Internal Medicine E and Keter B Departments, Rambam Health Care Campus, Haifa, Israel.
Department of Vascular Surgery, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Int J Infect Dis. 2021 May;106:401-404. doi: 10.1016/j.ijid.2021.04.023. Epub 2021 Apr 20.
For more than a year, health systems all over the world have been combating the global coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first described in the city of Wuhan in China, presenting as an atypical infection of the lower respiratory tract.
COVID-19 is characterized by multisystemic involvement, and mortality is attributed mainly to the respiratory system involvement, which may lead to severe acute respiratory distress syndrome and respiratory failure. Several COVID-19-associated complications are being increasingly reported, including arterial and venous thromboembolic events that may lead to amputation of the affected limbs. So far, a large number of reports have described hypercoagulability crises leading to amputation of the lower limbs. However, a search of the National Library of Medicine (MEDLINE) revealed no cases of urgent upper limb amputation in COVID-19 patients.
This article describes a novel case of upper limb ischemia in a COVID-19 patient, with rapid progression to hand necrosis, requiring urgent through-arm amputation of the upper limb.
This case emphasizes the need for anticoagulant therapy in COVID-19 patients and to maintain a constant awareness of the possible thromboembolic COVID-19-related sequelae.
一年多来，世界各地的卫生系统一直在与由严重急性呼吸系统综合征冠状病毒 2 型（SARS-CoV-2）引起的全球 2019 年冠状病毒病（COVID-19）大流行作斗争。该疾病最初在中国武汉市被描述为下呼吸道的非典型感染。
COVID-19 的特点是多系统受累，死亡率主要归因于呼吸系统受累，这可能导致严重的急性呼吸窘迫综合征和呼吸衰竭。越来越多的 COVID-19 相关并发症正在被报道，包括可能导致受影响肢体截肢的动脉和静脉血栓栓塞事件。到目前为止，大量报告描述了导致下肢截肢的高凝危机。然而，对美国国立医学图书馆（MEDLINE）的搜索并未发现 COVID-19 患者上肢紧急截肢的病例。
本文描述了一例 COVID-19 患者上肢缺血的新病例，手部迅速坏死，需要紧急进行上肢断臂截肢。
该病例强调了 COVID-19 患者需要抗凝治疗，并始终保持对可能的血栓栓塞 COVID-19 相关后遗症的认识。
