Thromboembolic complications in patients with COVID-19 - experiences of the General Surgery Department of Zemun Clinical Hospital Center

Abstract

Introduction/Objective. More than three years have passed since the discovery of the new virus strain SARS-CoV-2, and the virus is still a challenge for all medical specialties. One of the most important characteristics is the tendency to develop thromboembolic complications, which are often lethal. The aim of this paper is to present the experience of the General Surgery Department of the Zemun Clinical Hospital Centar in the surgical treatment of patients with thromboembolic complications. Methods. The research was conceived as a retrospective study conducted in the period from March 2020 to March 2021. A total of 42 patients participated in the study and were divided into a group diagnosed with small and large bowel ischemia and a group diagnosed with acute limb ischemia. Results. In both groups, males were predominantly represented. The first group consisted of nine patients, all of whom had a clinical finding of acute abdomen and ileus, while seven of them also had a severe computed tomography image of bilateral pneumonia. In the second group, a smaller number of patients were initially candidates for thrombectomy, while in others, primary amputation treatment was approached. Mortality from the underlying disease in both groups was high. Conclusion. Moderate and severe forms of SARS-CoV-2 infection are associated with an inflammatory response leading to endothelial dysfunction accompanied by a high incidence of thromboembolic complications despite pharmacological prophylaxis. The current consensus supports the use of anticoagulants in all hospitalized patients with moderate to severe disease, as well as in critically ill patients.