Post-COVID-19 acute thrombotic arterial ischemia

Abstract

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has produced a high incidence of coagulopathy associated with an increase in morbidity and mortality in patients suffering from it. Coagulopathy is mainly thrombotic, determined by endothelial damage, inflammation, extracellular neutrophil traps, macrophage activation and cytokine storm that maintain the vicious cycle of inflammation and thrombosis. The thrombotic events observed during COVID-19 were mainly venous thromboembolic and myocardial infarction; however, the evidence showed an increase in a vascular complication that had not been described: acute peripheral arterial thrombosis. The objective of this article was to expose the infrequency of acute arterial ischemia as a form of clinical presentation of COVID-19. A 54-year-old male patient with severe pain located at the level of the right lower extremity, thermal gradient, pallor, distal cyanosis and functional impotence, with a clinical and ultrasound diagnosis of acute arterial ischemia of thrombotic cause of the right femoral and iliac arterial sector is presented. The evolution of the patient was satisfactory and he is kept under medical follow-up to evaluate the permeability of the unobstructed arterial sector.