Rapidly Progressive Bilateral Extremity Necrosis Associated with Coronavirus Disease 2019

Abstract

Severe acute respiratory syndrome coronavirus 2, the causative virus of coronavirus disease 2019, causes thrombosis via direct effects on vascular endothelial cells. Necrosis of the extremities due to arterial occlusion has been reported in patients with coronavirus disease 2019. Here, we report a case of multiple arterial occlusions associated with coronavirus disease 2019. Although the extent to which severe acute respiratory syndrome coronavirus 2 infection is responsible for the development of necrosis of the extremities in this patient is uncertain, surgeons who routinely treat patients with necrosis of the extremities should consider severe acute respiratory syndrome coronavirus 2 infection as a possible cause of necrosis of the extremities, which can present with rapid progression in multiple extremities.

Day 26 after being tested positive for coronavirus disease 2019.

(a), (b) Necrosis of the right first, second, third, fourth, and fifth toes. (c), (d) Severe cyanosis of the left foot from the ankle to toes. (e), (f) Necrosis of the right second, third, fourth, and fifth fingers.