Characteristics of COVID-19 arterial thrombotic complications

Etkin^[1]

(Northwell; New York, US)

45% with ischemia on presentation

Total: 49

• LE: 35
• UE: 7
• Visceral artery: 10
• Carotid thrombosis: 5
• Multiple thromboses: 6

Median age: 67

Male sex: 76%

White American: 35%
African American: 18%

Asian American: 12%

Median BMI: 28 kg/m² (interquartile range 25 to 32)

HTN: 53%

DM: 35%

PAD: 4%

CKD: 4%

Atrial fibrillation: 14%

Multiple comorbidities: 45%

No past medical history: 27%

CT angiogram: 51%

Duplex ultrasound: 39%

Clinical diagnosis only (instability): 5%

Median D-dimer: 2673 ng/mL (interquartile range 723 to 7139; D-dimer>1000 ng/mL in 83%)

LE (35 total):

• 9 open thrombectomy
• 2 endovascular thrombectomy
• 5 primary amputation
• 19 anticoagulation only

UE: 7 anticoagulation only

Mesenteric: 1 open thrombectomy, 1 thrombolysis

Limb loss: 18%

In-hospital mortality: 46%

• with LE ischemia: 50%
• with UE ischemia: 57%
• with mesenteric ischemia: 100%

Llonzo^[2]

(Mount Sinai; New York, US)

24% with ischemia on presentation

Total: 16

• LE: 12
• UE: 4

Mean age: 63.3

Male sex: 50%

White American: 37%

African American: 25%

Asian American: 0%

Hispanic American: 37%

Mean BMI: 33.6 kg/m²

HTN: 87%

DM: 56%

PAD: 37.5%

CKD: 12%

CT angiogram: 25%

Duplex ultrasound: 25%

D-dimer*: 4000 ng/mL

5 open thrombectomy

2 endovascular

2 primary amputation

4 palliation

Limb loss: 12.5%

Mortality: 33%

Indes^[3]

(Montefiore; New York, US)

20% with ischemia on presentation

Total: 15 (COVID-19 positive group)

• LE: 13
• UE: 3
• Carotid: 2 
• Prior leg bypass: 1

Median age: 64

Male sex: 66.7%

White American: 20%

Black American: 20%

Hispanic American: 40%

Median BMI: 32.6 kg/m (interquartile range 28 to 33)

HTN: 80%

DM: 53%

PAD: 27%

CKD: 7%

Atrial fibrillation: 0%

Duplex ultrasound

CT angiogram

Median D-dimer: 17,300 ng/mL (interquartile range 5500 to 20,000)

6 open thrombectomy

4 anticoagulation only

5 no treatment

Limb loss: 31%

Mortality: 40%