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新型冠状病毒肺炎导致双侧肺栓塞及右心室血栓形成:关联还是因果关系?一例病例报告。

COVID-19 resulting in bilateral pulmonary emboli and a right ventricular thrombus: association or causation? A case report.

作者信息

Kaplan Jason G, Kanwal Arjun, Malek Ryan, Dickey John Q, Keirn Richard, Zweig Bryan, Minter David

机构信息

McLaren Oakland/Michigan State Internal Medicine Residency Program, Pontiac, MI, USA.

Medstar Health Internal Medicine Residency Program, Baltimore, MD, USA.

出版信息

Eur Heart J Case Rep. 2020 Oct 2;4(5):1-5. doi: 10.1093/ehjcr/ytaa276. eCollection 2020 Oct.

Abstract

BACKGROUND

SARS-CoV-2 is a novel viral illness originating out of Wuhan China in late 2019. This global pandemic has infected nearly 3 million people and accounted for 200 000 deaths worldwide, with those numbers still climbing.

CASE SUMMARY

We present a 54-year-old patient who developed respiratory failure requiring endotracheal intubation from her infection with SARS-CoV-2. This patient was subsequently found to have a right ventricular thrombus and bilateral pulmonary emboli, likely contributing to her respiratory status. On the 14th day of hospitalization, the patient was successfully extubated, and 5 days later was discharged to the rehabilitation unit.

DISCUSSION

SARS-CoV-2 presents primarily with pulmonary symptoms; however, many patients, particularly those who are severely ill, exhibit adverse events related to hypercoagulability. The exact mechanism explaining this hypercoagulable state has yet to be elucidated, but these thrombotic events have been linked to the increased inflammation caused by SARS-CoV-2. This novel viral illness is still largely misunderstood, but the hypercoagulable state, seen in severely ill patients, appears to play a major role in disease progression and prognosis.

摘要

背景

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是2019年末起源于中国武汉的一种新型病毒性疾病。这场全球大流行已感染近300万人,全球死亡人数达20万,且这些数字仍在攀升。

病例摘要

我们报告一名54岁患者,因感染SARS-CoV-2出现呼吸衰竭,需要进行气管插管。该患者随后被发现有右心室血栓和双侧肺栓塞,这可能导致了她的呼吸状况。住院第14天,患者成功拔管,5天后出院至康复科。

讨论

SARS-CoV-2主要表现为肺部症状;然而,许多患者,尤其是重症患者,会出现与高凝状态相关的不良事件。解释这种高凝状态的确切机制尚未阐明,但这些血栓形成事件与SARS-CoV-2引起的炎症增加有关。这种新型病毒性疾病在很大程度上仍未被充分理解,但在重症患者中出现的高凝状态似乎在疾病进展和预后中起主要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09be/7649511/eca5cd825e20/ytaa276f1.jpg

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