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新型冠状病毒相关高凝及血栓并发症的发病机制与治疗策略。

Pathogenesis and Treatment Strategies of COVID-19-Related Hypercoagulant and Thrombotic Complications.

机构信息

Department of Blood Transfusion Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

出版信息

Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620944497. doi: 10.1177/1076029620944497.

Abstract

The new type of pneumonia caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is endemic worldwide, and many countries cannot be spared, becoming a global health concern. The disease was named COVID-19 by the World Health Organization (WHO) on January 30, 2020, when the WHO declared the Chinese outbreak of COVID-19 to be a public health emergency of international concern. The clinical features of COVID-19 include dry cough, fever, diarrhea, vomiting, and myalgia. Similar to SARS-CoV and MERS-CoV, nearly 20% of patients experienced various fatal complications, including acute kidney injury and acute respiratory distress syndrome caused by cytokine storm. Furthermore, systemic cytokine storm induced vascular endothelial injury, which extensively mediates hypercoagulability in blood vessels and disseminated intravascular coagulation. The autopsy pathology of COVID-19 confirmed the above. This article briefly summarizes the mechanism of hypercoagulability and thrombotic complications of severe COVID-19 and proposes that blood hypercoagulability and intravascular microthrombosis are the development nodes of severe COVID-19. Therefore, anticoagulation and anti-inflammatory therapy can be used as important treatment strategies for severe COVID-19.

摘要

由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的新型肺炎在全球流行,许多国家都未能幸免,成为全球关注的健康问题。世界卫生组织(WHO)于 2020 年 1 月 30 日将该病命名为 COVID-19,当时世卫组织宣布中国爆发的 COVID-19 为国际关注的突发公共卫生事件。COVID-19 的临床特征包括干咳、发热、腹泻、呕吐和肌痛。与 SARS-CoV 和 MERS-CoV 类似,近 20%的患者出现各种致命并发症,包括由细胞因子风暴引起的急性肾损伤和急性呼吸窘迫综合征。此外,全身细胞因子风暴诱导血管内皮损伤,广泛介导血管内高凝状态和弥散性血管内凝血。COVID-19 的尸检病理学证实了这一点。本文简要总结了严重 COVID-19 高凝和血栓并发症的发生机制,并提出血液高凝状态和血管内微血栓形成是严重 COVID-19 的发展节点。因此,抗凝和抗炎治疗可作为严重 COVID-19 的重要治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3767/7391437/be79702f01de/10.1177_1076029620944497-fig1.jpg

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