Kyriakoulis Konstantinos G, Kokkinidis Damianos G, Kyprianou Ioanna A, Papanastasiou Christos A, Archontakis-Barakakis Paraschos, Doundoulakis Ioannis, Bakoyiannis Christos, Giannakoulas George, Palaiodimos Leonidas
Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece.
Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, USA.
Phlebology. 2021 Mar;36(2):91-99. doi: 10.1177/0268355520955083. Epub 2020 Sep 10.
Coronavirus disease 2019 (COVID-19) does not only affect the respiratory system but appears to be a systemic disease. Venous thromboembolism is a common manifestation in hospitalized patients with COVID-19 with a reported incidence that is significantly higher compared to other acute viral infections. The pathophysiology mechanisms have not been fully explored and autopsy studies might enhance our understanding on this topic. Microthrombi formation occurs mainly in the pulmonary vasculature but can also occur in other organs. The high inflammatory burden related to COVID-19 seems to be associated with the coexisting coagulopathy. Concomitant manifestations of COVID-19, such as severe pneumonia, which has similar clinical presentation with pulmonary embolism (PE), and barriers related to strict isolation protocols are the two main reasons why PE diagnosis might be more challenging in patients with COVID-19. Medical societies have published guidance reports suggesting the administration of prophylactic anticoagulant therapy in hospitalized patients with COVID-19, but several questions regarding the optimal acute and long-term treatment of these patients remain unanswered.
2019冠状病毒病（COVID-19）不仅影响呼吸系统，似乎还是一种全身性疾病。静脉血栓栓塞是COVID-19住院患者的常见表现，据报道其发病率显著高于其他急性病毒感染。其病理生理机制尚未完全阐明，尸检研究可能会增进我们对这一主题的理解。微血栓形成主要发生在肺血管系统，但也可能发生在其他器官。与COVID-19相关的高炎症负荷似乎与同时存在的凝血病有关。COVID-19的伴随表现，如与肺栓塞（PE）临床表现相似的重症肺炎，以及与严格隔离方案相关的障碍，是COVID-19患者PE诊断可能更具挑战性的两个主要原因。医学协会已发布指导报告，建议对COVID-19住院患者进行预防性抗凝治疗，但关于这些患者最佳急性和长期治疗的几个问题仍未得到解答。
