Upper Extremity Arterial Thromboembolism in a Coronavirus Patient. A Case Report

Scott, Beverley-Ann; Garg, Karan; Johnson, William S.; Al-Ajam, Mohammad; Patalano, Peter; Rotella, Vittorio; Edwards, Jodi-Ann; Aboushi, Haytham; Lee, Paul; Daniel, Melissa; Rancy, Schneider K.; Heimann, David M.

doi:10.1007/s42399-020-00694-2

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…In these cases, revascularization was achieved with anticoagulant therapy or after thrombectomy. [7,13,[17][18][19] In the present case, although arterial thromboembolectomy was performed twice, revascularization could not be achieved and amputation was required at the forearm level.…”

Section: Discussionmentioning

confidence: 72%

Upper extremity arterial thromboembolism in a patient with severe COVID-19 pneumonia: A case report

et al. 2021

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Although novel coronavirus-2019 (COVID-19) primarily affects the respiratory system, it can affect multiple organ systems, leading to serious complications, such as acute respiratory distress syndrome (ARDS) and multiple organ failure. Nearly 20 to 55% of patients with COVID-19 experience coagulation disorders that cause high mortality in line with the severity of the clinical picture. Thromboembolism can be observed in both venous and arterial systems. The vast majority of thromboembolic events are associated with the venous system and are often observed as pulmonary embolism. Arterial thromboembolisms often involve the arteries in the lower extremities, followed by those in the upper extremities. Herein, we report a rare case of COVID-19 pneumonia whose left arm was amputated at the forearm level after arterial thromboembolism in the left upper extremity. This case report is valuable, as it is the first reported case of upper extremity arterial thromboembolism in Turkey, as well as the only case in the literature in which the patient underwent four surgical interventions and is still alive.

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Section: Discussionmentioning

confidence: 72%

Upper extremity arterial thromboembolism in a patient with severe COVID-19 pneumonia: A case report

et al. 2021

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“…Until now, a number of case reports describing acute limb ischemia, usually manifesting as digital necroses, have been published [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] . Acute necrosis of fingers or toes, in some patients affecting also more proximal parts of the extremities, were typically seen in older individuals presenting with acute respiratory failure due to viral pneumonia.…”

Section: Clinical Characteristics Of Patients With Covid-19-associated Digital Necrosismentioning

confidence: 99%

Is digital necrosis in COVID-19 caused by neutrophil extracellular traps: Potential therapeutic strategies

Simka¹

2021

Medical Hypotheses

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Some of the COVID-19 patients present with ischemic lesions of their finger and toes. Standard anticoagulant therapy is usually unsuccessful for the treatment of this unique presentation of COVID-19. In this review current evidence is presented, which supports the hypothesis that these necrotic lesions are primarily related to the formation of neutrophil extracellular traps is blood vessels. Also, currently available and potential pharmacological methods of the management of this unique thrombotic complication are discussed. Drugs that possibly could be used in COVID-19 patients suffering from acute ischemia of distal parts of the extremities particularly comprise DNase I and DNase1L3, which could directly dissolve these extracellular webs that are mostly composed of DNA. However, at the moment, none of these enzymes are registered for an intravascular administration in humans. Lactoferrin and dipyridamole are other pharmaceutical agents that could potentially be used for the treatment of neutrophil extracellular traps-evoked digital ischemia. These agents exhibit prophylactic activity against excessive formation of these extracellular structures. Such an experimental treatment should probably be accompanied by standard antithrombotic management with heparin. Open-label and then randomized trials are needed to confirm feasibility, safety and efficacy of the above-suggested management of critically ill COVID-19 patients.

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“…The Zaharin-Head regions have been shown to reflect somatosensory sensations, such as acute or chronic pain, and can serve as markers of organic lesions in the preterminal or terminal stages [13]. In cases of upper limb arterial occlusion, the pain may manifest as sensations of itching and numbness along the ulnar nerve pathway [14].…”

Section: Introductionmentioning

confidence: 99%

The biochemical approach to thromboembolism: the relevance of molecular aspects

Croitoru,

Pavlovschi

2023

MJHS

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Introduction. Arterial and venous thromboembolism is a disease with a high impact on morbidity and mortality. Their pathological mechanisms of aggregation directed by the clotting factors along with the variations in clinical manifestation are regarded to a high moiety of genetic polymorphisms along with a wide diversity of comorbidities. Material and methods. A comprehensive literature review was conducted, which included a total of 119 sources. Among these, 60 sources were systematically collected, while the remaining 59 sources were selected through non-systematic methods. Results. We have identified different treatment options that regard both the venous or arterial thromboembolism in contrast with numerous pathogenetic outcomes, population groups along with biomarkers that significantly modify the clinical aspects of the therapeutical and post-clinical treatment aspect. At the moment its diagnosis is continuously improving worldwide, taking into consideration a high diversity of experts’ opinions with a wide practical experience. Conclusions. Arterial and venous thromboembolisms are serious medical conditions that can be prevented and effectively managed with modern diagnostic and therapeutic techniques.

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Upper Extremity Arterial Thromboembolism in a Coronavirus Patient. A Case Report

Cited by 3 publications

References 11 publications

Upper extremity arterial thromboembolism in a patient with severe COVID-19 pneumonia: A case report

Upper extremity arterial thromboembolism in a patient with severe COVID-19 pneumonia: A case report

Is digital necrosis in COVID-19 caused by neutrophil extracellular traps: Potential therapeutic strategies

The biochemical approach to thromboembolism: the relevance of molecular aspects

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