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A Patient-Tailored Approach to Management of Acute Limb Ischemia in Patients with COVID-19: A Case Series

Ahmed A. Alhumaid, Abdulmajeed Altoijry, B. Aljabri, Kaisor Iqbal, Hesham Alghofili

The American journal of case reports, 2022

Abstract

Case series Patients: Male, 61-year-old • Female, 41-year-old • Male, 65-year-old • Male, 41-year-old Final Diagnosis: Acute limb ischemia Symptoms: Limb pain Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Coronavirus disease 2019 (COVID-19) has a tremendous impact on the respiratory tract. In severe COVID-19 infections, patients may experience shock and multiple organ failure. We described 4 cases of severe arterial thrombosis induced by COVID-19 with and without other stressors and their responses to treatment measures. Case Reports: In Case 1, a 61-year-old man was hospitalized for COVID-19 pneumonia 2 weeks prior to the presentation of acute upper-limb ischemia after intravenous forearm line insertion. He was classified as IIB and thus underwent emergency thrombectomy followed by 3 months of enoxaparin. Case 2 was a 41-year-old female patient with granulomatosis who was admitted to the Intensive Care Unit due to COVID-19 pneumonia and developed acute upper-limb ischemia. A medical approach using therapeutic heparin was used. Case 3 was a 65-year-old man who was admitted due to COVID-19-related pneumonia and was otherwise medically and surgically free. We assessed and managed a new onset of the lower-limb IIB acute limb ischemia (ALI). Case 4 was a patient with the first COVID-19 presentation of ALI, which was managed accordingly. Conclusions: The development of a thrombotic event in patients with COVID-19 was…

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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