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冠状病毒感染(COVID-19)中的血液学参数及其临床意义。

Hematologic parameters in coronavirus infection (COVID-19) and their clinical implications.

作者信息

Waleed Rao Muhammad, Sehar Inbisat, Iftikhar Waleed, Khan Huma Saeed

机构信息

CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan.

California Institute of Behavioral Neurosciences & Psychology, Fairfield, CA 94534, USA.

出版信息

Discoveries (Craiova). 2020 Oct 1;8(4):e117. doi: 10.15190/d.2020.14.

DOI:10.15190/d.2020.14
PMID:33110936
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7585459/
Abstract

Coronaviruses are a class of enveloped RNA viruses that cause infections of the respiratory tract, characterized by fever, tiredness, dry cough, diarrhea, loss of smell or taste, chest pain and shortness of breath. Many patients with mysterious pneumonia were distinguished in December 2019 in Wuhan. The pneumonia of obscure origin was found to be ascribed to a novel coronavirus and described as novel coronavirus pneumonia (NCP). The Chinese authorities initially reported the wave of mysterious pneumonia on December 31st, 2019 and it was declared as an outbreak of international concern on January 30th, 2020. A systematic search of relevant research was conducted, and a total of 58 primary research articles were identified, analyzed, and debated to better understand the hematologic profile in COVID-19 (Coronavirus disease) infection and its clinical implications. All the findings in this article manifest a true impression of the current interpretation of hematological findings of the SARS-COV-2 disease. Pathophysiology of COVID-19 disease can be better interpreted by taking into consideration the hematologic parameters. Clinical implications of the hematologic profile of COVID-19 patients including cytokine storm, coagulation profile, and thrombophilic complications are under-recognized. Therefore, this review focuses on the coagulation profile, cytokine storm, and its treatment options. The role of pre-existing thrombophilia in COVID-19 patients and how it could result in the poor prognosis of the disease is also debated. The recent data suggests that hypercoagulability could be the potential cause of fatalities due to COVID-19. Potential effects of tocilizumab, metronidazole, and ulinastatin in suppressing cytokine storm may help to treat SARS-COV-2 infection. This review also highlights the significance of thrombophilia testing in SARS-CoV-2 patients depending on the clinical features and especially in pregnant women.

摘要

冠状病毒是一类包膜RNA病毒,可引起呼吸道感染,其特征为发热、乏力、干咳、腹泻、嗅觉或味觉丧失、胸痛和呼吸急促。2019年12月,武汉发现了许多患有不明原因肺炎的患者。这种来源不明的肺炎被发现归因于一种新型冠状病毒,并被描述为新型冠状病毒肺炎(NCP)。中国当局最初于2019年12月31日报告了这波不明原因肺炎疫情,并于2020年1月30日宣布其为国际关注的突发公共卫生事件。我们进行了相关研究的系统检索,共识别、分析和讨论了58篇原始研究文章,以更好地了解新型冠状病毒肺炎(COVID-19)感染中的血液学特征及其临床意义。本文中的所有发现都真实反映了目前对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疾病血液学检查结果的解读。考虑血液学参数可以更好地解释COVID-19疾病的病理生理学。COVID-19患者血液学特征的临床意义,包括细胞因子风暴、凝血指标和血栓形成并发症,尚未得到充分认识。因此,本综述重点关注凝血指标、细胞因子风暴及其治疗选择。还讨论了COVID-19患者中既往存在的血栓形成倾向的作用及其如何导致疾病预后不良。最近的数据表明,高凝状态可能是COVID-19导致死亡的潜在原因。托珠单抗、甲硝唑和乌司他丁在抑制细胞因子风暴方面的潜在作用可能有助于治疗SARS-CoV-2感染。本综述还强调了根据临床特征,尤其是在孕妇中,对SARS-CoV-2患者进行血栓形成倾向检测的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/887d3a837825/discoveries-08-117-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/fb2af4968ae8/discoveries-08-117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/a7ec4107acaf/discoveries-08-117-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/887d3a837825/discoveries-08-117-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/fb2af4968ae8/discoveries-08-117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/a7ec4107acaf/discoveries-08-117-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/2ab95d20df8b/discoveries-08-117-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85a5/7585459/887d3a837825/discoveries-08-117-g004.jpg

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Extrapulmonary manifestations of COVID-19.COVID-19 的肺外表现。
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COVID-19 and immunomodulation treatment for women with reproductive failures.COVID-19 与免疫调节治疗对生殖失败女性的影响。
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The cytokine storm in COVID-19: An overview of the involvement of the chemokine/chemokine-receptor system.COVID-19 中的细胞因子风暴:趋化因子/趋化因子受体系统的参与概述。
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