Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19)
Objective Few studies have focused on arterial thrombosis and acute limb ischemia in COVID-19. This international registry intended to study the spectrum of clinical characteristics, therapeutic trends, and outcomes in a cohort of Ibero-Latin American patients with arterial thrombosis or acute limb...
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crsagepubl:10.1177/17085381211052033 2024-04-28T08:12:49+00:00 Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19) Gonzalez-Urquijo, Mauricio Gonzalez-Rayas, Jose Manuel Castro-Varela, Alejandra Hinojosa-Gonzalez, David E Ramos-Cazares, Ray Erick Vazquez-Garza, Eduardo Paredes-Vazquez, Jose Gildardo Castillo-Perez, Mauricio Jerjes-Sanchez, Carlos Fabiani, Mario Alejandro 2021 http://dx.doi.org/10.1177/17085381211052033 http://journals.sagepub.com/doi/pdf/10.1177/17085381211052033 http://journals.sagepub.com/doi/full-xml/10.1177/17085381211052033 en eng SAGE Publications http://journals.sagepub.com/page/policies/text-and-data-mining-license Vascular volume 30, issue 6, page 1107-1114 ISSN 1708-5381 1708-539X Cardiology and Cardiovascular Medicine Radiology, Nuclear Medicine and imaging General Medicine Surgery journal-article 2021 crsagepubl https://doi.org/10.1177/17085381211052033 2024-04-09T08:01:22Z Objective Few studies have focused on arterial thrombosis and acute limb ischemia in COVID-19. This international registry intended to study the spectrum of clinical characteristics, therapeutic trends, and outcomes in a cohort of Ibero-Latin American patients with arterial thrombosis or acute limb ischemia and COVID-19. Methods Data were retrospectively obtained from 21 centers in 9 countries. Patients with proven COVID-19 and asymptomatic or symptomatic arterial thrombosis were included. COVID-19 diagnosis was established by RT-PCR assay or IgM serology plus suggestive clinical/radiographical findings. We recorded and analyzed variables related to demography, clinical presentation, therapeutic trends, and outcomes. Results Eighty one patients were included in the registry. In 38.3%, acute limb ischemia symptoms were the first manifestation of COVID-19. Non-surgical management was more frequent in severe cases than surgical interventions, 11.1% vs. 88.9%, respectively ( p = 0.004). Amputation rates were similar between all COVID severity groups ( p = 0.807). Treatment was classified as non-surgical, open surgical, and endovascular treatment. Further analysis revealed an equal frequency of major leg amputation between treatment groups and increased mortality in patients with non-surgical management. However, multivariate regression analysis showed that treatment choices are associated with disease severity, with significant non-surgical treatment in critical patients; thus, mortality is related to the severity and confounds treatment analysis. Conclusion Arterial thrombosis can be the initial symptom of a patient presenting with COVID-19. Physicians and health workers should potentially suspect COVID-19 in acute ischemia cases without a known risk factor or embolic cause. More experimental and clinical research is required to understand the complex phenomenon of arterial COVID-19 induced coagulopathy fully. Article in Journal/Newspaper artico SAGE Publications Vascular 170853812110520 |
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English |
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Cardiology and Cardiovascular Medicine Radiology, Nuclear Medicine and imaging General Medicine Surgery |
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Cardiology and Cardiovascular Medicine Radiology, Nuclear Medicine and imaging General Medicine Surgery Gonzalez-Urquijo, Mauricio Gonzalez-Rayas, Jose Manuel Castro-Varela, Alejandra Hinojosa-Gonzalez, David E Ramos-Cazares, Ray Erick Vazquez-Garza, Eduardo Paredes-Vazquez, Jose Gildardo Castillo-Perez, Mauricio Jerjes-Sanchez, Carlos Fabiani, Mario Alejandro Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19) |
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Cardiology and Cardiovascular Medicine Radiology, Nuclear Medicine and imaging General Medicine Surgery |
description |
Objective Few studies have focused on arterial thrombosis and acute limb ischemia in COVID-19. This international registry intended to study the spectrum of clinical characteristics, therapeutic trends, and outcomes in a cohort of Ibero-Latin American patients with arterial thrombosis or acute limb ischemia and COVID-19. Methods Data were retrospectively obtained from 21 centers in 9 countries. Patients with proven COVID-19 and asymptomatic or symptomatic arterial thrombosis were included. COVID-19 diagnosis was established by RT-PCR assay or IgM serology plus suggestive clinical/radiographical findings. We recorded and analyzed variables related to demography, clinical presentation, therapeutic trends, and outcomes. Results Eighty one patients were included in the registry. In 38.3%, acute limb ischemia symptoms were the first manifestation of COVID-19. Non-surgical management was more frequent in severe cases than surgical interventions, 11.1% vs. 88.9%, respectively ( p = 0.004). Amputation rates were similar between all COVID severity groups ( p = 0.807). Treatment was classified as non-surgical, open surgical, and endovascular treatment. Further analysis revealed an equal frequency of major leg amputation between treatment groups and increased mortality in patients with non-surgical management. However, multivariate regression analysis showed that treatment choices are associated with disease severity, with significant non-surgical treatment in critical patients; thus, mortality is related to the severity and confounds treatment analysis. Conclusion Arterial thrombosis can be the initial symptom of a patient presenting with COVID-19. Physicians and health workers should potentially suspect COVID-19 in acute ischemia cases without a known risk factor or embolic cause. More experimental and clinical research is required to understand the complex phenomenon of arterial COVID-19 induced coagulopathy fully. |
format |
Article in Journal/Newspaper |
author |
Gonzalez-Urquijo, Mauricio Gonzalez-Rayas, Jose Manuel Castro-Varela, Alejandra Hinojosa-Gonzalez, David E Ramos-Cazares, Ray Erick Vazquez-Garza, Eduardo Paredes-Vazquez, Jose Gildardo Castillo-Perez, Mauricio Jerjes-Sanchez, Carlos Fabiani, Mario Alejandro |
author_facet |
Gonzalez-Urquijo, Mauricio Gonzalez-Rayas, Jose Manuel Castro-Varela, Alejandra Hinojosa-Gonzalez, David E Ramos-Cazares, Ray Erick Vazquez-Garza, Eduardo Paredes-Vazquez, Jose Gildardo Castillo-Perez, Mauricio Jerjes-Sanchez, Carlos Fabiani, Mario Alejandro |
author_sort |
Gonzalez-Urquijo, Mauricio |
title |
Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19) |
title_short |
Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19) |
title_full |
Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19) |
title_fullStr |
Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19) |
title_full_unstemmed |
Unexpected arterial thrombosis and acute limb ischemia in COVID-19 patients. Results from the Ibero-Latin American acute arterial thrombosis registry in COVID-19: (ARTICO-19) |
title_sort |
unexpected arterial thrombosis and acute limb ischemia in covid-19 patients. results from the ibero-latin american acute arterial thrombosis registry in covid-19: (artico-19) |
publisher |
SAGE Publications |
publishDate |
2021 |
url |
http://dx.doi.org/10.1177/17085381211052033 http://journals.sagepub.com/doi/pdf/10.1177/17085381211052033 http://journals.sagepub.com/doi/full-xml/10.1177/17085381211052033 |
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artico |
genre_facet |
artico |
op_source |
Vascular volume 30, issue 6, page 1107-1114 ISSN 1708-5381 1708-539X |
op_rights |
http://journals.sagepub.com/page/policies/text-and-data-mining-license |
op_doi |
https://doi.org/10.1177/17085381211052033 |
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170853812110520 |
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