Carro Gabriela V, Dini Andrés, de Los Ríos Espada Grecia B, Tamashiro Gustavo, Llanos María de Los Ángeles, Claros Fuentes Diego E
Servicio de Clínica Médica, Hospital Nacional Prof. Alejandro Posadas, El Palomar, Provincia de Buenos Aires, Argentina. E-mail:
Servicio de Hemodinamia, Hospital Nacional Prof. Alejandro Posadas, El Palomar, Provincia de Buenos Aires, Argentina.
Medicina (B Aires). 2021;81(6):1076-1080.
Medical attention of patients with a diabetic foot has been disrupted since de COVID-19 pandemic began, because health systems had to provide care to those patients affected by this disease to the detriment of the control of chronic diseases. Several reports show an increase in amputations during the pandemic, primarily due to the lack of health controls in patients suffering from diabetes or diabetic foot. This could have resulted in later consultation and more severe presentations. We describe three medical cases that had recently been affected by COVID-19 and developed a rare and rapidly evolving diabetic foot that required a major amputation. One possible explanation for this atypical presentation could be that COVID-19 predisposes patients to vein and arterial thrombosis due to systemic inflammation, platelet activation, endothelial dysfunction and stasis from prolonged immobility. This could have exacerbated chronic ischemia secondary to diabetes in which metabolic disturbances often seen in these patients predispose to atherosclerosis.
自新冠疫情开始以来,糖尿病足患者的医疗护理受到了干扰,因为卫生系统不得不为感染这种疾病的患者提供护理,从而牺牲了慢性病的控制。几份报告显示,疫情期间截肢病例有所增加,主要原因是糖尿病或糖尿病足患者缺乏健康管控。这可能导致了就诊延迟和病情更严重。我们描述了三例近期感染新冠病毒并发展为罕见且迅速演变的糖尿病足、需要进行大截肢的病例。这种非典型表现的一个可能解释是,新冠病毒由于全身炎症、血小板激活、内皮功能障碍以及长期不动导致的血流淤滞,使患者易发生静脉和动脉血栓形成。这可能加剧了糖尿病继发的慢性缺血,而这些患者中常见的代谢紊乱易导致动脉粥样硬化。