Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.200234
Jornal Vascular Brasileiro
Case Report

Isquemia arterial aguda de membros superiores em pacientes diagnosticados com COVID-19: série de casos

Acute upper limb arterial ischemia in patients diagnosed with COVID-19: case series

Felipe Damascena Rosa; Marcelo Calil Burihan; Elexandra Aparecida Simões; João Paulo de Souza Abdala; Orlando da Costa Barros; Felipe Nasser

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Resumo

Resumo: A infecção pelo coronavírus 2 causador da síndrome respiratória aguda grave (SARS-CoV-2) em humanos foi detectada pela primeira vez em Wuhan, na China, em 2019 e dispersada mundialmente ao longo de 2020. As diferentes manifestações clínicas, com amplo espectro de apresentação, desde infecções assintomáticas até formas graves que podem levar a óbito, são desafiadoras. Este trabalho objetiva descrever uma série de quatro casos de isquemia arterial aguda dos membros superiores em pacientes diagnosticados com COVID-19, os quais foram manejados clinicamente com anticoagulação, antiagregação plaquetária e uso de prostanoides. Dois pacientes receberam alta hospitalar com regressão e delimitação da área isquêmica, sem necessidade de intervenção cirúrgica, e dois pacientes faleceram em decorrência de complicações pulmonares. Uma adequada compreensão da fisiopatologia dessa doença pode favorecer um melhor manejo clínico de suas complicações.

Palavras-chave

COVID-19, anticoagulantes, embolia e trombose, isquemia, prostaglandinas

Abstract

Infection by coronavirus 2, cause of the severe acute respiratory syndrome (SARS-CoV-2) in humans, was detected for the first time in Wuhan, China, in 2019, and spread globally over the course of 2020. Its different clinical manifestations are challenging, with a wide spectrum of presentations, ranging from asymptomatic infections to severe forms that can result in death. The objective of this study is to describe a series of four cases of acute arterial ischemia involving the upper limbs in patients diagnosed with COVID-19, which were managed clinically with anticoagulation, platelet antiaggregation, and prostanoids. Two patients were discharged from hospital with regression and delimitation of the ischemic zone, without needing surgical intervention, while two patients died from pulmonary complications. Adequate understanding of the pathophysiology of this disease could support better clinical management of its complications.

Keywords

COVID-19; anticoagulants; emboli and thrombosis; ischemia; prostaglandins.

References

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Submitted date:
01/11/2021

Accepted date:
03/17/2021

60c9ebd0a9539538651fa384 jvb Articles

J Vasc Bras

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