Coronavirus risks: COVID-19 patients prone to gangrene, experts warn of serious complications

The second wave of coronavirus has fueled many complications for COVID-19 patients and brought along many severe symptoms as well. One, among the many, could be gangrene risk, which could also be a sign of severe COVID-19 infection in patients.

According to Delhi-based doctors, gangrene, a skin tissue infection, can also be a possible COVID-19 marker.

What doctors also say is that gangrene, for some COVID-19 patients could show up much before the typical respiratory signs and symptoms and become a cause of worry.

Not only is gangrene a big risk factor in itself, experts now worry that a possible link between COVID-19 and gangrene could be as scary as the emergence of black fungal infections.

Here's everything we know about the same.

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The clinical observations have been based on a study done by doctors at Dr Ram Manohar Lohia Hospital, Delhi, who saw a patient showing signs of gangrene after being tested positive for coronavirus.

The patient, 65 years old, who tested positive was found to have gangrene signs and symptoms before the typical upper-respiratory symptoms of COVID showed up.

The study also mentioned that the 65-year-old, who had zero comorbidities, complained of weakness and thrombotic pain near his limbs for a while before classic COVID markers showed up. Upon evaluation, signs like edema, poor pulse, discolouration were also observed. While the patient was put on aggressive treatment using steroids and antibiotics, he succumbed to the disease (due to pulmonary embolism) days after testing positive. The progression of the symptom is one reason why doctors believe that gangrene risk with COVID-19 could be much more severe than usual.

Gangrene refers to a condition where or when skin tissues die because of a lack of proper blood supply (which may be disrupted due to a number of reasons). The tissue damage often occurs in skin extremities and can most often affect toes, fingers, limbs, muscle tissues and in severe organs, vital organs.

Since gangrene is caused by an infection that can progress and spread fast, immediate care and antibiotic treatment is needed for the same.

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Gangrene isn't the only skin infection or symptom traced to COVID-19 spread.

For a long time, it has been observed much like how COVID-19 profoundly impacts vital organs, the manifestations of viral spread could also be felt on the skin and impact the bloodstream, causing surface-level inflammation. Skin symptoms like rashes, urticaria (hives), painful blisters, dry skin can all be expected. Infamous COVID nails and toes are also symptoms that have been talked about a lot.

However, what's concerning is that while a gangrene risk with COVID infection may be a severe one, skin manifestations caused by COVID, which can strike a lot many COVID patients may not always be severe or progress with the infection. International journals and scientific studies have also mentioned that COVID-related rashes, blisters have no specific link to the severity of infection.

Unlike the common skin-specific COVID symptoms discussed above, a gangrene observation or progression could be a severe sign of the infection and require assistance at once. This could primarily be because of the SARS-COV-2's impact on the blood, increased precedence of thrombosis (blood clotting) and underlying conditions.

While more research is underway, doctors believe that gangrene risk could swell up due to severe clotting of blood, which is now seen in a lot of COVID-19 cases. Progressing sepsis risk (when an infection triggers immune reactions), poor inflammatory markers could consequently also make the gangrene develop fast and worse, putting vital parameters at risk and hence, be considered as a tell-tale sign of severe COVID-19, even in the absence of other signs and symptoms.

There are a lot many risk factors for gangrene including obesity, diabetes, poor blood pressure control, excess alcohol intake, smoking and other vascular diseases which increase inflammation in the body or disrupt blood supply in the body.

Gangrene, without comorbidities, could also develop as a result of an underlying injury, a condition that has caused significant nerve damage or disrupts healthy blood flow.

While more research may be needed before we fully classify gangrene to be a classic severity and fatality indicator of COVID-19, symptoms of a gangrene-like-infections need to be identified and treated fast.

With gangrene infections, symptoms can develop very fast and compromise health. While the first primary markers of the same can be seen on the skin (including discolouration), initial redness and swelling, loss of sensation. There can also be a foul-smelling discharge, blisters and sores which may peel.

Apart from the physical symptoms, the infection may also be accompanied by rising fevers, abnormal heart rate and cause acute damage to the blood vessels as well. If left undetected or untreated, it can cause significant damage or even fatality.