Sudden development of the upper and lower limb ischemia as the first manifestation of COVID-19 infection

• Published in: International journal of surgery case reports Vol. 96; p. 107332
• Main Authors: Aliasgarzadeh, Shafagh, Arabzadeh, AmirAhmad, Fathibitaraf, Sepideh, Negaresh, Mohammad
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.07.2022; Elsevier
• Subjects: Case Report; COVID-19; Ischemia; Lower extremities; Upper extremities; COVID-19; Lower extremities; Upper extremities; Ischemia
• DOI: 10.1016/j.ijscr.2022.107332
• ISSN: 2210-2612

Atherosclerosis is the most common cause of peripheral vascular disease, and common predisposing causes are inflammation and diabetes. It is over two year that the COVID-19 pandemic has impacted the world and costed millions of lives. The patient was a case of COVID-19 infection presenting as acute arterial occlusion in the upper and lower limb. Hyper coagulopathy is one of the COVID-19 outcomes that may develop PAD following the involvement of vascular endothelium in the cytokine storm phase. Endothelial damage following COVID-19, especially in those with underlying diseases such as diabetes mellitus or inflammatory diseases with vascular involvement, can cause acute vascular events. Patients with inflammatory diseases and diabetes are prone to the uncommon symptoms of COVID-19 and more vulnerable to peripheral vascular occlusion, especially when the underlying disease remains uncontrolled, so anticoagulation with therapeutic doses is recommended for their treatment. Inflammation as a predisposing factor for PAD should be controlled using plasmapheresis or anti-inflammatory drugs depending on the patient's condition. •Peripheral arterial disease (PAD) is a slowly progressive condition caused by atherosclerotic changes in the artery wall.•The incidence of thromboembolism in the lower extremities is four times higher than that of the upper extremities.•The risk factors of thrombosis of the upper extremity include age, hypertension, diabetes, heart failure, and trauma.•Numerous reports highlighted coagulation disorders in patients with COVID-19.•Patients with inflammatory diseases and diabetes are prone to the uncommon symptoms of COVID-19.