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Abstract

Introduction: Corona virus disease 2019 (COVID-19) presents with un-expected complications. Diabetic patients are more susceptible for lower limb complications. Importance: Peripheral gangrene may be associated with COVID-19 in diabetic patients. Case presentation: We described one diabetic patient with COVID-19 associated peripheral gangrene (PG) in lower limb. A 56 years old female patient with type-1 diabetes tested positive for COVID-19. She suffered from PG in her left foot. Hematological, biochemical, Doppler sonography, echocardiography (Echo) and electrocardiogram (ECG) tests were done for diagnosis and evaluation of the case. General checkup indicated presence of an abscess in her foot. Later, abscess drainage surgery was done. Unfortunately, her foot showed digital necrotic advanced to PG. The affected patient’s foot eventuated to digital amputations. Clinical discussion: PG correlated with leukocytosis, lymphopenia, eosinopenia and high levels of D-Dimer, ferritin, erythrocyte sedimentation rate (ESR) & C-reactive protein (C.R.P). In accordance, it associated with low levels of saturation of peripheral oxygen (SpO2) and anemia. On the other hand, the patient had normal Echo, ECG and platelets (PLT) count. Patient’s HbA1C levels indicated good control of hyperglycemia. Poor prognosis associated with thrombotic events and coagulopathies could enhance the severity of COVID-19 and negatively impacted on its complications. Conclusion: Even good control of hyperglycemia, COVID-19 as a thrombo-inflammatory disease may induce PG and digital amputation in diabetic patient.

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