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新冠病毒检测呈阳性患者的缺血性中风:面向神经介入医生的新冠病毒2型及血栓形成机制概述

Ischemic stroke in COVID-19-positive patients: an overview of SARS-CoV-2 and thrombotic mechanisms for the neurointerventionalist.

作者信息

Zakeri Amanda, Jadhav Ashutosh P, Sullenger Bruce A, Nimjee Shahid M

机构信息

Neurosurgery, The Ohio State University Medical Center, Columbus, Ohio, USA.

Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.

出版信息

J Neurointerv Surg. 2021 Mar;13(3):202-206. doi: 10.1136/neurintsurg-2020-016794. Epub 2020 Dec 9.

Abstract

Coronavirus disease 2019 (COVID-19) results from infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first reported in Wuhan, China in patients suffering from severe pneumonia and acute respiratory distress syndrome and has now grown into the first pandemic in over 100 years. Patients infected with SARS-CoV-2 develop arterial thrombosis including stroke, myocardial infarction and peripheral arterial thrombosis, all of which result in poor outcomes despite maximal medical, endovascular, and microsurgical treatment compared with non-COVID-19-infected patients. In this review we provide a brief overview of SARS-CoV-2, the infectious agent responsible for the COVID-19 pandemic, and describe the mechanisms responsible for COVID-19-associated coagulopathy. Finally, we discuss the impact of COVID-19 on ischemic stroke, focusing on large vessel occlusion.

摘要

2019冠状病毒病(COVID-19)由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染所致。该病最初在中国武汉被报告,患者表现为重症肺炎和急性呼吸窘迫综合征,现已演变成100多年来的首次大流行。与未感染COVID-19的患者相比,感染SARS-CoV-2的患者会发生动脉血栓形成,包括中风、心肌梗死和外周动脉血栓形成,尽管采取了最大程度的药物、血管内和显微外科治疗,所有这些情况的预后都很差。在本综述中,我们简要概述了导致COVID-19大流行的病原体SARS-CoV-2,并描述了与COVID-19相关凝血病的发病机制。最后,我们讨论COVID-19对缺血性中风的影响,重点关注大血管闭塞。

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