New, Lethal COVID-19 Complication: Upper Limb Ischemia

Limb ischemia occurs when the blood flow through the arteries to a limb is limited or blocked, preventing the blood from carrying essential oxygen and nutrients to the tissues. While limb ischemia is very rare, it is also very serious and often fatal. A complete blockage of blood flow in a limb, such as from artery plaque, can cause death within a few hours.

Limb ischemia may affect any of the limbs: arms, hands, feet and legs. When it occurs in the upper extremities it is called Upper Limb Ischemia. Chronic limb ischemia (CLI) develops gradually over time as the blood vessels narrow. However, acute limb ischemia occurs when there is a sudden decrease in blood flow to a limb caused by a blood clot or piece of plaque.

Acute Upper Limb Ischemia in COVID-19 Patients

Unfortunately, doctors are constantly identifying new and unusual symptoms and health issues that are related to Covid-19 infection. For example, the loss of taste and smell have now been widely reported in recovering coronavirus patients.

Very recently, some studies have reported acute upper limb ischemia in some patients with Covid-19 pneumonia. These and other severe vascular complications during SARS-CoV-2 infection are being identified even in young and healthy patients with no prior medical history. [Acute Upper Limb Ischemia in a Patient with COVID-19 Pneumonia; Clin Med Journal; Roaa Alosaimi, MD1*, Ahood A Albajri, MD, et. al.]

Because of the acute and immediate danger presented by Upper Limb Ischemia, those studies recommend doctors be vigilant to identify, diagnose, prevent and treat any patient with Covid-19 pneumonia who shows signs of limited blood flow in any of the arteries to the limbs.

Symptoms of Acute Upper Limb Ischemia

The traditional “5 P’s” are used to identify possible acute ischemia in a limb:

  • Pain – that is intense or extreme
  • Paresthesia – tingling, pricking, chilling, burning, or numbness
  • Pallor – paleness
  • Pulselessness – no pulse in the affected limb
  • Poikilothermia – the inability to maintain a constant body temperature

Treating Upper Limb Ischemia

Both surgical and nonsurgical approaches are taken to treating Acute Upper Limb Ischemia.  Anti-coagulant drugs have shown useful both in treatment and prevention of Upper Limb Ischemia in Covid-19 pneumonia patients, and in the general population

Additionally, Upper Limb Ischemia patients also often have underlying cardiac issues, heart disease or other systemic disease. So, doctors need to adopt a multidisciplinary approach to minimize complications from an acute Upper Limb Ischemia event, and to prevent future occurrences.

Studies have also shown that a conservative, non-surgical approach to treating Upper Limb Ischemia is effective in up to 88% of patients – offering the added advantage of not having to subject them to dangerous surgery.

Detroit Hand & Arm Doctor

If you are suffering from an injury or pain in your fingers, wrist, elbow or arm, contact board certified hand Clarkston area hand surgeon Doctor Rehman for a comprehensive evaluation and consultation. Early detection, awareness, and rapid treatment is the only way to prevent death in patients with Upper Limb Ischemia. If you are experiencing any of the symptoms of this condition, it is essential to contact your doctor or 911 and head immediately to the nearest emergency room.

Detroit Area Hand & Arm Doctor: 248.335.2638