RESUMEN
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Asunto(s)
Humanos , Pandemias , Infecciones por Coronavirus/epidemiología , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Trombosis , Pulmón , Coagulación Intravascular DiseminadaRESUMEN
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Asunto(s)
Humanos , Pandemias , Infecciones por Coronavirus/epidemiología , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Trombosis , Pulmón , Coagulación Intravascular DiseminadaRESUMEN
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Asunto(s)
Humanos , Femenino , Adulto , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamiento farmacológico , Embolia Pulmonar/terapia , Várices , Disnea , Servicios Médicos de Urgencia , CefaleaRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/tratamiento farmacológico , Embolia Pulmonar/terapia , Várices , Disnea , Servicios Médicos de Urgencia , CefaleaAsunto(s)
COVID-19 , Trombosis , COVID-19/complicaciones , Humanos , Circulación Pulmonar , Trombosis/etiologíaRESUMEN
AIM: In 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. METHODS: All 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. RESULTS: We 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). CONCLUSION: The 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".
Asunto(s)
COVID-19/epidemiología , Eritema Pernio/epidemiología , Isquemia/epidemiología , Enfermedad de Raynaud/epidemiología , Piel/irrigación sanguínea , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/diagnóstico , Eritema Pernio/diagnóstico , Eritema Pernio/tratamiento farmacológico , Comorbilidad , Femenino , Gangrena , Humanos , Incidencia , Isquemia/diagnóstico , Isquemia/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Enfermedad de Raynaud/diagnóstico , Enfermedad de Raynaud/tratamiento farmacológico , Factores de Riesgo , Piel/patología , España/epidemiología , Tratamiento Farmacológico de COVID-19Asunto(s)
Prueba de Absorción de Anticuerpos Fluorescentes de Treponema , Aneurisma Ilíaco/etiología , Sífilis Cardiovascular/complicaciones , Sífilis/complicaciones , Anciano de 80 o más Años , Angiografía , Antibacterianos/uso terapéutico , Anticuerpos Antibacterianos/sangre , Procedimientos Endovasculares , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Aneurisma Ilíaco/diagnóstico por imagen , Aneurisma Ilíaco/terapia , Masculino , Penicilina G Benzatina/uso terapéutico , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis Cardiovascular/diagnóstico , Sífilis Cardiovascular/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Treponema pallidum/inmunología , UltrasonografíaRESUMEN
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