Unilateral deep vein thrombosis with gangrene involving the ascending aorta with sepsis and pulmonary thromboembolism-a pertinent cutaneous marker of severity of COVID-19.

While myriad skin manifestations have been reported with COVID, they are insignificant as compared to the number of cases and do not indicate specificity as the studies that report them have either been based on telephonic consultation or have not been compared with case-control analysis from a normal skin OPD or IPD referral population. The most feared complication of COVID-19 is the combination of coagulopathy and thromboembolism, which is consequent to thrombo-inflammation and a heightened prothrombotic state. It is exaggerated in severe COVID associated with sepsis and skin manifestations that correlate with severity are more useful to clinicians. We had a case of COVID-positive 65-year-old man with features of thromboembolism followed by general symptoms of cough and fever. D-dimer test was positive, and the Ultrasound Doppler showed thrombosis in the right lower limb arteries and deep vein thrombosis in right lower limb veins.