Acute peripheral ischemia associated with SARS-CoV-2 infection: experience in diagnosis and treatment

Abstract

The study aimed to evaluate the outcomes of treatment of acute limb ischemia (ALI) in patients with novel coronavirus infection (COVID-19). The study group included 62 patients; 67 extremities: upper – 19 (28.3%), lower – 48 (71.6%). Distribution of cases according to ALI grades (Rutherford): I – 7 (10.4%), IIA – 10 (14.9%), IIB – 34 (50.7%), III – 16 (23.8%). COVID-19 was confirmed by the polymerase chain reaction test; 45 (72.5%) patients being documented to have lung injury. Fifty (80.6%) patients underwent surgical treatment on 52 limbs. Amputation rate during hospitalization (9.4±9 days) – 19.4%; mortality rate – 43.5%, being significantly influenced by the presence or absence of lung damage – 55.5% vs. 11.7% (P=0.002; χ² test). The following serum biomarkers served as potential predictors of mortality: C-reactive protein to albumin ratio, platelets to lymphocytes and fibrinogen to albumin ratio. At follow-up of 21 (25%-75%IQR 19-28) months overall and amputation-free survival rates were 56.4% and 57.1%.