@article{ajmcr2021962,
author={{Kariyanna, Pramod Theetha and Jayarangaiah, Apoorva and Kaur, Anahat and Jayarangaiah, Amog and Das, Sushruth and Yadav, Ruchi and Onkaramurthy, Neema Jayachamarajapura and Tadayoni, Ashkan and Salifu, Moro O. and McFarlane, Isabel M.},
title={COVID-19 and Acute Limb Ischemia: A Systematic Review},
journal={American Journal of Medical Case Reports},
volume={9},
number={6},
pages={312--317},
year={2021},
url={http://pubs.sciepub.com/ajmcr/9/6/2},
issn={2374-216X},
abstract={The extraordinary prothrombotic manifestations of Coronavirus Disease-2019 (COVID-19), caused by severe acute respiratory syndrome CoV (SARS-CoV-2) virus, presenting as venous and arterial thrombosis have been reported in the literature. The incidence of arterial thrombosis is reported to be 4% in critically ill COVID-19 patients.. Arterial thrombosis in the setting of COVID-19 has been reported to occur in a multitude of organs leading to ischemic strokes, ST-segment elevation myocardial infarction, aortic thrombus and acute limb ischemia. Diffuse endothelial activation, along with aberrant immuno-thrombotic mechanisms have been implicated in the widespread thrombosis occurring in COVID-19 patients. We performed a literature review of 55 reported cases to delineate the clinical characteristics, management patterns and outcomes of patients with COVID-19 who developed complications of acute limb thrombosis and ischemia. Our systematic review revealed that acute limb ischemia had a male predominance, with either hypertension or diabetes mellitus as the most common underlying cardiovascular risk factors. Aortic thrombus was reported in 23.6% of the cases. The majority of the cases involved thrombosis in more than one limb, indicative of a diffuse thrombotic state. The most common artery affected was the left popliteal artery. Upper limb thrombosis occurred in 40% of the cases. Most of the cases (74.5%) were managed with urgent revascularization interventions and anticoagulation. Negative outcomes, including amputations (14.9%) and death (26.5%) occurred at a higher rate in this population, despite  the use of standard management.},
doi={10.12691/ajmcr-9-6-2}
publisher={Science and Education Publishing}
}