{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:43:50Z","timestamp":1761745430968,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,1,4]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Novel COVID-19 continues to intrigue medical professionals with its varied presentations. Though it affects the respiratory tract primarily, thrombogenesis has been the Achilles\u2019 heel. A 44-year-old man diagnosed with COVID-19 presented with upper limb pain at a local hospital and was found to have thrombosis of the right axillary artery. Despite a successful embolectomy at the local hospital, there was re-occlusion of the axillary artery and the limb became ischaemic. He was referred to our institution by which time the limb became gangrenous above the elbow and had to be amputated. Extensive sloughing of the nerves was also seen in the local area. Hypercoagulability presenting with various manifestations is common in COVID-19 and needs early anticoagulation. We present this asymptomatic patient who lost a limb to this COVID-19 sequelae.<\/jats:p>","DOI":"10.1136\/bcr-2020-240981","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T12:42:47Z","timestamp":1611664967000},"page":"e240981","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Axillary artery thrombosis resulting in upper limb amputation as a COVID-19 sequela"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2773-5950","authenticated-orcid":false,"given":"Riju","family":"Ramachandran","sequence":"first","affiliation":[{"name":"General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2088-7206","authenticated-orcid":false,"given":"Anoop","family":"Vasudevan Pillai","sequence":"additional","affiliation":[{"name":"General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0697-6923","authenticated-orcid":false,"given":"Suyambu","family":"Raja","sequence":"additional","affiliation":[{"name":"General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sailakshmi","family":"Sailesh","sequence":"additional","affiliation":[{"name":"General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"2025082800452923000_14.1.e240981.1","unstructured":"India Today . Kerala confirmed first novel coronavirus case in India. Available: https:\/\/www.indiatoday.in\/india\/story\/kerala-reports-first-confirmed-novel-coronavirus-case-in-india-1641593-2020-01-30 [Accessed 30 Jan 2020]."},{"key":"2025082800452923000_14.1.e240981.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"2025082800452923000_14.1.e240981.3","doi-asserted-by":"crossref","unstructured":"Sun P , Qie S , Liu Z . Clinical characteristics of 50466 hospitalized patients with 2019-nCoV infection. J Med Virol 2020.","DOI":"10.1101\/2020.02.18.20024539"},{"key":"2025082800452923000_14.1.e240981.4","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1001\/jamacardio.2020.1286","article-title":"Potential effects of coronaviruses on the cardiovascular system: a review","volume":"5","author":"Madjid","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2025082800452923000_14.1.e240981.5","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14435"},{"key":"2025082800452923000_14.1.e240981.6","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.200685"},{"key":"2025082800452923000_14.1.e240981.7","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjaa204","article-title":"Coagulopathy in COVID-19 infection: a case of acute upper limb ischemia","volume":"2020","author":"Galanis","year":"2020","journal-title":"J Surg Case Rep"},{"key":"2025082800452923000_14.1.e240981.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2013656"},{"key":"2025082800452923000_14.1.e240981.9","doi-asserted-by":"crossref","first-page":"e438","DOI":"10.1016\/S2352-3026(20)30145-9","article-title":"Coagulation abnormalities and thrombosis in patients with COVID-19","volume":"7","author":"Levi","year":"2020","journal-title":"Lancet Haematol"},{"key":"2025082800452923000_14.1.e240981.10","doi-asserted-by":"publisher","DOI":"10.1002\/path.1570"},{"key":"2025082800452923000_14.1.e240981.11","first-page":"39","article-title":"Pro-Inflammatory and prothrombotic factors and metabolic syndrome","volume":"18","author":"Sypniewska","year":"2007","journal-title":"EJIFCC"},{"key":"2025082800452923000_14.1.e240981.12","article-title":"Acute limb ischemia in COVID-19 disease: a mysterious coagulopathy","volume":"12","author":"Anwar","year":"2020","journal-title":"Cureus"},{"key":"2025082800452923000_14.1.e240981.13","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1016\/j.jvs.2020.04.483","article-title":"Acute limb ischemia in patients with COVID-19 pneumonia","volume":"72","author":"Bellosta","year":"2020","journal-title":"J Vasc Surg"},{"key":"2025082800452923000_14.1.e240981.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06062-x"},{"key":"2025082800452923000_14.1.e240981.15","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s00701-020-04374-x","article-title":"SARS-CoV-2 can induce brain and spine demyelinating lesions","volume":"162","author":"Zanin","year":"2020","journal-title":"Acta Neurochir"},{"key":"2025082800452923000_14.1.e240981.16","doi-asserted-by":"crossref","first-page":"266","DOI":"10.4103\/2229-5151.141487","article-title":"Intravenous colistin-induced acute respiratory failure: a case report and a review of literature","volume":"4","author":"Shrestha","year":"2014","journal-title":"Int J Crit Illn Inj Sci"},{"key":"2025082800452923000_14.1.e240981.17","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-232354","article-title":"Efficacy of colistimethate sodium as local application in necrotising fasciitis","volume":"12","author":"Murali","year":"2019","journal-title":"BMJ Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:45:41Z","timestamp":1756367141000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,26]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/bcr-2020-240981"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240981","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}