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新型冠状病毒感染患者的凝血功能障碍:COVID-19、SARS-CoV-1、MERS-CoV 及过去的经验教训。

Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past.

机构信息

Institute of Health Innovations and Outcomes Research, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA; Surgery Working Group, Society of Junior Doctors, Athens, Greece.

Surgery Working Group, Society of Junior Doctors, Athens, Greece; Department of Surgery, Division of Hepatobiliary Surgery and Liver Transplantation, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

出版信息

J Clin Virol. 2020 Jun;127:104362. doi: 10.1016/j.jcv.2020.104362. Epub 2020 Apr 9.

Abstract

Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus strain disease, has recently emerged in China and rapidly spread worldwide. This novel strain is highly transmittable and severe disease has been reported in up to 16% of hospitalized cases. More than 600,000 cases have been confirmed and the number of deaths is constantly increasing. COVID-19 hospitalized patients, especially those suffering from severe respiratory or systemic manifestations, fall under the spectrum of the acutely ill medical population, which is at increased venous thromboembolism risk. Thrombotic complications seem to emerge as an important issue in patients infected with COVID-19. Preliminary reports on COVID-19 patients' clinical and laboratory findings include thrombocytopenia, elevated D-dimer, prolonged prothrombin time, and disseminated intravascular coagulation. As the pandemic is spreading and the whole picture is yet unknown, we highlight the importance of coagulation disorders in COVID-19 infected patients and review relevant data of previous coronavirus epidemics caused by the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome coronavirus (MERS-CoV).

摘要

2019 年冠状病毒病(COVID-19)或严重急性呼吸综合征冠状病毒 2(SARS-CoV-2),一种新型冠状病毒株疾病,最近在中国出现并迅速在全球范围内传播。这种新型菌株具有高度传染性,高达 16%的住院病例出现严重疾病。已经确诊超过 60 万例,死亡人数不断增加。COVID-19 住院患者,特别是那些患有严重呼吸或全身表现的患者,属于急性重病医疗人群,静脉血栓栓塞风险增加。血栓并发症似乎成为 COVID-19 感染患者的一个重要问题。COVID-19 患者临床和实验室研究结果的初步报告包括血小板减少症、D-二聚体升高、凝血酶原时间延长和弥散性血管内凝血。随着大流行的蔓延和全貌尚不清楚,我们强调 COVID-19 感染患者凝血障碍的重要性,并回顾由严重急性呼吸综合征冠状病毒 1(SARS-CoV-1)和中东呼吸综合征冠状病毒(MERS-CoV)引起的先前冠状病毒流行的相关数据。

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