ABSTRACT
OBJECTIVES: To describe a case of acute limb ischemia caused by arterial thrombosis due to coronavirus disease 2019. DESIGN: Clinical observation of a patient. SETTING: Academic medical center. PATIENT: A 59-year-old female with history of hypertension, hyperlipidemia, and prior smoking. INTERVENTION: Clinical observation and data extraction from electronic medical records. MEASUREMENTS AND MAIN RESULTS: We report a case of peripheral arterial thrombosis associated with coronavirus disease 2019, resulting in acute limb ischemia of the right lower extremity. This event was heralded by a sudden and significant elevation in d-dimer levels. At the time of surgery, a long, gelatinous clot was retrieved from the right popliteal artery. Perioperatively, she continued to have absent pedal Doppler signals and after multiple embolectomy attempts, required distal arterial cut down with removal of additional thrombi and resultant improvement of distal arterial flow. CONCLUSIONS: This case demonstrates the importance of regularly checking d-dimer levels and vigilant monitoring for arterial thrombotic events, as they can rapidly become catastrophic.
Subject(s)
Coronavirus Infections/therapy , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Personal Protective Equipment/statistics & numerical data , Physician-Patient Relations , Pneumonia, Viral/therapy , Severe Acute Respiratory Syndrome/therapy , COVID-19 , Conscious Sedation/methods , Coronavirus Infections/diagnosis , Forecasting , Humans , Intubation, Intratracheal , Male , Narration , Pandemics , Patient Care Team/organization & administration , Pneumonia, Viral/diagnosis , Respiration, Artificial/methods , Risk Assessment , Severe Acute Respiratory Syndrome/diagnosis , Treatment OutcomeABSTRACT
Enzyme-linked immunosorbent assays (ELISAs) are used widely in biotechnology, pharmaceutical, and clinical medicine labs. At the same time, they appear to be underrepresented in chemistry and biochemistry curricula, even though their sensitivity, selectivity, and ease of use would argue for their widespread use. We describe here an online ELISA activity suitable for stand-alone use or in conjunction with an actual wet lab ELISA. Specifically, we offer real and mock data for a hypothetical ELISA to detect plasma antibodies to COVID-19 in infected patients who have had the disease. Much of the activity focuses on chemical and mathematical models to fit ELISA or any macromolecule/ligand binding data, a skill that addresses perhaps the most relevant and difficult learning goal of an ELISA experiment.