Extensive Peripheral Arterial Thrombosis in a Patient with SARS-CoV-2 Infection

Chowdhury, Yuvraj S.; Mitre, Cristina A.; Rotella, Vittorio; Garg, Karan; Lee, David K; Belligund, Pooja; Chen, Lu; Madaj, Paul; Aboushi, Haytham; Al-Ajam, Mohammad; McFarlane, Samy I.

doi:10.12691/ajmcr-8-12-15

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…In total, 34 eligible studies (19 case reports and 15 case series/cohort studies) were included. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ( Figure 1 ) Regarding quality, 5 studies were of high quality, 5 studies of medium quality and 24 studies (mainly case reports) of lower quality. These studies evaluated a total of 540 patients out of which 199 were eligible for this analysis.…”

Section: Resultsmentioning

confidence: 99%

Acute limb ischemia among patients with COVID-19 infection

Galyfos

Sianou

Frountzas

et al. 2022

Journal of Vascular Surgery

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Introduction SARS-CoV-2 infection has been associated with thrombotic complications such as deep vein thrombosis or stroke. Recently, numerous cases of acute limb ischemia (ALI) have been reported although pooled data are lacking. Methods We systematically searched PubMed, Embase, Scopus, and the Cochrane Library for studies published online up to January 2021 that reported cases with SARS-CoV-2 infection and ALI. Eligible studies should have reported early outcomes including mortality. Primary endpoints included also pooled amputation, clinical improvement and reoperation rates. Results In total, 34 studies (19 case reports and 15 case series/cohort studies) including a total of 540 patients (199 patients were eligible for analysis) were evaluated. All studies were published in 2020. Mean age of patients was 61.6 years (range 39-84 years; data from 32 studies) and 78.4% of patients were of male gender (data from 32 studies). There was a low incidence of comorbidities: arterial hypertension: 49% (29 studies); diabetes mellitus: 29.6% (29 studies); dyslipidemia: 20.5% (27 studies); chronic obstructive pulmonary disease: 8.5% (26 studies); coronary disease: 8.3% (26 studies); and chronic renal disease: 7.6% (28 studies). Medical treatment was selected as first-line treatment for 41.8% of cases. Pooled mortality rate among 34 studies reached 31.4% (95% CI = 25.4% to 37.7%). Pooled amputation rate among 34 studies reached 23.2% (95% CI = 17.3% to 29.7%). Pooled clinical improvement rate among 28 studies reached 66.6% (95% CI = 55.4% to 76.9%). Pooled reoperation rate among 29 studies reached 10.5% (95% CI = 5.7% to 16.7%). Medical treatment was associated with a higher death risk compared to any intervention (OR = 4.04; 95% CI [1.075 – 15.197]; P = .045) although amputation risk was not different between the two strategies (OR = .977; 95% CI [.070 – 13.600]; P = .986) (data from 31 studies). Conclusions SARS-CoV-2 infection is associated with a high risk for thrombotic complications including ALI. Covid-associated ALI presents in patients with a low incidence of comorbidities, and it is associated with a high mortality and amputation risk. Conservative treatment seems to have a higher mortality risk compared to any intervention although amputation risk is similar.

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Section: Resultsmentioning

confidence: 99%

Acute limb ischemia among patients with COVID-19 infection

Galyfos

Sianou

Frountzas

et al. 2022

Journal of Vascular Surgery

View full text Add to dashboard Cite

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“… 6 Incidentally, many of the case reports have illustrated patients developing gangrene during ICU admission early, within four to six weeks. 11 , 12 , 13 The purpose of this study is to compare the incidence of gangrene in the ICU associated the limb loss – in COVID patients specifically – to baseline inpatient levels before the pandemic. Secondary outcomes report favorable and unfavorable predictors associated with ICU limb gangrene.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Analysis of Critical Limb Ischemia in the Intensive Care Unit since the COVID-19 Pandemic

Malkoc

Gnanadev

Botea³

et al. 2023

Annals of Vascular Surgery

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Acute Limb Ischemia in COVID-19: A Systematic Review

Indriani,

Amshar,

Nugraha

et al. 2023

Int J Angiol

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Numerous studies have reported cases of acute limb ischemia (ALI) in coronavirus disease 2019 (COVID-19), along with a sharp increase of ALI incidence during the COVID-19 pandemic. The objective of this study was to analyze the clinical features, treatment strategies, and outcomes in COVID-19 patients who developed ALI. A systematic search was performed in PubMed, ScienceDirect, and Cochrane to identify relevant articles. Variables of interest included ALI location, ALI and COVID-19 severity, concomitant thrombosis, comorbidities/risk factors, coagulation and inflammatory parameters, therapy, outcome, and cause of death. Data extraction and pooling were conducted by two reviewers. Fifty-six articles with a total of 191 subjects were included in the analysis; 78.5% of the subjects were male; mean age was 64.2 years; 94.2% of cases were ALI de novo; 41.1% of the subjects had ALI stage IIB; 82.7% of ALI occurred in the lower limb. The popliteal artery was the most commonly affected artery (48.2% of subjects); 38.1% of the subjects had severe COVID-19; 11.1% had asymptomatic COVID-19, and 15.9% were post-COVID-19; 50.7% of the subjects had hypertension; 12.0% of the subjects had concomitant thrombosis; 98.1% of the subjects had elevated D-dimer, and 83.3% of the subjects had elevated C-reactive protein; 61.9% of the subjects underwent surgical thromboembolectomy, 21.3% underwent conservative treatment, and 8.1% underwent amputation initially. The overall mortality rate and limb amputation rate were 39.3 and 22.4%, respectively; 67.6% of deaths were due to respiratory failure. Our study supports that COVID-19 is associated with hypercoagulability that may trigger the development of ALI, and that ALI is a possible predictor of poor outcome in COVID-19 patients.

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Extensive Peripheral Arterial Thrombosis in a Patient with SARS-CoV-2 Infection

Cited by 3 publications

References 10 publications

Acute limb ischemia among patients with COVID-19 infection

Acute limb ischemia among patients with COVID-19 infection

A Comparative Analysis of Critical Limb Ischemia in the Intensive Care Unit since the COVID-19 Pandemic

Acute Limb Ischemia in COVID-19: A Systematic Review

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