The Path to Amputation in Patients with Myositis And Foot Drop Caused by Popliteal Aartery Thrombosis Following COVID-19 Infection

The Path to Amputation in Patients with Myositis And Foot Drop Caused by Popliteal Aartery Thrombosis Following COVID-19 Infection

A 68-year-old male patient admitted to a pandemic hospital with cough, fever and weakness was diagnosed with COVID-19, and he was hospitalized for treatment. On the 7th day after being discharged, the patient who had pain, redness, and foot drop that developed in his right leg was diagnosed with ischemic myositis and foot drop due to popliteal artery thrombosis. Because the clinical condition of the patient undergoing a percutaneous transluminal angioplasty (PTA) was not improved and a necrotic demarcation line appeared, the right leg of the patient was amputated above the knee. This case shows that cases of venous thromboembolism as well as arterial thrombosis in COVID-19 patients can lead to negative consequences leading to amputation. In order to prevent this condition, it will be effective to continue therapeutic anticoagulation for at least 2 more weeks after discharge to avoid arterial and venous thrombosis.

___

  • 1. Marietta M, Coluccio V, Luppi M. COVİD‑19, coagulopathy and venous thromboembolism: more questions than answers. Internal and Emergency Medicine https://doi.org/10.1007/s11739-020-02432-x
  • 2. Grover SP, Mackman N. Tissue factor: an essential mediator of hemostasis and trigger of thrombosis. Arterioscler Thromb Vasc Biol 2018;38:709–725.
  • 3. Ranucci M, Ballotta A, Di Dedda U, Bayshnikova E, Dei Poli M, Resta M at al. The procoagulant pattern of patients with COVİD-19 acute respiratory distress syndrome J Thromb Haemost 2020 Jul;18(7):1747-1751.
  • 4. Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arteriyel thromboembolic complications in COVİD-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9-14.
  • 5. Middeldorp S, Coppens M, van Haaps TF, Foppen M, Vlaar AP, Müller MCA et al. Incidence of venous thromboembolism in hospitalized patients with COVİD-19. J Thromb Haemost 2020 Aug;18(8):1995-2002.
  • 6. Llitjos JF, Leclerc M, Chochois C, Monsallier JM, Ramakers M, Auvray M et al. High incidence of venous thromboembolic events in anticoagulated severe COVİD-19 patients. J Thromb Haemost. 2020 Jul;18(7):1743-1746
  • 7. Wichmann D, Sperhake JP, Lütgehetmann M, Steurer S, Edler C, Heinemann A et al. Autopsy findings and venous thromboembolism in patients with COVİD-19: a prospective cohort study. Ann Intern Med. 2020 Aug 18;173(4):268-277.
  • 8. Dominguez-Erquicia P, Dobarro D, Raposeiras-Roubín S, Bastos-Fernandez G, Iñiguez-Romo A. Multivessel coronary thrombosis in a patient with COVİD-19 pneumonia (published online ahead of print, 2020 May 6). Eur Heart J. 2020 Jun 7;41(22):2132.
  • 9. Hess DC, Eldahshan W, Rutkowski E. COVİD-19-Related Stroke. Transl Stroke Res. 2020;1-4.
  • 10. Vulliamy P, Jacob S, Davenport RA. Acute aorto-iliac and mesenteric arteriyel thromboses as presenting features of COVİD-19. Br J Haematol. 2020 Jun;189(6):1053-1054.
  • 11. De Barry O, Mekki A, Diffre C, Seror M, Hajjam ME, Carlier RY. Arteriyel and venous abdominal thrombosis in a 79-year-old woman with COVİD-19 pneumonia (published online ahead of print, 2020 Apr 29). Radiol Case Rep. 2020 Apr 29;15(7):1054-1057
  • 12. A Beccara L, Pacioni C, Ponton S, Francavilla S, Cuzzoli A. Arteriyel Mesenteric Thrombosis as a Complication of SARS-CoV-2 Infection. Eur J Case Rep Intern Med. 2020 Apr 30;7(5):001690.
  • 13. Singh G, Attique H, Gadela N, Mapara K, Manickaratnam S et. COVİD-19 Related Arteriyel Coagulopathy. Cureus 2020 12(7): 9490.
  • 14. Levolger S, Bokkers RPH, Wille J, Kropman RHJ, Vries JPM. Arteriyel thrombotic complications in COVİD-19 patients J Vasc Surg Cases Innov Tech2020 Sep;6(3):454-459.
  • 15. Goldman JA , YE K, Scheinfeld MH. Lower-extremity Arteriyel Thrombosis Associated with COVİD-19 Is Characterized by Greater Thrombus Burden and Increased Rate of Amputation and Death. Radiology 2020 Nov;297(2):263-269.
  • 16. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18:844–847.
  • 17. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020 Jul 1;180(7):934-943.
  • 18. WHO Interim guidance (2020) Clinical management of severe acute respiratory infection (SARI) when COVİD-19 disease is suspected. Published 13 March 2020. https ://apps.who.int/iris/ handl e/10665 /33144 6. Accessed May 5 2020.
  • 19. Marietta M, Ageno W, Artoni A, De Candia E, Gresele P, Marchetti M, Marcucci R, Tripodi A. COVİD-19 and haemostasis: a position paper from Italian Society on Thrombosis and Haemostasis (SISET). Blood Transfus. 2020 May;18(3):167-169.
  • 20. Zhai Z, Li C, Chen Y, Gerotziafas G, Zhang Z, Wan J et al. Prevention treatment of VTE associated with COVİD-19 Infection Consensus Statement Group. Prevention and treatment of venous thromboembolism associated with coronavirus disease 2019 infection: a consensus statement before guidelines. Thromb Haemost. 2020 Jun;120(6):937-948.
  • 21. American Society of Hematology COVİD-19 Resources. COVİD19 and VTE/Anticoagulation: frequently asked questions. https :// www.hemat ology .org/COVİD -19/COVİD -19-and-vte-anticoagulation. Accessed 06 May 2020.
Journal of Immunology and Clinical Microbiology-Cover
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2016
  • Yayıncı: Erkan YULA