ArticleVascular health and risk management2020
Incidence, Characteristics, Laboratory Findings and Outcomes in Acro-Ischemia in COVID-19 Patients.
Article in Vascular health and risk management, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Are the chilblain-like lesions observed during the COVID-19 pandemic due to severe acute respiratory syndrome coronavirus 2? Systematic review and meta-analysis.Journal of the European Academy of Dermatology and Venereology : JEADV · 2022Pooled it
- COVID-19 and peripheral arterial complications in people with diabetes and hypertension: A systematic review.Diabetes & metabolic syndromePooled it
- COVID-19 and acute limb ischemia: latest hypotheses of pathophysiology and molecular mechanisms.Journal of Zhejiang University. Science. B · 2025Review
- Thromboembolic Presentations among Patients Hospitalized to the Intensive Care Unit for Coronavirus Disease 2019 (COVID-19) - A Northern Taiwan Single Center Experience.Acta Cardiologica Sinica · 2023Article
- Observational
- Worsening of Primary Raynaud's Phenomenon During Episodes of Pyrexia and Rigors in SARS-CoV-2 Infection.Cureus · 2023Article
- Unexpected arterial thrombosis and acute limb ischemia in a young male patient with COVID-19: A case report.Frontiers in surgery · 2023Article
- Prognostic Value of Catestatin in Severe COVID-19: An ICU-Based Study.Journal of clinical medicine · 2022Article
- [Pulmonary Vascular Tone Dysregulation and Microthrombosis in COVID-19].Archivos de bronconeumologia · 2022Article
- Pathogenesis of Two Faces of DVT: New Identity of Venous Thromboembolism as Combined Micro-Macrothrombosis via Unifying Mechanism Based on "Two-Path Unifying Theory" of Hemostasis and "Two-Activation Theory of the Endothelium".Life (Basel, Switzerland) · 2022Review
- The Potential Impact of COVID-19 Virus on the Heart and the Circulatory System.Infection and drug resistance · 2022Review
- Viruses, Variants, and Vaccines: How COVID-19 Has Changed the Way We Look at Skin.Current dermatology reports · 2022Review
- Diagnosis and management of patients with acute limb ischemia after Covid-19 infection: a case series.Jornal vascular brasileiro · 2022Article
- Acute limb ischemia among patients with COVID-19 infection.Journal of vascular surgery · 2022Review
- [Acute appendicitis in children with multisystemic inflammatory syndrome associated to SARS-CoV-2 (MIS-C). A complication to consider].Anales de pediatria (Barcelona, Spain : 2003) · 2021Article
- Acute appendicitis in children with multisystemic inflammatory syndrome associated to SARS-CoV-2 (MIS-C). A complication to consider.Anales de pediatria · 2021Article
- Dermatological manifestations associated with COVID-19: A comprehensive review of the current knowledge.Journal of medical virology · 2021Review
- Time of Onset of Selected Skin Lesions Associated with COVID-19: A Systematic Review.Dermatology and therapy · 2021Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimIn addition to its respiratory impact of SARS-CoV2, skin lesions of probable vascular origin have been described. This study intends to quantify the incidence of acro-ischemic lesions in COVID-19 infected adult subjects in our population, describing clinical patterns and associated findings.
methodsAll adult confirmed cases of COVID-19 infection who presented with acro-ischemic lesions and received care in our institution were prospectively enrolled up to May 15th, 2020. The variables included demographics, comorbidities, analytical parameters, clinical presentations and COVID-19 treatment.
resultsWe enrolled 24 patients. The overall rate of acro-ischemic findings in COVID-19 patients was 1.2% [0.6% for outpatients and 2.9% for hospitalized (ICU and non-ICU patients)], but the observed incidence for acro-ischemia in ICU patients was remarkably higher (23.0%, p<0.001). We have described four different clinical patterns of acroischemia: atypical Raynaud´s phenomenon (ARP), (4); pseudo-pernio (PP), (5); severe microcirculatory ischemia with preserved pulse (SMI), (6); and dry gangrene with arteriosclerosis obliterans (AO), (9). Kendall´s τ correlation with lung disease severity was 0.877 (95% CI, 0.756 to 0.968); p<0.01). ARP individuals were predominantly female, while SMI appeared lately in elderly hospitalized subjects with better prognosis. AO occurred in patients with more comorbidity and younger than those with SMI. We observed other associated lesions of suggestive ischemic nature in other organs in all groups (15 patients of total sample). Plasma procalcitonin was significantly higher in patients who developed SMI (median and interquartile range: 9.99 (4.2, 12.3) mg/mL vs 0.26 (0.11, 0.89) mg/mL; p<0.001), and D-dimer level at hospital admission was significantly higher in AO patients (median and interquartile range: 1166 (1050, 2111) mg/L vs 502 (448, 777) mg/L; p<0.001).
conclusionThe observed risk for acroischemia in COVID-19 is high in ICU patients (23%). We have described four different clinical patterns of acroischemia (ARP, PP, SMI and AO) associated with lung disease severity. Authors have communicated various lesions of suggestive ischemic nature in other organs. Raynaud-like pattern is reported as a "novelty".
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