DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20211910

Acute limb ischemia in COVID-19 patients: an overview

Hashem Bark Abood, Wael Hamed Alsaedi, Abdulwahab Mohammad Bokhari, Ahmad Mohammed Almughalleq, Ranin Owaidh Algethami, Sama Mohammed Zaini, Hanin Abdulrahman Ayoub, Maan Khaled Baamer, Wael Hassan Alanazi, Ahmed Ebraheem Al Mohammedali, Zoha Saleh Alghamdi

Abstract


COVID-19 causes a wide range of clinical symptoms. COVID-19 hematologic and cardiovascular involvement induces thromboembolic symptoms in various organs, most notably venous thromboembolism (VTE); peripheral arterial involvement is uncommon. Acute limb ischemia (ALI) is a vascular emergency known as a dramatic drop in arterial perfusion of a limb that poses a challenge to the limb's viability. Given routine need for thromboprophylaxis, hospitalised COVID-19 patients are at an elevated risk of ALI, limb loss, or even mortality. Understanding the various specific symptoms of COVID-19 patients, especially extrapulmonary manifests, is crucial for both better patient care and the development of adequate infection prevention methods. Although ALI is a complication of COVID-19 in hospitalized patients, it is now being understood that it can arise in patients with mild COVID-19 symptoms, and that ALI can be the first presenting sign of COVID-19 even in the absence of respiratory symptoms. It is recommended that acutely admitted COVID-19 cases should be given pharmacologic thromboprophylaxis with low molecular weight heparin (LMWH) or fondaparinux unless there is a chance of bleeding or contraindicated. Anticoagulant treatment, primarily with LMWH, correlates strongly with an improved prognosis in serious COVID-19 patients who follow sepsis-induced coagulopathy requirements or have significantly elevated D-dimer levels.


Keywords


COVID-19, SARS-CoV-2, Ischemia, ALI, Thrombosis

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