RESUMEN
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an acute infectious disease that spreads mainly via the respiratory route. Elderly patients or those with underlying diseases are more seriously affected. We report a case of COVID-19 infection in a geriatric patient with arteriovenous thrombosis of the right lower limb. Despite persistent anticoagulant therapy, the patient's arterial thrombosis continued to progress and presented with ischemic necrosis of the lower extremity. After amputation in this case, the levels of D-dimer and inflammatory cytokine increased progressively, and he presented with acute myocardial infarction, which progressed rapidly to multisystem organ failure. However, whether coronavirus can directly cause the damage of the cardiovascular system and thrombosis needs further investigation.
Asunto(s)
Amputación Quirúrgica , COVID-19 , Extremidad Inferior , Insuficiencia Multiorgánica , Infarto del Miocardio , Complicaciones Posoperatorias , SARS-CoV-2/aislamiento & purificación , Trombosis , Anciano , Amputación Quirúrgica/efectos adversos , Amputación Quirúrgica/métodos , COVID-19/complicaciones , COVID-19/diagnóstico , COVID-19/fisiopatología , COVID-19/terapia , Resultado Fatal , Arteria Femoral/diagnóstico por imagen , Vena Femoral/diagnóstico por imagen , Humanos , Extremidad Inferior/irrigación sanguínea , Extremidad Inferior/patología , Extremidad Inferior/cirugía , Masculino , Insuficiencia Multiorgánica/diagnóstico , Insuficiencia Multiorgánica/etiología , Insuficiencia Multiorgánica/terapia , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/etiología , Infarto del Miocardio/terapia , Necrosis/etiología , Necrosis/cirugía , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/terapia , Trombosis/complicaciones , Trombosis/etiología , Trombosis/fisiopatología , Trombosis/terapia , Ultrasonografía/métodosRESUMEN
Since December 2019, COVID-19, an acute infectious disease, has gradually become a global threat. We report a case of thoracolumbar fractures (T12 and L1) and incomplete lower limb paralysis in a patient with COVID-19. After a series of conservative treatment which did not work at all, posterior open reduction and pedicle screw internal fixation of the thoracolumbar fracture were performed in Wuhan Union Hospital. Three weeks later, the patient could stand up and the pneumonia is almost cured. We successfully performed a surgery in a COVID-19 patient, and to our knowledge it is the first operation for a COVID-19 patient ever reported.