COVID-19 diagnosis in a patient with critical limb ischemia: complications and clinical outcomes

• Autor(a) principal: Soares,Rafael de Athayde
• Data de Publicação: 2020
• Outros Autores: Vedovello,Rafael Salem, Medeiros,Samanta Christine Guedes de, Nunes,Celso Zaffani, Sian,Carlos Alberto, Jorge,Paulo Daenekas de Melo
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Jornal Vascular Brasileiro (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492020000100613
• topic: COVID-19; critical limb ischemia; endovascular surgery; angioplasty; peripheral occlusive arterial disease; gangrene

Abstract A 67-year-old male diabetic patient with systemic arterial hypertension was admitted to the emergency department with a necrotic ulcer in the left external malleolus and no palpable popliteal or pedal pulses. Arterial Duplex ultrasound identified femoropopliteal occlusion, with popliteal refilling below the knee and a patent peroneal artery. An endovascular procedure was performed, requiring retrograde access to the popliteal artery to re-establish blood flow and deploy a popliteal stent. Technical success was achieved and the patient underwent debridement of the wound. Two days later, about 48 hours after the operation, the patient began to exhibit respiratory symptoms, with coughing and dyspnea. He immediately underwent a chest CT that identified ground glass opacities, the crazy-paving pattern, and bilateral air bronchogram in the lungs. A reverse transcription – polymerase chain reaction (RT-PCR) test was positive for SARS-Cov-2. The patient was moved to an intensive care unit and put on mechanical ventilation. Both hydroxychloroquine and azithromycin were administered. Despite appropriate treatment, the patient died 4 days after he was diagnosed with COVID-19.