At least “some” NFL fans who attended a near-record cold game in Kansas City suffered extreme frostbite and had to undergo amputations, doctors have revealed.

Spectators braved -20C (-4F) temperatures to watch the Kansas City Chiefs host the Miami Dolphins at Arrowhead Stadium in the AFC wildcard round back on 13 January.

The wind chill – what the temperature feels like to the human body – dipped as low as -33C (-27F).

As a result, some fans were treated for frostbite, which causes damage to the skin and tissue, particularly extremities such as fingers and toes, after exposure to freezing temperatures.

The Research Medical Centre in Kansas said it had treated dozens of people who had experienced frostbite during an 11-day cold snap at the beginning of the year.

Twelve of those people, including some who were at the football game, had to undergo amputations involving mostly fingers and toes.

The centre said it was expecting to carry out more surgeries over the next few weeks as “injuries evolve”.

Christine Hamele, associate vice president of HCA Midwest Health, which operates seven hospitals, including the Research Medical Centre and its Grossman Burn Centre, said: “To date, 12 patients have undergone amputation surgeries, some of which attended the Chiefs game.

“Our specialised physicians and expert care team continue to treat and monitor patients’ healing to address long-term needs, and we expect more surgical procedures over the next two to four weeks as their injuries evolve.”

However, Ms Hamele cautioned against drawing any direct lines between amputations and the 13 January game because the frostbite could have resulted from other exposures.

“Some patients came in post-Chief game, assuming it would heal,” she said.

“When they arrived in the outpatient, they don’t always reference the Chiefs game. For example, one gentleman was at the Chiefs game, but is also a meter reader.”

The University of Kansas hospital said it also treated frostbite victims after the game, but didn’t report any amputations.

Frostbite can occur on exposed skin within 30 minutes, Dr Megan Garcia, medical director of the Grossman Burn Centre, said.

She added that the timing can be even shorter if there is a wind chill.

The 13 January game – which ended with a 26-7 victory for Kansas over Miami – became the coldest on record to be held in Arrowhead Stadium history.

At one point during the match, Andy Reid, the head coach of the Chiefs, was seen with a build-up of ice on his moustache.

However, it narrowly missed out on being the coldest game in NFL history, which remains the 1967 NFL Championship in Wisconsin, where temperatures reached -25C, earning it the nickname the “Ice Bowl”.

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Taylor Swift was among the spectators at Arrowhead on 13 January, supporting her boyfriend and Chiefs tight end, Travis Kelce.

However, she avoided the below-freezing temperatures in a luxury suite. Later in the same month, the couple celebrated Kelce’s Super Bowl victory – making headlines around the world.

Outside at the 13 January match, fans were allowed to bring heated blankets into the stadium and small pieces of cardboard to place under their feet on the cold concrete.

Fifteen fans, 10 with cold-related symptoms, were taken to hospitals by the Kansas City Fire Department that evening, according to officials.

In New York, the wild-card game between the Buffalo Bills and Pittsburgh Steelers scheduled for the same day was pushed back due to heavy snow.