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. 2021 Feb 4;5(2):ytaa525. doi: 10.1093/ehjcr/ytaa525
Day 1 A 72-year-old patient with a critical course of COVID-19 (severe acute respiratory syndrome coronavirus 2) infection admitted to the intensive care unit (ICU) for intubation, inotropes, and continuous veno-venous hemofiltration
Day 21 Extubation
Day 23 Re-intubation due to progressive respiratory insufficiency
  • Computed tomography (CT) thorax angiography: severe COVID-19 related bilateral ground glass pattern of the lungs without signs of pulmonary embolism

  • Computed tomography angiography: free-floating thrombus in the distal thoracic aorta

  • Start unfractionated heparin therapy

Day 24 Physical examination: blue toe syndrome
Day 25 Computed tomography angiography vasculature lower extremities: occlusion of the right posterior tibial artery
Day 30 Dark blue toes/signs of toe necrosis
Day 30 Follow-up CT angiography: decrease of the aortic thrombus load
Day 35

Weaning from mechanical ventilation

Stop heparin therapy, start oral anticoagulants

Day 45 Intensive care unit acquired weakness and ongoing delirium
Day 90 Normal cognitive functions, substantial physical rehabilitation in progress
Day 150 Surgical surveillance and amputation of necrotic toes, general daily life activities independently