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      Isquemia arterial aguda en pacientes con infección por COVID-19 Translated title: Acute arterial ischemia in patients with COVID 19 infection

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          Abstract

          RESUMEN La infección por el nuevo coronavirus SARS-COV-2 (COVID-19) y declarada pandemia mundial por la OMS, ha demostrado en algunos pacientes ser una enfermedad altamente trombogénica, tanto venosa como arterial, generando trombosis venosa profunda, embolismo pulmonar y cuadros de isquemia aguda, tanto en pacientes sin patología previa como con ellas. Se presentan cuatro casos de pacientes atendidos en el Hospital Gómez Ulla de Madrid durante la pandemia. Se compara su presentación clínica y evolución con otras series similares.

          Translated abstract

          SUMMARY The infection caused by the novel coronavirus SARS-COV-2 (COVID-19) which was declared global pandemic by the WHO has showed to be a highly thrombotic disease in some patients, presenting with venous and arterial complications such as deep vein thrombosis, pulmonary embolism and acute ischemia affecting patients with and without previous diseases. We describe four cases of COVID-19 patients treated in Gomez Ulla Hospital of Madrid during the pandemic. Clinical manifestations and outcome are compared with other similar series.

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          Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

          Nanshan Chen, Min Zhou, Xuan Dong … (2022)
          Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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            High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study

            Julie Helms, Charles Tacquard, François Séverac … (2020)
            Little evidence of increased thrombotic risk is available in COVID-19 patients. Our purpose was to assess thrombotic risk in severe forms of SARS-CoV-2 infection.
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              Acute limb ischemia in patients with COVID-19 pneumonia

              Raffaello Bellosta, Luca Luzzani, Giuseppe Natalini … (2020)
              Objectives The aim of our study is to describe the incidence and characteristics, as well as clinical outcomes of patients presenting and treated for acute limb ischemia (ALI) in patients with novel coronavirus (COVID-19) infection during the 2020 coronavirus pandemic. Methods This is a single center, observational cohort study. Data of all patients tested positive with COVID-19 and presented with ALI vascular diseases requiring urgent operative treatment were collected in a prospectively maintained database. For this series, successful revascularization of the treated arterial segment was defined as the absence of early (<30 days) re-occlusion, or major amputation or death ≤24 hours. Primary outcomes were successful revascularization, early (≤30 days) and late survival (≥30 days), postoperative (≤ 30 days) complications, and limb salvage. Results We evaluated 20 patients with ALI who were positive for COVID-19. Considering the period January-to-March, the incidence rate of patients presenting with ALI in 2020 was significantly higher than 2019 [23/141 (16.3%) vs. 3/163 (1.8%), P < 0.001)]. There were 18 (90%) male and 2 female patients. Mean age was 75 years ± 9 (range, 62-95). All patients had already been diagnosed with COVID-19 pneumonia. Operative treatment was performed in 17 (85%) patients. Revascularization was successful in 12/17 (70.6%) patients. Although successful revascularization was not significantly associated with the postoperative use of intravenous heparin (64.7% vs. 83.3%, P = 0.622), no patients receiving intravenous heparin required reintervention. There were 8 (40%) in-hospital mortalities. Age was significantly higher in those who died (years, 81 ± 10 vs. 71 ± 5, P = 0.008). The use of continued postoperative systemic heparin infusion was significantly associated with survival (0% vs. 57.1%, P = 0.042). Conclusions In our preliminary experience, the incidence of ALI has significantly increased during COVID-19 pandemic in the Italian Lombardia region. Successful revascularization was lower than expected which we hypothesize is due to a virus-related hypercoagulable state. The use of prolonged systemic heparin may improve surgical treatment efficacy as well as improve limb salvage and overall mortality.
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                Author and article information

                Journal
                Journal ID (publisher-id): sm
                Title: Sanidad Militar
                Abbreviated Title: Sanid. Mil.
                Publisher: Ministerio de Defensa (Madrid, Madrid, Spain )
                ISSN (Print): 1887-8571
                Publication date (Print and electronic): June 2020
                Volume: 76
                Issue: 2
                Pages: 71-73
                Affiliations
                [1] Madrid orgnameHospital Central de la Defensa «Gómez Ulla» orgdiv1Servicio de Cirugía Vascular
                [3] Madrid orgnameHospital Central de la Defensa «Gómez Ulla» orgdiv1Servicio de Cirugía Vascular
                [2] Madrid orgnameHospital Central de la Defensa «Gómez Ulla» orgdiv1Servicio de Cirugía Vascular
                Article
                Publisher ID: S1887-85712020000200004 Publisher ID: S1887-8571(20)07600200004
                DOI: 10.4321/s1887-85712020000200004
                SO-VID: 913671c9-1c02-451c-b888-5a86558053c6
                License:

                http://creativecommons.org/licenses/by/4.0/

                History
                Date accepted : 21 August 2020
                Date received : 20 August 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 6, Pages: 3
                Product

                SciELO Spain

                Categories
                Subject: Comunicación Breve

                Keywords: Coronavirus COVID-19,Estados hipercoagulables,Acute arterial ischemia and exacerbated chronic ischemia,hypercoagulable states,Isquemia arterial aguda y crónica agudizada
                Data availability:
                Keywords: Coronavirus COVID-19, Estados hipercoagulables, Acute arterial ischemia and exacerbated chronic ischemia, hypercoagulable states, Isquemia arterial aguda y crónica agudizada

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