Management of Thrombotic Complications in Patients with COVID

Management strategies have yet to be proven, however when large- or medium-sized vessels are involved, re-vascularization may be an option. Some people might think of hyperbaric oxygen therapy in small vessel thrombosis. Because of the potential for microvascular injury in COVID-19, patients with COVID-19 may be more susceptible to deep-tissue injuries and developing pressure ulcers.

It is important to pay attention to ALL areas—sacrum/glutes/heels are now joined by iliac crests, clavicles, and knees—remember that we are proning many COVID-19 patients!

1. Bellosta R, Luzzani L, Natalini G, et al. Acute limb ischemia in patients with COVID-19 pneumonia. J Vasc Surg. 2020;72(6):1864-1872. doi:10.1016/j.jvs.2020.04.483
2. Bilaloglu S, Aphinyanaphongs Y, Jones S, Iturrate E, Hochman J, Berger JS. Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System. JAMA. 2020;324(8):799-801. doi:10.1001/jama.2020.13372
3. Etkin Y, Conway AM, Silpe J, et al. Acute Arterial Thromboembolism in Patients with COVID-19 in the New York City Area. Ann Vasc Surg. 2021;70:290-294. doi:10.1016/j.avsg.2020.08.085
4. Hanff TC, Mohareb AM, Giri J, Cohen JB, Chirinos JA. Thrombosis in COVID-19. Am J Hematol. 2020;95(12):1578-1589. doi:10.1002/ajh.25982
5. Indes JE, Koleilat I, Hatch AN, et al. Early experience with arterial thromboembolic complications in patients with COVID-19. J Vasc Surg. 2021;73(2):381-389.e1. doi:10.1016/j.jvs.2020.07.089
6. Ilonzo N, Rao A, Safir S, et al. Acute thrombotic manifestations of coronavirus disease 2019 infection: Experience at a large New York City health care system [published online ahead of print, 2020 Sep 1]. J Vasc Surg. 2020;S0741-5214(20)31922-4. doi:10.1016/j.jvs.2020.08.038