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深静脉血栓形成和肺栓塞:新型冠状病毒肺炎的两种并发症?

Deep Vein Thrombosis and Pulmonary Embolism: Two Complications of COVID-19 Pneumonia?

作者信息

Poggiali Erika, Bastoni Davide, Ioannilli Eva, Vercelli Andrea, Magnacavallo Andrea

机构信息

Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.

出版信息

Eur J Case Rep Intern Med. 2020 Apr 8;7(5):001646. doi: 10.12890/2020_001646. eCollection 2020.

Abstract

UNLABELLED

Coronavirus disease 19 (COVID-19) is a worldwide infection which was recently declared a global health emergency by the WHO Emergency Committee. The most common symptoms are fever and cough, which can progress to pneumonia, acute respiratory distress syndrome (ARDS) and/or end-organ failure. Risk factors associated with ARDS and death are older age, comorbidities (e.g., hypertension, diabetes, hyperlipidaemia), neutrophilia, and organ and coagulation dysfunction. Disseminated intravascular coagulation and coagulopathy can contribute to death. Anticoagulant treatment is associated with decreased mortality in severe COVID-19 pneumonia. In this report we describe two patients with COVID-19 pneumonia who developed venous thromboembolism.

LEARNING POINTS

Deep vein thrombosis and pulmonary embolism can occur in patients with COVID-19 pneumonia.Low-molecular-weight heparin prophylaxis does not decrease the risk of venous thromboembolism (VTE) in COVID-19 pneumonia.In the presence of clinical signs and/or suspicion of VTE, compression ultrasound and echocardiography should be always performed, irrespective of disease stage.

摘要

未标注

新型冠状病毒肺炎(COVID-19)是一种全球性感染疾病,世界卫生组织突发事件委员会最近宣布其为全球卫生紧急事件。最常见的症状是发热和咳嗽,可进展为肺炎、急性呼吸窘迫综合征(ARDS)和/或终末器官衰竭。与ARDS和死亡相关的危险因素包括老年、合并症(如高血压、糖尿病、高脂血症)、中性粒细胞增多以及器官和凝血功能障碍。弥散性血管内凝血和凝血病可导致死亡。抗凝治疗与重症COVID-19肺炎患者死亡率降低相关。在本报告中,我们描述了两名患有COVID-19肺炎并发生静脉血栓栓塞的患者。

学习要点

COVID-19肺炎患者可发生深静脉血栓形成和肺栓塞。低分子量肝素预防不能降低COVID-19肺炎患者静脉血栓栓塞(VTE)的风险。在存在VTE临床体征和/或怀疑VTE时,无论疾病处于何阶段,均应始终进行加压超声检查和超声心动图检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04c2/7213837/4d7b6457b953/1646_Fig1.jpg

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