General Surgery Department, 162307Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey.
Surg Innov. 2021 Apr;28(2):236-238. doi: 10.1177/1553350620962892. Epub 2020 Sep 30.
The disease caused by the 2019 novel coronavirus is known predominantly for its respiratory outcomes; a subset of critically ill patients demonstrates clinically remarkable hypercoagulability in which thrombotic events range from acute pulmonary embolism in patients with COVID-19 pneumonia to extremity ischemia. Our observational study aimed to describe the incidence and characteristics, as well as clinical outcomes, of patients presenting and treated for mesenteric ischemia during the COVID-19 pandemic. Between March 13 and May 13, 2020, 60 patients operated for emergency reasons were analyzed, and it was noticed that 5 of the 6 COVID-positive patients were operated due to mesenteric ischemia. Five of sixty patients (83.3%) applied to our emergency clinic with COVID-19 positive and acute abdomen. Two of them (40%) did not have any comorbidities. All of them (%100) were male. There were no complications and only 1 death (20%). Mean leukocyte, neutrophil, and platelet levels were within the normal range, while the lymphocyte level was near the lower limit. C-Reactive Protein was above the limit in all patients. The mean levels of International Normalized Ratio, Platelet, and Activated Partial Thromboplastin Time were above the limits. While D-dimer levels were close to the upper limit; fibrinogen levels were above the normal limit for each patient. The presence of hypercoagulation status in critical COVID-19 patients should be observed closely, and anticoagulation therapy can be considered in selected patients. More clinical data are needed to examine the role of anticoagulation in COVID-19 treatment.
由 2019 年新型冠状病毒引起的疾病主要表现为呼吸道疾病；一部分危重症患者表现出明显的高凝状态，其中血栓事件范围从 COVID-19 肺炎患者的急性肺栓塞到四肢缺血。我们的观察性研究旨在描述 COVID-19 大流行期间出现并接受肠系膜缺血治疗的患者的发病率、特征以及临床结局。在 2020 年 3 月 13 日至 5 月 13 日期间，分析了 60 例因紧急原因而接受手术的患者，注意到 6 例 COVID 阳性患者中有 5 例因肠系膜缺血而接受手术。在 60 例患者中，有 5 例（83.3%）因 COVID-19 阳性和急性腹痛就诊于我们的急诊室。其中 2 例（40%）没有任何合并症。他们均为男性（100%）。没有并发症，仅 1 例死亡（20%）。白细胞、中性粒细胞和血小板水平均值均在正常范围内，而淋巴细胞水平接近下限。所有患者的 C 反应蛋白均高于正常值。国际标准化比值、血小板和活化部分凝血活酶时间的平均水平均高于正常值。D-二聚体水平接近上限；纤维蛋白原水平均高于每位患者的正常上限。应密切观察危重症 COVID-19 患者的高凝状态，并可考虑在选定的患者中进行抗凝治疗。需要更多的临床数据来研究抗凝在 COVID-19 治疗中的作用。
