Axillary artery thrombosis resulting in upper limb amputation as a COVID-19 sequela

Area of Science:

• Vascular Surgery
• Infectious Diseases
• Hematology

Background:

• Novel coronavirus disease (COVID-19) primarily affects the respiratory system but is increasingly associated with thrombotic events.
• Hypercoagulability is a recognized complication of COVID-19, necessitating vigilance for vascular manifestations.
• Thrombosis in COVID-19 can present with diverse and severe clinical outcomes.

Observation:

• A 44-year-old male with COVID-19 developed thrombosis of the right axillary artery, leading to limb ischemia.
• Initial surgical intervention (embolectomy) failed, resulting in re-occlusion and progression to gangrene.
• The patient ultimately required limb amputation due to irreversible ischemic damage.

Findings:

• COVID-19 can precipitate severe arterial thrombosis, even in asymptomatic or mildly affected individuals.
• Axillary artery thrombosis is a rare but devastating complication of COVID-19, potentially leading to limb loss.
• The case underscores the hypercoagulable state induced by COVID-19 and its potential for catastrophic vascular sequelae.

Implications:

• Early recognition and prompt anticoagulation therapy are critical for patients with COVID-19 to prevent severe thrombotic complications.
• Vascular surgeons and infectious disease specialists must be aware of the potential for arterial thrombosis in COVID-19 patients.
• This case emphasizes the need for heightened awareness and proactive management of hypercoagulability in the context of COVID-19 to avoid limb-threatening ischemia.