Arterial thrombotic complications in COVID-19 patients

被引:1
作者
Gomez-Arbelaez, Diego [1 ]
Ansuategui Vicente, Marina [1 ]
Ibarra Sanchez, Gabriela [1 ]
Garcia-Gutierrez, Ania [1 ]
Comanges Yeboles, Alejandra [1 ]
Cases Perez, Cristina [1 ]
Antonio Gonzalez-Fajardo, Jose [1 ]
机构
[1] Hosp Univ 12 Octubre, Serv Angiol Cirugia Vasc & Endovasc, Ave Cordoba S-N, Madrid 28041, Spain
来源
ANGIOLOGIA | 2021年 / 73卷 / 03期
关键词
COVID-19; Complications; Coagulopathy; Peripheral arterial; thrombosis; COAGULOPATHY;
D O I
10.20960/angiologia.00285
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objectives: to describe our experienced incidence, prognosis and management of hospitalized COVID-19 patients with peripheral arterial thrombosis in a major teaching hospital in Madrid (Spain). Material and methods: we designed an observational cohort study of confirmed (PCR-test) COVID-19 patients at the Hospital Universitario 12 de Octubre.We analyzed all symptomatic periheral arterial thrombosis diagnosed and treated during March and April 2020, which corresponds to the first wave of the pandemic. All elective scheduled surgery was canceled during this period due to absence of postoperative intensive care unit (ICU) or resuscitation beds and only urgent surgeries were performed. Results: from March 1 to April 30, 2,943 COVID-19 patients were admitted in our hospital and 261 patients in the intensive care unit (ICU). During this period, 154 urgent operations were performed on COVID-19 patients in our hospital. Fourteen COVID-19 patients were diagnosed with symptomatic peripheral arterial thrombosis. The average age was 74 (range, 50-92) and these events were more common in men than in women (12:2). Out of these 14 patients, only 7 underwent vascular surgery by acute limb isc hernia. This represented 4.5 %of all urgent operations performed in our hospital. Postoperative mortality was 4 of 7 patients due to re-thrombosis despite anticoagulation. Among the non-operated patients, 2 had floating aortic thrombus and evolved satisfactorily with anticoagulation, while the other 5 patients were managed by palliatives measures due to the poor clinical conditions until they died. No analytical parameter was predictive of arterial thrombosis. No bleedings were recorded in this series. Conclusions: the surgical trauma increased the vulnerability of these patients with COVID-19, and therefore, surgery should be avoided whenever possible. The mortality rate in vascular surgery was dramatically high. The high thrombogenicity of these patients discourages bypass or other revascularization procedures. All hospitalized COVID-19 patients should receive a ntithrombotic prophylaxis with low molecular weight heparin (LMWH), and those at high risk should be fully anti coagulated.
引用
收藏
页码:132 / 139
页数:8
相关论文
共 26 条
[1]  
[Anonymous], 2020, THROMB RES
[2]  
[Anonymous], 2020, N Engl J Med, DOI DOI 10.1056/NEJMoa2002032
[3]   COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow [J].
Bikdeli, Behnood ;
Madhavan, Mahesh V. ;
Jimenez, David ;
Chuich, Taylor ;
Dreyfus, Isaac ;
Driggin, Elissa ;
Der Nigoghossian, Caroline ;
Ageno, Walter ;
Madjid, Mohammad ;
Guo, Yutao ;
Tang, Liang V. ;
Hu, Yu ;
Giri, Jay ;
Cushman, Mary ;
Quere, Isabelle ;
Dimakakos, Evangelos P. ;
Gibson, C. Michael ;
Lippi, Giuseppe ;
Favaloro, Emmanuel J. ;
Fareed, Jawed ;
Caprini, Joseph A. ;
Tafur, Alfonso J. ;
Burton, John R. ;
Francese, Dominic P. ;
Wang, Elizabeth Y. ;
Falanga, Anna ;
McLintock, Claire ;
Hunt, Beverley J. ;
Spyropoulos, Alex C. ;
Barnes, Geoffrey D. ;
Eikelboom, John W. ;
Weinberg, Ido ;
Schulman, Sam ;
Carrier, Marc ;
Piazza, Gregory ;
Beckman, Joshua A. ;
Steg, Gabriel ;
Stone, Gregg W. ;
Rosenkranz, Stephan ;
Goldhaber, Samuel Z. ;
Parikh, Sahil A. ;
Monreal, Manuel ;
Krumholz, Harlan M. ;
Konstantinides, Stavros V. ;
Weitz, Jeffrey I. ;
Lip, Gregory Y. H. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2020, 75 (23) :2950-2973
[4]   COVID-19 and its implications for thrombosis and anticoagulation [J].
Connors, Jean M. ;
Levy, Jerrold H. .
BLOOD, 2020, 135 (23) :2033-2040
[5]   Coagulation disorders in coronavirus infected patients: COVID-19, SARS- CoV-1, MERS-CoV and lessons from the past [J].
Giannis, Dimitrios ;
Ziogas, Ioannis A. ;
Gianni, Panagiota .
JOURNAL OF CLINICAL VIROLOGY, 2020, 127
[6]   COVID-19-Related Aortic Thrombosis: A Report of Four Cases [J].
Gomez-Arbelaez, Diego ;
Ibarra-Sanchez, Gabriela ;
Garcia-Gutierrez, Ania ;
Comanges-Yeboles, Alejandra ;
Ansuategui-Vicente, Marina ;
Gonzalez-Fajardo, Jose Antonio .
ANNALS OF VASCULAR SURGERY, 2020, 67 :10-13
[7]  
Gonzalez-Fajardo JA, 2021, MED CLIN-BARCELONA, V156, P112, DOI [10.1016/j.medcli.2020.10.004, 10.1016/j.medcle.2020.10.008]
[8]   COVID-19: progression of disease and intravascular coagulation - present status and future perspectives [J].
Harenberg, Job ;
Favaloro, Emmanuel .
CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2020, 58 (07) :1029-1036
[9]   High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study [J].
Helms, Julie ;
Tacquard, Charles ;
Severac, Francois ;
Leonard-Lorant, Ian ;
Ohana, Mickael ;
Delabranche, Xavier ;
Merdji, Hamid ;
Clere-Jehl, Raphael ;
Schenck, Malika ;
Fagot Gandet, Florence ;
Fafi-Kremer, Samira ;
Castelain, Vincent ;
Schneider, Francis ;
Grunebaum, Lelia ;
Angles-Cano, Eduardo ;
Sattler, Laurent ;
Mertes, Paul-Michel ;
Meziani, Ferhat .
INTENSIVE CARE MEDICINE, 2020, 46 (06) :1089-1098
[10]   COVID-19-Related Stroke [J].
Hess, David C. ;
Eldahshan, Wael ;
Rutkowski, Elizabeth .
TRANSLATIONAL STROKE RESEARCH, 2020, 11 (03) :322-325