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Acute arterial occlusion of the lower limb as the main clinical manifestation in a patient with Covid-19 - Case Report.
Costa, Víctor de Oliveira; de Almeida, Guilherme Bicalho Civinelli; Nicolini, Eveline Montessi; Rodrigues, Guilherme de Abreu; da Costa, Bruna Malaquias Arguelles; Carvalho, Guilherme Heluey; Dos Reis, Álvaro Luiz Segregio; Colen, Davi Pinto.
  • Costa VO; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora and Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: victordeoliveiracosta82@gmail.com.
  • de Almeida GBC; Vascular Surgery, Hospital Monte Sinai and Hospital Universitário da Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: guibicalho@gmail.com.
  • Nicolini EM; Thoracic Surgery, Hospital Monte Sinai, Juiz de fora, Minas Gerais, Brazil. Electronic address: evelinemontessinep@gmail.com.
  • Rodrigues GA; Thoracic Surgery, Hospital Monte Sinai, Juiz de fora, Minas Gerais, Brazil. Electronic address: gui.armed@hotmail.com.
  • da Costa BMA; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: bruna.arguelles@gmail.com.
  • Carvalho GH; Vascular Surgery, Hospital Monte Sinai and Santa Casa de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: guiheluey@yahoo.com.br.
  • Dos Reis ÁLS; Vascular Surgery, Hospital Monte Sinai and Santa Casa de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: asegregio@yahoo.com.br.
  • Colen DP; Vascular Surgery, Hospital Monte Sinai and Unimed Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil. Electronic address: davipcolen@hotmail.com.
Int J Surg Case Rep ; 77: 454-458, 2020.
Article in English | MEDLINE | ID: covidwho-926900
ABSTRACT
INTRODUTION COVID-19 infection may predispose to venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilization and disseminated intravascular coagulation; however, there are few reports of lower limb ischemia as the main manifestation of the disease. PRESENTATION OF CASE Male patient, 69 years old, asthmatic, ex-smoker and bearer of systemic arterial hypertension, has been admitted to the emergency department with sudden onset of pain in the right lower limb (RLL), associated with cyanosis and reduced temperature of the limb. He has been tested for COVID-19 in the OR with positive result for IGG and IGM. Computed tomography angiography (AngioCT) was performed, showing signs of arterial embolization to both limbs, right internal iliac artery, and superior mesenteric artery. Faced with the threat of limb loss and the absence of signs and symptoms of visceral ischemia, the patient underwent full anticoagulation and RLL thromboembolectomy and tricompartmental fasciotomy. He was discharged after 7 days of hospitalization and demonstrated no other signs and symptoms of COVID-19, following outpatient follow-up.

DISCUSSION:

COVID-19 is associated with high risk of thrombotic complications being related to the clinical severity of the patient, with few studies that show symptoms of sudden pain in the lower limb without other complaints.

CONCLUSION:

Individuals infected with COVID-19 are at risk for arterial thromboembolic events, and knowledge of such cases is essential in order to create specific protocols for prophylaxis of thrombotic events in these patients, in addition to increasing the suspicion of infection in individuals with acute arterial occlusion, mostly during pandemic times.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Cohort study / Prognostic study Language: English Journal: Int J Surg Case Rep Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Cohort study / Prognostic study Language: English Journal: Int J Surg Case Rep Year: 2020 Document Type: Article