Efendizade Aslan, Dmytriw Adam A, Hewitt Kevin, Davies Gwynivere A
Department of Diagnostic Radiology, State University of New York (SUNY) Downstate Medical Center, University Hospital Brooklyn, Brooklyn, NY, United States.
Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Front Neurol. 2020 Sep 25;11:573356. doi: 10.3389/fneur.2020.573356. eCollection 2020.
Thromboembolism is a known phenomenon in patients with Coronavirus disease 2019 (COVID-19). Recent investigations have revealed that a significant proportion of those hospitalized with severe COVID-19 demonstrate clinical and laboratory markers compatible with hypercoagulability, which is differentiated from disseminated intravascular coagulation (DIC), termed COVID-associated coagulopathy. Additionally, there is increasing concern for development of acute ischemic stroke because of this hypercoagulable state. We present a patient with COVID-19 pneumonia who was managed with unfractionated heparin (UFH) infusion and developed a large ischemic infarct shortly after cessation of the infusion. In retrospect, the patient's coagulation parameters were consistent with overt DIC, although some of these parameters are easily masked by the effects of UFH. These findings emphasize the importance of anticoagulation as well as its careful discontinuation, as failure to do so may result in a significant thromboembolic event.
血栓栓塞是2019冠状病毒病（COVID-19）患者中已知的一种现象。最近的调查显示，相当一部分因重症COVID-19住院的患者表现出与高凝状态相符的临床和实验室指标，这种高凝状态与弥散性血管内凝血（DIC）不同，被称为COVID-19相关凝血病。此外，由于这种高凝状态，急性缺血性卒中的发生也越来越受到关注。我们报告了一名患有COVID-19肺炎的患者，该患者接受了普通肝素（UFH）输注治疗，在输注停止后不久发生了大面积缺血性梗死。回顾来看，患者的凝血参数与明显的DIC一致，尽管其中一些参数很容易被UFH的作用掩盖。这些发现强调了抗凝治疗及其谨慎停药的重要性，因为如果不这样做可能会导致严重的血栓栓塞事件。
