ABSTRACT
Arterial thrombosis encountered during sars-cov2 infections is a rare complication with a poor prognosis compared to venous ones. They generally occur in severe and critical clinical forms of covid19 [1,2]. The physiopathology of arterial thrombosis, even if not completely understood highlights hypercoagulability and excessive inflammation as risk factors with a major role of the endothelial lesions in their occurrence. The presence of cardiovascular risk factors in patients infected with covid19 is also discussed as a predisposing factor for arterial thrombosis [2,3]. We report the case of a North African male patient hospitalized for acute respiratory distress syndrome (ARDS) secondary to covid19 pneumonia, complicated by the occurrence of multiple arterial thrombosis of the aorto-iliac axis with the rare finding of two free floating thrombus in the aorta and the right common iliac artery. Clinically, the patient had developed acute bilateral lower limb ischemia and multi-organ failure and the evolution was dramatic with rapid worsening of the patient…s health and eventually his death. Thromboembolic complications are frequent during covid19 infection but the aortic localization is very rare. Its diagnosis is difficult and it has a poor prognosis. Our objective through this case report is to increase knowledge about arterial thromboembolic events while discussing their link to the sars-cov2 viral infection. © 2022
ABSTRACT
Aims Determine the impact of the COVID-19 pandemic on the upper endoscopic activity of the emergency departments ofour service by comparing the epidemiological, clinical and endoscopic profile of patients who had an upper digestiveendoscopy in an emergency context in 2 distinct periods before and during the pandemic COVID-19. Methods It's a retrospective, descriptive and comparative study of patients who had an upper digestive endoscopy (UDE),over two successive 8 months Period (1) non COVID-19: 01/03/2019-31/10/2019 and Period (2) COVID 19: 01/03/2020-31/10/2020 in the hepato-gastroenterology department of the university hospital Mohammed VI Oujda. Results During the study period, 54 urgent UDE were performed during period (2) versus 153 endoscopies during period(1) The average age of our patients was 60±2 during period (2) versus 56±3 during period (1), sex ratio (H/F) was 1.8 inperiod (1) and 1.2 in period (2) Concerning gastroduodenal ulcer during the period (2) 11 % were stage IIb-I with 24 % bulbar locations compared to 6 %stage IIb-I during period (1). The 2 endoscopies performed in patients with COVID-19 pneumonia had esophageal various and stage IIb gastric ulcertherapeutic endoscopic procedures were performed for 15 % patients during period (2) including clips, ligations and APCcompared with 13 % during period (1). Conclusions There is a marked reduction in UDE case volume during the COVID-19 period. Self-medication by non-steroidal anti-inflammatory drugs was higher during this period with a slight increase in the prevalence of ulcer disease withadvanced lesions and the use of an interventional endoscopic gesture during this period. In addition, there is a stability in the number of hemorrhagic decompensations of chronic liver disease and also in theprevalence of tumor pathology diagnosed on endoscopy during this period that can be related the silent evolution of thesepathologies.