Critical Care Medicine, Respiratory Institute, Cleveland Clinic.
Clinical Instructor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.
Cleve Clin J Med. 2020 Jul 31;87(8):461-468. doi: 10.3949/ccjm.87a.ccc024.
Severe COVID-19 illness is associated with intense inflammation, leading to high rates of thrombotic complications that increase morbidity and mortality. Markedly elevated levels of D-dimer with normal fibrinogen levels are the hallmark laboratory findings of severe COVID-19- associated coagulopathy. Prophylaxis against venous thromboembolism is paramount for all hospitalized patients, with more aggressive prophylaxis and screening recommended for patients with D-dimer levels above 3.0 μg/mL. Point-of-care ultrasonography is the imaging method of choice for patients at high risk, as it entails minimal risk of exposing providers to the virus.
严重的 COVID-19 疾病与强烈的炎症有关，导致血栓并发症的发生率很高，从而增加发病率和死亡率。显著升高的 D-二聚体水平伴正常的纤维蛋白原水平是严重 COVID-19 相关凝血功能障碍的实验室特征。所有住院患者都需要预防静脉血栓栓塞，对于 D-二聚体水平高于 3.0 μg/mL 的患者，建议采用更积极的预防和筛查措施。对于高危患者，床旁超声是首选的影像学方法，因为它使提供者暴露于病毒的风险最小化。
