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. 2025 Apr 17;17(4):e82459.
doi: 10.7759/cureus.82459. eCollection 2025 Apr.

Diagnosis of Digital Ischemia During the COVID-19 Pandemic: A Study From a Developing Country

Bidhan Neupane  1 , Md Nazrul Islam  2 , Abul Khair Ahmedullah  2 , Haner Direskeneli  3 , Md Saif Ullah Khan  4
Affiliations

Diagnosis of Digital Ischemia During the COVID-19 Pandemic: A Study From a Developing Country

Bidhan Neupane et al. Cureus. .

Abstract

Objective: Digital ischemia (DI) is an uncommon condition. Information on the etiology of DI is limited. This study aimed to determine the diagnosis of DI in a tertiary care center in Bangladesh.

Methods: This cross-sectional study was conducted in the rheumatology department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from September 1, 2020, to August 31, 2021. A total of 25 consecutive patients with DI were enrolled. Each patient was assessed following the classification/diagnostic criteria for vasculitis and vasculopathy. The 2012 International Chapel Hill Consensus Conference on the Nomenclature of Vasculitides was used for case definition. The study subjects were divided into vasculitis and vasculopathy groups. Fisher's exact and Student's t-tests were used to compare the groups.

Results: The mean age was 35.88 years with a female predominance (72%). Among 25 patients, 15 (60%) were in the vasculitis group and 10 (40%) in the vasculopathy group. Takayasu arteritis was found in one subject (4%), and another 14 had vasculitis associated with connective tissue diseases: 11 (44%) lupus vasculitis, two (8%) rheumatoid vasculitis, and one (4%) associated with dermatomyositis. In the vasculopathy group, five cases (20%) had systemic sclerosis (SSc), four (16%) had peripheral arterial disease (PAD), and one (4%) had primary antiphospholipid syndrome (APS). Fever (p=0.01), arthralgia/arthritis (p=0.01), and high CRP (p=0.04) were significantly associated with vasculitis.

Conclusion: In the hospital setting, connective tissue disease-associated vasculitis and SSc-related vasculopathy were the common causes of DI.

Keywords: covid-19; diagnosis; digital ischemia; vasculitis; vasculopathy.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Bangabandhu Sheikh Mujib Medical University issued approval no. BSMMU/2021/283. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This manuscript is developed from my thesis entitled "Evaluation of Patient With Digital Ischemia for the Etiology," which I completed. After completing my course (MD Rheumatology) at the university, I received a thesis grant. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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