Department of Dermatology, Venereology, and Leprosy, RG Kar Medical College and Hospital, 1, Khudiram Bose Sarani, Kolkata, 700004, India.
Department of Neurology, Bangur Institute of Neurosciences, IPGMER and SSKM Hospital, Annex 1, 52/1 Shambhunath Pandit Street, Kolkata, 700020, India.
Diabetes Metab Syndr. 2022 Jan;16(1):102356. doi: 10.1016/j.dsx.2021.102356. Epub 2021 Nov 27.
The novel coronavirus disease (COVID-19) caused by SARS-CoV-2 has turned the world topsy-turvy since its onset in 2019. The thromboinflammatory complications of this disease are common in critically ill patients and associated with poor prognosis. Symmetrical peripheral gangrene (SPG) is characterized by symmetrical distal gangrene in absence of any large vessel occlusion or vasculitis and it is usually associated with critical illness. Our aim was to report the clinical profile and outcome of patients diagnosed with SPG associated with COVID-19. To the best of our knowledge, no such similar cases have been reported till date.
In this case series, we have discussed the clinical presentation, laboratory parameters and outcome in a series of two patients of SPG associated with COVID-19 and also compared those findings. Due to paucity of data, we also reviewed the literature on this under-diagnosed and rarely reported condition and association.
Two consecutive patients (both males, age range: 37-42 years, mean: 39.5 years) were admitted with the diagnosis of COVID-19 associated SPG. Both patients had clinical and laboratory evidence of disseminated intravascular coagulation (DIC). Leucopenia was noted in both patients. Despite vigorous therapy, both patients succumbed to their illness within a fortnight of admission.
SPG in the background of COVID-19 portends a fatal outcome. Physicians should be aware of its grim prognosis.
由 SARS-CoV-2 引起的新型冠状病毒病 (COVID-19) 自 2019 年爆发以来，使世界陷入混乱。这种疾病的血栓炎症并发症在重症患者中很常见，且与预后不良相关。对称性周围性坏疽 (SPG) 的特征是在没有任何大血管阻塞或脉管炎的情况下出现对称性远端坏疽，通常与重病有关。我们的目的是报告与 COVID-19 相关的 SPG 患者的临床特征和结局。据我们所知，迄今为止尚未报告此类类似病例。
在本病例系列中，我们讨论了与 COVID-19 相关的 SPG 的两例连续患者的临床表现、实验室参数和结局，并对这些发现进行了比较。由于数据有限，我们还回顾了关于这种诊断不足且很少报道的疾病和关联的文献。
两名连续患者（均为男性，年龄范围：37-42 岁，平均年龄：39.5 岁）因 COVID-19 相关 SPG 入院。两名患者均有弥散性血管内凝血 (DIC) 的临床和实验室证据。两名患者均出现白细胞减少。尽管进行了积极的治疗，但两名患者均在入院后两周内死亡。
COVID-19 背景下的 SPG 预示着致命的结局。医生应该意识到其预后不良。
