Histopathologic Evaluation of COVID-19 Patients With Peripheral Arterial Thromboembolism: Does Clot Composition Make Any Sense?

Yeşilkaya, Nihan Karakaş; TELLİOĞLU, Tahsin Murat; Ünay, Fulya Çakalağaoğlu; İner, Hasan; Besir, Yuksel; Gokalp, Orhan; Yilik, Levent; Gürbüz, Ali

doi:10.1016/j.avsg.2021.03.004

Cited by 5 publications

(13 citation statements)

References 34 publications

(16 reference statements)

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“…The quality of studies is shown in Table 2. Four studies [6,9,10,13] were of good quality, and six studies [4,5,[14][15][16][17] were of poor quality.…”

Section: Study Qualitymentioning

confidence: 99%

“…Six studies [4][5][6]9,13,17] mentioned the re-thrombosis rate in the revascularized limb in ALI patients with COVID-19. The data were pooled to do the analysis.…”

Section: Re-thrombosismentioning

confidence: 99%

“…Ten studies [4][5][6]8,9,[13][14][15][16][17] mentioned the overall mortality rate in COVID-19 patients with ALI. The data were pooled to do the analysis.…”

Section: Mortalitymentioning

confidence: 99%

“…However, the data on this was restricted to case reports and a few case series only. While some studies showed comparable results [6], other studies showed the poor outcome of ALI patients suffering from COVID-19 compared to COVID-19 negative patients [7][8][9]. A systematic review done by Putko et al concluded an increased risk of limb or digital ischemia in patients with COVID-19 [10].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Patients With Acute Limb Ischemia in Patients With COVID-19: A Systemic Review and Meta-Analysis

Jain¹,

Reddy²,

Murugesan³

et al. 2022

Cureus

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A systemic review and meta-analysis of perioperative outcomes of acute limb ischemia (ALI) in patients with and without coronavirus disease-2019 to determine the outcomes of ALI and compare the outcomes in patients with and without COVID-19 infection. A literature search of the Medline, Science Direct and Cochrane Library was performed from inception to July 15, 2021. Studies involving ALI in patients with COVID-19 were searched through three electronic databases. The endpoints include limb salvage, re-thrombosis, and mortality, and these outcomes were compared between patients with and without COVID-19 infection and type of management. The primary outcome was early limb salvage (till the patient was discharged from the hospital). The other outcomes assessed were re-thrombosis and mortality. These outcomes were compared between patients with and without COVID-19 infection and the type of management. Pooled estimates were presented as odds ratios (ORs) using a random or fixed effect model based on the results of the chi-square test and calculation of I 2 . Comparing the ALI outcomes in patients with and without COVID-19 infection, there was no significant difference in limb salvage rate (OR=0.26, 95% CI:0.02-3.09), but there was a significantly higher re-thrombosis (OR=2.65, 95% CI:1.34-5.23) and mortality rate (OR=4.71, 95% CI:1.11-19.99) in patients with COVID-19 infection. On comparing outcomes based on management, intervention group, and anticoagulant alone group, no significant difference was noted concerning limb salvage (OR=1.40, 95% CI:0.27-7.13) and mortality rates (OR=0.2, 95% CI:0.04-1.07). This meta-analysis demonstrates a higher re-thrombosis and mortality in ALI patients with COVID-19 infection when compared to patients without COVID-19 but with similar limb salvage.

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“…The quality of studies is shown in Table 2. Four studies [6,9,10,13] were of good quality, and six studies [4,5,[14][15][16][17] were of poor quality.…”

Section: Study Qualitymentioning

confidence: 99%

“…Six studies [4][5][6]9,13,17] mentioned the re-thrombosis rate in the revascularized limb in ALI patients with COVID-19. The data were pooled to do the analysis.…”

Section: Re-thrombosismentioning

confidence: 99%

“…Ten studies [4][5][6]8,9,[13][14][15][16][17] mentioned the overall mortality rate in COVID-19 patients with ALI. The data were pooled to do the analysis.…”

Section: Mortalitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes of Patients With Acute Limb Ischemia in Patients With COVID-19: A Systemic Review and Meta-Analysis

Jain¹,

Reddy²,

Murugesan³

et al. 2022

Cureus

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“…NET plays a key role in immunothrombosis and was demonstrated to be consistently increased in COVID-19 and linked to disease severity (26, 27). Indeed, complications such as acute arterial thromboembolism have been reported in COVID-19 (28) and inflammatory cells are prominent in arterial thromboembolic material from COVID-19 patients (29). However, recent data did not provide evidence for classic thrombotic microangiopathy in COVID-19 (22) which is in agreement with our observation that higher cfDNA concentrations were not associated with thromboembolism.…”

Section: Discussionmentioning

confidence: 99%

Evidence for the utility of cfDNA plasma concentrations to predict disease severity in COVID-19

Hoeter

Neuberger

Fischer

et al. 2021

Preprint

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COVID-19 is a pandemic caused by the highly infective SARS-CoV-2. There is a need for biomarkers not only for overall prognosis but also for predicting the response to treatments and thus for improvements in the clinical management of patients with COVID-19. Circulating cell-free DNA (cfDNA) has emerged as a promising biomarker in the assessment of various disease conditions. The aim of this retrospective and observational pilot study was to examine the potential value of cfDNA plasma concentrations as a correlative biomarker in hospitalized COVID-19 patients. Lithium-Heparin plasma samples were obtained from twenty-one COVID-19 patients during hospitalization in the University Medical Center of Mainz, Germany, and the cfDNA concentrations were determined by quantitative PCR yielding amplicons of long interspersed nuclear elements (LINE-1). cfDNA plasma concentrations of COVID-19 patients ranged between 247.5 and 6346.25 ng/ml and the mean concentrations were 1831 ± 1388 ng/ml (± standard deviation). Correlations were found between cfDNA levels and the occurrence of acute respiratory distress symptom (ARDS), acute kidney injury (AKI), myositis, neurological complications, bacterial superinfection and disease severity as defined by sepsis-related organ failure assessment score (SOFA) score. D-Dimer and C-reactive-protein (CRP), determined by clinical laboratory analysis, showed the highest correlations with cfDNA levels. The results of this observational study suggest that cfDNA plasma concentrations may serve as a predictive biomarker of disease severity in COVID-19. Prospective studies enrolling larger patient cohorts are ongoing to test this hypothesis.

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Outcomes of Surgical Revascularization for Acute Limb Ischemia in COVID-19 Patients Comparing to Noninfected Cohort: A Single-Center Observational Prospective Study

Predenciuc

Casian

Culiuc

2023

Annals of Vascular Surgery

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Histopathologic Evaluation of COVID-19 Patients With Peripheral Arterial Thromboembolism: Does Clot Composition Make Any Sense?

Cited by 5 publications

References 34 publications

Outcomes of Patients With Acute Limb Ischemia in Patients With COVID-19: A Systemic Review and Meta-Analysis

Outcomes of Patients With Acute Limb Ischemia in Patients With COVID-19: A Systemic Review and Meta-Analysis

Evidence for the utility of cfDNA plasma concentrations to predict disease severity in COVID-19

Outcomes of Surgical Revascularization for Acute Limb Ischemia in COVID-19 Patients Comparing to Noninfected Cohort: A Single-Center Observational Prospective Study

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