Acute arterial ischemia in COVID-19

Area of Science:

• Vascular Surgery
• Infectious Diseases
• Hematology

Background:

• The COVID-19 pandemic has been linked to an increase in acute limb ischemia (ALI).
• SARS-CoV-2 infection may cause ALI through arterial thrombosis.
• Elevated D-dimer in COVID-19 patients indicates a hypercoagulable state and poor prognosis.

Purpose of the Study:

• To describe two cases of ALI in COVID-19 patients requiring urgent surgical intervention.
• To highlight the association between SARS-CoV-2 infection, hypercoagulability, and ALI.

Main Methods:

• Case report of two patients with ALI and COVID-19.
• Review of clinical presentation, diagnostic findings (including D-dimer levels), and treatment outcomes.
• Surgical revascularization for limb salvage was performed.

Main Results:

• Both patients presented with ALI and tested positive for COVID-19.
• Elevated D-dimer levels were observed, indicative of a hypercoagulable state.
• Urgent surgical revascularization was necessary for limb salvage.

Conclusions:

• COVID-19 may contribute to ALI via SARS-CoV-2-induced arterial thrombosis and hypercoagulability.
• Surgical revascularization for ALI in COVID-19 patients may be associated with poor outcomes.
• This highlights the critical need to consider COVID-19 in patients presenting with ALI, especially during the pandemic.