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COVID-19 相关静脉血栓栓塞症:目前我们了解多少?

Venous Thromboembolism Complicated with COVID-19: What Do We Know So Far?

机构信息

Cardiology Department, Rabin Medical Center, Petah Tikva, Israel,

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,

出版信息

Acta Haematol. 2020;143(5):417-424. doi: 10.1159/000508233. Epub 2020 May 12.

Abstract

Coronavirus disease (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is responsible for the ongoing 2019-2020 pandemic. Venous thromboembolism (VTE), a frequent cardiovascular and/or respiratory complication among hospitalized patients, is one of the known sequelae of the illness. Hospitalized COVID-19 patients are often elderly, immobile, and show signs of coagulopathy. Therefore, it is reasonable to assume a high incidence of VTE among these patients. Presently, the incidence of VTE is estimated at around 25% of patients hospitalized in the intensive care unit for COVID-19 even under anticoagulant treatment at prophylactic doses. In this review, we discuss present knowledge of the topic, the unique challenges of diagnosis and treatment of VTE, as well as some of the potential mechanisms of increased risk for VTE during the illness. Understanding the true impact of VTE on patients with COVID-19 will potentially improve our ability to reach a timely diagnosis and initiate proper treatment, mitigating the risk for this susceptible population during a complicated disease.

摘要

新型冠状病毒病(COVID-19)是由新型严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的,是目前正在发生的 2019-2020 年大流行的病因。静脉血栓栓塞症(VTE)是住院患者常见的心血管和/或呼吸系统并发症之一,是该疾病的已知后遗症之一。住院 COVID-19 患者通常年龄较大、活动不便且存在凝血功能障碍的迹象。因此,可以合理地假设这些患者 VTE 的发生率较高。目前,即使在预防剂量的抗凝治疗下,COVID-19 患者在重症监护病房住院的 VTE 发生率估计约为 25%。在这篇综述中,我们讨论了目前对该主题的了解,包括诊断和治疗 VTE 的独特挑战,以及疾病期间 VTE 风险增加的一些潜在机制。了解 VTE 对 COVID-19 患者的真正影响,可能会提高我们及时诊断和适当治疗的能力,从而减轻这一易感人群在复杂疾病期间的风险。

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