Acute Arterial Occlusions in COVID-19 Times: A Comparison Study Among Patients with Acute Limb Ischemia With or Without COVID-19 Infection

Outcomes of Surgical Revascularization for Acute Limb Ischemia in COVID-19 Patients Comparing to Noninfected Cohort: A Single-Center Observational Prospective Study

“…Upper limb ischemia was diagnosed approximately in one quarter of observations. Other authors [ 11 , 17 ] provide similar results with exception of the study published by Sekar et al , where only 29% of cases were categorized as Rutherford IIB [ 18 ]. It is worth to mention that in our study anatomic location of arterial occlusion, severity and duration of ischemia were similar in infected and non-infected patients as well as mean preoperative ABI value.…”

“…Our results generally are in consonance with those reported by other investigators. Positive COVID-19 status was significantly associated with mortality in current study (OR 4.0, 95% CI 1.48 – 11.1), in the comparison study of Athayde Soares et al, (HR 1.8, 95% CI 1.0 – 4.0) [ 17 ] and according to the results of the single metanalysis available at the moment (pooled OR 4.71, 95% CI 1.1 – 19.9) [ 13 ]. While in some studies COVID-19 was an independent predictor of limb loss [ 17 ], our data (OR 1.8, 95% CI 0.5 – 6.2) and results of the metanalysis (OR 0.26, 95% CI 0.02 – 3.0) have not demonstrated significant association between these variables.…”

“…Single metanalysis performed by Jain et al , included 11 articles that reported data on 196 patients with ALI and SARS-CoV-2 infection [ 13 ]. At the moment only four published studies have directly compared outcomes of ALI treatment (amputation, re-thrombosis and mortality) in COVID-19 positive and COVID-19 negative patients [ 14 , 15 , 16 , 17 ]. Thus, our prospective study with a sample size of 21 infected and 109 non-infected patients undergoing urgent revascularization procedure in a single tertiary institution can provide some additional data to this important issue.…”

“…It is worth to mention that in our study anatomic location of arterial occlusion, severity and duration of ischemia were similar in infected and non-infected patients as well as mean preoperative ABI value. In contrast, Athayde Soares R et al , reported mean preoperative ABI of 0.35 in non-infected patients (39% of cases with viable limb – category Rutherford I) compared to mean ABI of 0.05 in patients with COVID-19 [ 17 ].…”

“…In study of Athayde Soares R et al, the D-dimers level > 1000 md/dL was independently associated with mortality and limb loss in multivariable analysis [ 17 ]. Our data did not demonstrate a statistically significant impact of D-dimers level upon probability of the composite outcome.…”