Relationship between COVID-19 Infection and Buerger's Disease-Related Amputations

Abstract

Introduction: Thromboangiitis obliterans (TAO) or Buerger's disease is a non-atherosclerotic, inflammatory arteritis involving small and medium-sized arteries and veins of the extremities, often causing gangrene and scarring. Coronavirus disease (COVID-19) may predispose to both arterial and venous thromboembolic complications. This study examined the relationship between COVID-19 infection and Buerger's disease-related amputations. Materials and Methods: Between January 2018 and July 2023, 54 patients who applied to our clinic for Buerger's disease and were followed up and treated were analyzed retrospectively. Follow-up information, demographic data of patients (age, gender, body mass index (BMI), education status), when they were diagnosed, amount of smoking (pack/year), all treatments applied for Buerger's disease (Pre-Covid – Covid period – Covid Afterwards), presence or absence of limb amputation, continued smoking, medications, cardiovascular risk factors, Charlson Comorbidity Index (CCI), Venous Thromboembolic Event (Pulmonary Embolism), Covid-19 History and vaccination information were noted. Results: The mean age of 54 patients included in the study was 38.1 (27-49), all male. The mean smoking rate was 32 (16 - 60) packs/year, and the mean exposure to the SARS-CoV-2 virus was 1.22 (0-4) times. There was a significant correlation between major amputations due to Buerger's disease and age, severity of COVID-19 disease, and systemic hypertension (p<0.005). Major amputation rates increased during the period of COVID-19 disease (p<0.05). Conclusion: We found a statistically significant increase in major amputations as the exposure to the virus or the severity of the COVID-19 disease increased. We also observed a significant increase in major amputation rates in the presence of systemic hypertension. The presence of COVID-19 disease and hypertension should be considered when planning treatment to prevent amputation in Buerger's patients.