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新型冠状病毒肺炎患者的血栓栓塞风险和抗凝治疗:新出现的证据和行动呼吁。

Thromboembolic risk and anticoagulant therapy in COVID-19 patients: emerging evidence and call for action.

机构信息

Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece.

出版信息

Br J Haematol. 2020 Jun;189(5):846-847. doi: 10.1111/bjh.16727. Epub 2020 May 4.

Abstract

Emerging evidence shows that severe coronavirus disease 2019 (COVID-19) can be complicated with coagulopathy, namely disseminated intravascular coagulation, which has a rather prothrombotic character with high risk of venous thromboembolism. The incidence of venous thromboembolism among COVID-19 patients in intensive care units appears to be somewhat higher compared to that reported in other studies including such patients with other disease conditions. D-dimer might help in early recognition of these high-risk patients and also predict outcome. Preliminary data show that in patients with severe COVID-19, anticoagulant therapy appears to be associated with lower mortality in the subpopulation meeting sepsis-induced coagulopathy criteria or with markedly elevated d-dimer. Recent recommendations suggest that all hospitalized COVID-19 patients should receive thromboprophylaxis, or full therapeutic-intensity anticoagulation if such an indication is present.

摘要

新出现的证据表明,严重的 2019 年冠状病毒病(COVID-19)可并发凝血功能障碍,即弥散性血管内凝血,其具有较高的静脉血栓栓塞风险,表现出较强的血栓形成特征。与其他包括患有其他疾病的患者在内的研究相比,重症监护病房中的 COVID-19 患者的静脉血栓栓塞发生率似乎略高。D-二聚体可能有助于早期识别这些高危患者,并预测预后。初步数据表明,在患有严重 COVID-19 的患者中,抗凝治疗似乎与符合脓毒症诱导的凝血障碍标准或 D-二聚体显著升高的亚组患者的死亡率降低相关。最近的建议表明,所有住院的 COVID-19 患者均应接受血栓预防治疗,如果存在这种指征,则应进行充分的治疗强度抗凝治疗。

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