Epidemiology, clinical features and prognostic factors in patients with Covid-19 and acute limb ischaemia – A single center study.

Publication date: Feb 28, 2024

The aim of this study was to determine the incidence, clinical and paraclinical characteristics and outcomes of Covid-19 positive patients presenting in the Emergency Department (ED) with and treated for acute limb ischaemia (ALI) during a 2-year period. This retrospective study was conducted in the ED of St. Spiridon County Clinical Emergency Hospital in Iasi, north-east region of Romania. The patients included in this study presented in the ED between March 1, 2020 and February 28, 2022 with ALI and Covid-19. During the study period, a total number of 141018 patients were evaluated in our ED, 8578 (representing 6,08%) patients being diagnosed with Covid-19. Of them, 98 (1. 14% of all with Covid-19) presented ALI. The mean age was 70. 9 +/- 10. 23 and 67. 3% of the patients were males. At admission, 57% of patients had Covid-19-related pneumonia, identified on X-ray or CT scan. Of all patients, 81 (82%) were diagnosed with ALI in lower limbs with 10% of them having affected both limbs. 95% of the patients presented comorbidities, the main being cardiac (85%), diabetes mellitus (37%), vascular (24%) and neurological (22. 6%). Non-survivor patients were more likely to have Covid-19 pneumonia on chest X-ray or CT scan, 92% versus 44% (OR 15, CI 3. 3; 68, p < .01), lymphopenia 96% versus 70% (OR 10. 2, CI 1. 30; 80. 9, p < .01), a NLR over 9. 77% versus 30% (OR 7. 5, CI 2. 6; 21. 4, p < .01), acidosis 65% versus 33% (OR 3. 8, CI 1. 4; 9. 7, p < .01), abnormal AST, 69% versus 29% (OR 5. 4, CI 2; 14. 5, p < .01) and secondary amputation, 38. 5 versus 11. 1% (OR 5, CI 1. 7; 14. 7, p < 0. 1). Overall, the mortality rate was 26. 5%. The prevalence of ALI in patients infected with Covid-19 who were evaluated in our ED was 1. 14%. The highest mortality rate was probably related to Covid-19 pneumonia. We observed that patients with Covid-19 pneumonia, lymphopenia, a NLR >9, metabolic acidosis, increased AST at ED admission and secondary amputation had a higher mortality.

Concepts Keywords
Diabetes Acute limb ischaemia
February Covid-19
Hospital
Romania

Semantics

Type Source Name
disease MESH Covid-19
disease MESH Emergency
disease MESH pneumonia
disease MESH diabetes mellitus
disease MESH lymphopenia
disease MESH acidosis
disease MESH Long Covid

Original Article

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