A Patient-Tailored Approach to Management of Acute Limb Ischemia in Patients with COVID-19: A Case Series

BACKGROUND Coronavirus disease 2019 (COVID-19) has a tremendous impact on the respiratory tract. In severe COVID-19 infections, patients may experience shock and multiple organ failure. We described 4 cases of severe arterial thrombosis induced by COVID-19 with and without other stressors and their...

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Bibliographic Details
Published in:The American journal of case reports 2022-02, Vol.23, p.e935264-e935264
Main Authors: Alhumaid, Ahmed, Altoijry, Abdulmajeed, Aljabri, Badr, Iqbal, Kaisor, AlGhofili, Hesham
Format: Article
Language:English
Subjects:
Adult
Aged
Arterial Occlusive Diseases
COVID-19
Enoxaparin
Female
Humans
Ischemia - etiology
Ischemia - therapy
Male
Middle Aged
SARS-CoV-2
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Summary:BACKGROUND Coronavirus disease 2019 (COVID-19) has a tremendous impact on the respiratory tract. In severe COVID-19 infections, patients may experience shock and multiple organ failure. We described 4 cases of severe arterial thrombosis induced by COVID-19 with and without other stressors and their responses to treatment measures. CASE REPORT In Case 1, a 61-year-old man was hospitalized for COVID-19 pneumonia 2 weeks prior to the presentation of acute upper-limb ischemia after intravenous forearm line insertion. He was classified as IIB and thus underwent emergency thrombectomy followed by 3 months of enoxaparin. Case 2 was a 41-year-old female patient with granulomatosis who was admitted to the Intensive Care Unit due to COVID-19 pneumonia and developed acute upper-limb ischemia. A medical approach using therapeutic heparin was used. Case 3 was a 65-year-old man who was admitted due to COVID-19-related pneumonia and was otherwise medically and surgically free. We assessed and managed a new onset of the lower-limb IIB acute limb ischemia (ALI). Case 4 was a patient with the first COVID-19 presentation of ALI, which was managed accordingly. CONCLUSIONS The development of a thrombotic event in patients with COVID-19 was previously reported. Moreover, different management options and outcomes have been reported in the literature. Therefore, careful planning is needed for procedures such as cannulation or central line insertion to prevent such events. In addition, short-term anticoagulation therapy might be of clinical benefit when planning a procedure or if the patient exhibits minor arterial complications.
ISSN:1941-5923
1941-5923
DOI:10.12659/AJCR.935264