Baram Aram, Kakamad Fahmi H, Abdullah Hadi M, Mohammed-Saeed Dana H, Hussein Dahat A, Mohammed Shvan H, Abdulrahman Binar B, Mirza Aram J, Abdulla Berwn A, Rahim Hawbash M, Rashid Mohammed J, Mohammed-Al Farhad F, Othman Yad N, Salih Abdulwahid M
College of Medicine, University of Sulaimani, Sulaimani, Kurdistan, Iraq.
Smart Health Tower, Madam Mitterrand Str, Sulaimani, Kurdistan, Iraq.
Ann Med Surg (Lond). 2020 Dec;60:526-530. doi: 10.1016/j.amsu.2020.11.030. Epub 2020 Nov 12.
Involvement of the large vessels is rarely reported and poorly understood in cases of Corona virus disease-19 (COVID-19). The aim of this study is to present a series of cases with large vessel thrombosis (LVT).
This is a multicenter prospective case series study. The participants were consecutive in order. All the patients were diagnosed as cases of COVID-19 with documented LVT were included in the study. Large vessels were defined as any vessel equal or larger than popliteal artery. The mean duration of follow up was 4 months.
The study included 22 cases, 19 (86.4%) cases were male, 3 (13.6%) patients were females. The age ranged from 23 to 76 with a mean of 48.4 years. Four (18.2%) cases had pulmonary embolism confirmed by IV contrast enhanced chest CT scan. All of the cases showed pulmonary parenchymal ground glass opacities (GGO) and high D-Dimers (ranging from 1267 to 6038 ng/ml with a mean of 3601 ng/ml).
COVID-19 is a hidden risk factor of LVT that may endanger the patient's life and lead to major amputation. Despite therapeutic anticoagulants still all COVID-19 patients are at risk for LVT, a high index of suspicion should be created and with minimal symptoms surgical consultation should be obtained.
在新型冠状病毒肺炎（COVID-19）病例中，大血管受累的报道很少，人们对此了解也很少。本研究的目的是介绍一系列大血管血栓形成（LVT）的病例。
这是一项多中心前瞻性病例系列研究。参与者按顺序连续纳入。所有被诊断为COVID-19且有记录的LVT病例均纳入研究。大血管定义为任何等于或大于腘动脉的血管。平均随访时间为4个月。
该研究纳入22例病例，19例（86.4%）为男性，3例（13.6%）为女性。年龄范围为23至76岁，平均48.4岁。4例（18.2%）经静脉注射造影剂增强胸部CT扫描确诊为肺栓塞。所有病例均显示肺实质磨玻璃影（GGO）和高D-二聚体（范围为1267至6038 ng/ml，平均3601 ng/ml）。
COVID-19是LVT的一个潜在危险因素，可能危及患者生命并导致大截肢。尽管使用了治疗性抗凝剂，但所有COVID-19患者仍有发生LVT的风险，应提高警惕，出现轻微症状时就应寻求外科会诊。
