A case of rapidly progressive upper limb ischemic necrosis in a patient with COVID-19

Int J Infect Dis. 2021 May:106:401-404. doi: 10.1016/j.ijid.2021.04.023. Epub 2021 Apr 20.

Abstract

Background: For more than a year, health systems all over the world have been combating the global coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first described in the city of Wuhan in China, presenting as an atypical infection of the lower respiratory tract.

Methods: COVID-19 is characterized by multisystemic involvement, and mortality is attributed mainly to the respiratory system involvement, which may lead to severe acute respiratory distress syndrome and respiratory failure. Several COVID-19-associated complications are being increasingly reported, including arterial and venous thromboembolic events that may lead to amputation of the affected limbs. So far, a large number of reports have described hypercoagulability crises leading to amputation of the lower limbs. However, a search of the National Library of Medicine (MEDLINE) revealed no cases of urgent upper limb amputation in COVID-19 patients.

Results: This article describes a novel case of upper limb ischemia in a COVID-19 patient, with rapid progression to hand necrosis, requiring urgent through-arm amputation of the upper limb.

Conclusions: This case emphasizes the need for anticoagulant therapy in COVID-19 patients and to maintain a constant awareness of the possible thromboembolic COVID-19-related sequelae.

Keywords: Amputation; COVID-19; Hypercoagulability; Ischemia; Thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Amputation, Surgical
  • COVID-19 / complications*
  • Disease Progression*
  • Humans
  • Ischemia / complications*
  • Ischemia / pathology*
  • Ischemia / surgery
  • Necrosis
  • Upper Extremity / pathology*
  • Upper Extremity / surgery