order to promptly diagnose and treat the infected patients. K E Y W O R D S evidence-based dermatology, infection, virologyThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Concomitant calciphylaxis and COVID-19 associated thrombotic retiform purpura

Cited by 16 publications

References 31 publications

Nonuremic calciphylaxis in a COVID‐19 patient

Nonuremic calciphylaxis in a COVID‐19 patient

Characterising COVID-19 as a Viral Clotting Fever: A Mixed Methods Scoping Review

A systematic review of dermatologic manifestations among adult patients with COVID‐19 diagnosis

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