Candice Davis was a healthy, 30-year-old flight attendant when she contracted COVID-19 in August 2021. Within days she was in the hospital on a ventilator. Over the next few weeks, as Davis lay unconscious, doctors transferred her from the ventilator to an ECMO machine, a life-support device that pumps oxygen into the blood. 

Life-threatening heart complications had developed, along with circulatory problems in her arms and legs. When she woke up, Davis faced a choice between amputation of her arms or survival. “If my arms gotta go, they gotta go,’” she said. “It’s my life.”

Davis is one of a small but growing number of COVID-19 patients who suffer from this serious complication even if they were previously healthy with no pre-existing conditions that would place them at high risk. 

How COVID-19 Can Lead to Amputation

A circulatory crisis is one of the disease’s most serious complications. It occurs partly because of the virus’s potential to cause increased blood clotting. How exactly the SARS-CoV-2 virus causes clotting is still being studied, said Julia Glaser, a vascular surgeon at Penn Medicine who treated Davis, but the virus seems to damage the lining of blood vessels, resulting in large clots that can cause strokes and other vascular issues. For Davis, tiny clots can also form throughout the body. In a limb, they can diminish blood flow enough that the tissue dies and infection develops. In these instances, the limb must be removed to save the patient’s life.

The risk of this happening is higher for older people and those with conditions such as diabetes and heart disease, but younger people can clearly be affected, as well. Davis lost not only both her arms below the elbow, but also one leg below the knee and part of a foot. She was not vaccinated when she contracted the virus, and now Davis shares her story to urge others to take the pandemic seriously and get vaccinated. “I didn’t have time to get to it,” she said. “But get the vaccine — you don’t want to lose your limbs. And, most importantly, you don’t want to lose your life.”

From Martial Artist to Amputee

The vaccines weren’t available in April 2020 when Mark Torregosa, 65, contracted COVID-19. A master in the Korean martial art Tang Soo Do, Torregosa also didn’t have any of the pre-existing health conditions that were linked to serious complications. Nevertheless, he quickly became so ill that, like Davis, he was placed on a ventilator, then transferred to an ECMO machine. He experienced two heart attacks while unconscious.

By June 2020, Torregosa’s limbs were swollen and black from lack of blood flow. On June 23, 2020, doctors amputated his left leg below the knee and part of his right foot. A week later, they amputated both his hands. Torregosa was not fully conscious in the weeks prior to the surgeries. He recalls waking up during recovery and being unable to push himself up in his hospital bed. “I said, ‘What happened? Where are my hands?’” he recounted. It was then that he realized the dramatic changes in his body.

Not All Amputations Due to COVID-19 Infections

Not all amputations that have occurred during the last two years are directly related to COVID-19 infections, however. According to Dr. Ajaykumar Rao, a physician at Temple Health with expertise in diabetes, endocrinology, and internal medicine, amputations were already on the rise in the U.S. prior to the COVID-19 pandemic, particularly for people with diabetes and other conditions that affect circulation.

Diabetes requires close, regular monitoring, and the lockdowns and restrictions, coupled with people’s fears of COVID exposure, resulted in many diabetes patients skipping their routine care appointments. “People early in the pandemic were afraid to come into the hospital,” Rao said, “even though they knew there was something wrong with their feet or their limbs. There’s a delay in detection.” A November 2020 study found that diabetes patients with foot problems were more than ten times more likely to have an amputation during the pandemic than before and were almost 13 times more likely to need a major amputation.

Not Giving Up on Dreams

Davis looks forward to continued health improvement, walking with prosthetics, and living as independently as possible. She has a degree in sociology and has long wanted to become a nurse. She realizes that there are certain activities she may not be able to perform, but her interactions with the nurses who care for her have encouraged her. “I know I can’t do some nursing, but talking to the nurses in here, some have explained to me there are other areas of nursing I can get involved in,” she said. “I’m very into anatomy, physiology, women’s health; watching them, seeing what they do, it’s like, I can do that.”

Her next step, however, is inpatient rehab at Magee Rehabilitation, the same facility where Torregosa spent the previous summer. Rehab can take a few weeks or a few months, then is generally continued at the patient’s home. For amputees who are also recovering from a severe COVID-19 illness, said Paula Bonsall, an occupational therapist at Magee, the initial goal is to simply restore strength. “Even the ability just to sit up is impaired because their chest muscles are weak, their respiratory system is weak…We kind of start with the basics.”

Not Letting Amputation Define You

Torregosa could hardly lift his arms away from his body when he first woke up. With therapy, he gained strength and learned to transfer from the bed to a chair, use his prosthetic leg, and stand with assistance. He started by walking 30 steps in a harness that supported his weight. He also received prosthetic hands, which he learned to control by contracting and relaxing various muscles, including those in his shoulders and triceps. It has been a physical, emotional, psychological, and cognitive journey.

When he left Magee in October 2020, Torregosa could walk laps on his prosthetic legs without additional support. Today, he eats on his own, has started golfing, and has even returned to a modified martial arts practice. Torregosa is Catholic and says his faith and mindset have sustained him. 

“Don’t focus on something you don’t have that you want,” he counsels. “As long as you have air in the lungs, you’re alive. That’s just what matters.”

*Laughlin, J. and Whelan, A. (2021, Dec. 3). COVID-19 is making amputations more common. Two Philly-area survivors tell their stories. The Philadelphia Inquirer. https://www.inquirer.com/health/coronavirus/covid-amputations-circulation-ventilator-complications-diabetes-20211203.html 

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.