Incidence of Major Limb Arterial Thrombosis in Positive versus Negative COVID-19 Patients: A Cross-Sectional Retrospective Study

Abstract

Introduction: The main goal of this cross-sectional retrospective study was to analyze the incidence and outcomes of acute limb ischemia (ALI) in patients suffering from coronavirus disease 2019 (COVID-19) in comparison to non-COVID-19 patients. Method: We performed a retrospective cross-sectional study across two centers under the Dubai Health Authority in Dubai, United Arab Emirates. Our study included 43 patients who were hospitalized for ALI between 2017 and 2021. They were divided into two groups according to our exclusion and inclusion criteria. Statistical analyses were performed using SPSS, version 26.0 (IBM Corp., Armonk, NY, USA). Proportions were compared by χ2 or Fisher’s exact tests. Results: A group of consecutive patients were hospitalized with ALI between 2017 and 2021. This study showed the amputation rate in COVID-19-infected patients (2/11 [18.2%]) was found to be higher than that in patients with non-COVID-19 infections (1/32 [3.1%]). Moreover, the percentage of failed limb salvage procedures also proved to be higher (4/11 [36.36%]) in the COVID-19-positive group versus (3/32 [9.37%]) in the non-COVID-19 group. Conclusions: ALI is a life-threatening condition that is caused by multiple predisposing factors in the general population and by a clot-forming process in the severe acute respiratory syndrome coronavirus 2 group as a result of hypercoagulable mechanisms. The management of ALI is not standardized and should be determined on a case-by-case basis. Due to the multiple complications of COVID-19, the mortality rate in patients with COVID-19 associated with ALI is significantly higher than in patients with isolated ALI. Therefore, it is essential to investigate the underlying mechanisms and clinical presentations of this condition to develop effective management strategies and minimize mortality.

Keywords

• acute limb ischemia
• critical limb
• severe acute respiratory syndrome coronavirus 2
• revascularization
• covid-19
• thrombosis
• surgical interventions
• arterial thrombosis
• re-thrombosis