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关于如何在 COVID-19 大流行期间进行血液学咨询的综述。

A review on how to do hematology consults during COVID-19 pandemic.

机构信息

Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, USA.

Division of Hematology and Oncology, Department of Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA.

出版信息

Blood Rev. 2021 May;47:100777. doi: 10.1016/j.blre.2020.100777. Epub 2020 Nov 8.

Abstract

The ongoing COVID-19 pandemic is the most trending and talked topic across the World. From its point of origin in Wuhan, China to clinical laboratory at NIH, a mere six-month-old SARS-CoV-2 virus is keeping the clinicians, and scientists busy at various fronts. However, COVID-19 is an emerging and evolving disease and each day brings in more data, new figures, and findings from the field of clinical practice. The role of hematologists has been increasingly recognized during the current pandemic because of several reasons. Most important of them are the characteristic hematological findings of COVID-19 patients that also have prognostic implications and that were not seen in other viral infections. The treatment of hematological complications in COVID-19 patients is very challenging given the critical care setting. There are interim and limited guidelines thus far due to the novelty of the disease. As this remains to be a quite fluid situation, all the appropriate medical societies including the major hematology bodies are proposing initial and interim guidelines (e.g. ASH guideline). This puts a hematologist on consult service in a dubious position where, he/she must tailor the recommendations on case to case basis. The purpose of this review is to provide the background context about the impact of COVID-19 on the blood system and to summarize the current interim guidelines to manage the associated hematological issues in COVID-19 infection.

摘要

正在持续的 COVID-19 大流行是全球最热门、讨论最多的话题。从中国武汉的起源地到 NIH 的临床实验室,仅仅六个月大的 SARS-CoV-2 病毒让临床医生和科学家在各个方面都忙得不可开交。然而,COVID-19 是一种新兴的、不断演变的疾病,每天都会带来更多的数据、新的数字和临床实践领域的发现。由于以下几个原因,血液病学家在当前的大流行中越来越受到重视。其中最重要的是 COVID-19 患者的特征性血液学发现,这些发现也具有预后意义,而在其他病毒感染中则没有。鉴于危重症患者的治疗环境,COVID-19 患者的血液学并发症的治疗极具挑战性。由于疾病的新颖性,迄今为止只有临时和有限的指南。由于这种情况仍然非常不稳定,所有适当的医学协会,包括主要的血液病协会,都在提出初步和临时指南(例如 ASH 指南)。这使得血液病学家在咨询服务中处于一个不确定的位置,他/她必须根据具体情况制定建议。本综述的目的是提供 COVID-19 对血液系统影响的背景信息,并总结目前治疗 COVID-19 感染相关血液学问题的临时指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d5a/7648889/20de0f39ef0b/gr1_lrg.jpg

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