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2019冠状病毒病的抗凝治疗:最新进展

Anticoagulation in COVID - 19: An Update.

作者信息

Tiwari Nishant R, Khatib Khalid I, Dixit Subhal B, Rathore Prajay K, Melinkeri Sameer, Ganapule Abhijeet, Borawake Kapil S, Mhatre Ujwala

机构信息

Byramjee Jeejeebhoy Medical College and Sassoon General Hospital, Pune, Maharashtra, India.

Smt Kashibai Navale Medical College and General Hospital, Pune, India.

出版信息

J Crit Care Med (Targu Mures). 2020 Nov 7;6(4):217-223. doi: 10.2478/jccm-2020-0033. eCollection 2020 Oct.

Abstract

The novel coronavirus disease, 2019 (COVID - 19) evolved as an unprecedented pandemic. The severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) infection has been associated with significantly deranged coagulation parameters and increased incidence of thrombotic events. Deranged coagulation parameters, such as D-dimers and fibrin degradation products, can indicate a poor prognosis, and their measurement will help stratify the patients according to the disease severity, need of intensive care unit admission, and prediction of the clinical course. Gaps in understanding the natural history of the disease cause difficulties in tailoring therapies and optimizing the management of patients. Lack of specific treatment further complicates this situation. While thrombotic events can cause significant morbidity and mortality in patients, a focused approach to the prevention and treatment of venous thromboembolism (VTE) can, to a great extent, decrease the disease burden caused by thrombotic diseases. Pharmacological prophylactic anticoagulants and mechanical therapies such as pneumatic compression devices can help prevent venous thromboembolism and other thrombotic events. Thrombotic events due to COVID-19, their prevention and management, are the focus of this paper, with the prospect of providing insights into this relatively unexplored area.

摘要

2019年新型冠状病毒病(COVID - 19)演变成了一场史无前例的大流行疾病。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染与凝血参数显著紊乱及血栓形成事件发生率增加有关。诸如D-二聚体和纤维蛋白降解产物等凝血参数紊乱可预示预后不良,对其进行检测将有助于根据疾病严重程度、入住重症监护病房的需求以及临床病程预测对患者进行分层。对该疾病自然史认识的不足给治疗方案的制定和患者管理的优化带来了困难。缺乏特异性治疗方法使这种情况更加复杂。虽然血栓形成事件可导致患者出现严重的发病和死亡情况,但针对静脉血栓栓塞症(VTE)的预防和治疗采取针对性方法,在很大程度上可减轻血栓性疾病造成的疾病负担。药物预防性抗凝剂和诸如气动压迫装置等机械疗法有助于预防静脉血栓栓塞症和其他血栓形成事件。本文重点关注COVID-19所致的血栓形成事件及其预防和管理,以期为这一相对未被充分探索的领域提供见解。

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Anticoagulation in COVID - 19: An Update.2019冠状病毒病的抗凝治疗:最新进展
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