eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-03-18 9 6 312 317 10.12691/ajmcr-9-6-2 AJMCR2021962 article Pramod Theetha Kariyanna 1 Apoorva Jayarangaiah 2 Anahat Kaur 2 Amog Jayarangaiah 3 Sushruth Das 3 Ruchi Yadav 4 Neema Jayachamarajapura Onkaramurthy 5 Ashkan Tadayoni 6 Moro O. Salifu 6 Isabel M. McFarlane Isabel.Mcfarlane@downstate.edu 6 Division of Interventional Cardiology, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Morningside/Beth Israel Hospitals, New York City, NY-10025, U.S.A. Division of Hematology and Oncology, Department of Internal Medicine, Albert Einstein College of medicine/ Jacobi Medical Center, Bronx, N.Y.-10461, U.S.A. Trinity School of Medicine, 925 Woodstock Road, Roswell, GA 30075, U.S.A. Department of Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, NY 11212, U.S.A. Department of Internal Medicine, NYC Health and Hospitals/Harlem Hospital Center, New York 10037, U.S.A Department of Internal Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY 11203, U.S.A. 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. http://pubs.sciepub.com/ajmcr/9/6/2/ajmcr-9-6-2.pdf Coronavirus Disease-2019 (COVID-19) severe acute respiratory syndrome CoV (SARS-CoV-2) virus acute limb ischemia immune-thrombosis