ABSTRACT
AIMS: Identify the prevalence, risk factors and outcomes of lower extremity ischemic complications. METHODS: A systematic review was conducted by searching PubMed and SCOPUS databases for SARS-CoV-2, COVID-19 and peripheral arterial complications. RESULTS: Overall 476 articles were retrieved and 31 articles describing 133 patients were included. The mean age was 65.4 years. Pain and gangrene were the most common presentation. Hypertension (51.3%), diabetes (31.9%) and hypercholesterolemia (17.6%) were associated co-morbidities. Overall, 30.1% of patients died and amputation was required in 11.8% patients. CONCLUSIONS: COVID-19 patients with diabetes or hypertension are susceptible for lower limb complications and require therapeutic anti-coagulation.
Subject(s)
COVID-19 , Diabetic Angiopathies , Hypertension , Aged , Amputation, Surgical/statistics & numerical data , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , Comorbidity , Diabetes Mellitus/diagnosis , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Diabetic Angiopathies/complications , Diabetic Angiopathies/diagnosis , Diabetic Angiopathies/epidemiology , Diabetic Angiopathies/therapy , Female , Gangrene/diagnosis , Gangrene/epidemiology , Gangrene/etiology , Gangrene/therapy , Humans , Hypertension/complications , Hypertension/diagnosis , Hypertension/epidemiology , Hypertension/therapy , Lower Extremity , Male , Middle Aged , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/epidemiology , Peripheral Arterial Disease/etiology , Peripheral Arterial Disease/therapy , Prevalence , Prognosis , Risk Factors , SARS-CoV-2/physiologyABSTRACT
At the onset of the COVID-19 crisis, a 63-year-old woman with multiple life-limiting comorbidities was referred with a necrotic infected left breast mass on a background of breast cancer treated with conservation surgery and radiotherapy 22 years previously. The clinical diagnosis was locally advanced breast cancer, but four separate biopsies were non-diagnostic. Deteriorating renal function and incipient sepsis and endocarditis resulted in urgent salvage mastectomy during the peak of the COVID19 pandemic. The final diagnosis was infected ischaemic/infarcted breast (wet gangrene) secondary to vascular insufficiency related to diabetes, cardiac revascularisation surgery and breast radiotherapy.