RESUMEN
Evidence suggests severe coronavirus disease-19 (COVID-19) infection is characterised by pulmonary and systemic microvasculature dysfunction, specifically, acute endothelial injury, hypercoagulation and increased capillary permeability. Diabetes, which is also characterised by vascular injury in itself, confers an increased risk of adverse COVID-19 outcomes. It has been suggested that pre-existing endothelial dysfunction and microvascular disease in diabetes will exacerbate the vascular insults associated with COVID-19 and thus lead to increased severity of COVID-19 infection. In this article, we evaluate the current evidence exploring the impact of microvascular complications, in the form of diabetic retinopathy and nephropathy, in individuals with COVID-19 and diabetes. Future insights gained from exploring the microvascular injury patterns and clinical outcomes may come to influence care delivery algorithms for either of these conditions.
Asunto(s)
COVID-19/fisiopatología , Angiopatías Diabéticas/fisiopatología , Endotelio Vascular/patología , Microcirculación , Pandemias , SARS-CoV-2 , Trombofilia/etiología , Albuminuria/etiología , COVID-19/complicaciones , Permeabilidad Capilar , Atención a la Salud , Angiopatías Diabéticas/complicaciones , Nefropatías Diabéticas/complicaciones , Nefropatías Diabéticas/fisiopatología , Neuropatías Diabéticas/complicaciones , Neuropatías Diabéticas/fisiopatología , Retinopatía Diabética/complicaciones , Retinopatía Diabética/fisiopatología , Endotelio Vascular/lesiones , Humanos , Obesidad/complicaciones , Obesidad/fisiopatología , Circulación Pulmonar , Edema Pulmonar/etiología , Edema Pulmonar/fisiopatología , Índice de Severidad de la Enfermedad , Trombofilia/fisiopatología , Resultado del TratamientoRESUMEN
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.