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[新型冠状病毒肺炎疫情期间的急性肺栓塞:诊断与治疗管理]

[Acute pulmonary embolism in times of SARS-CoV-2: Diagnostic and therapeutic management].

作者信息

Scatularo Cristhian E, Farina Juan, Cigalini Ignacio M, Pérez Gonzalo, Wyss Fernando S, Saldarriaga Clara, Baranchuk Adrián

机构信息

Servicio de Cardiología, Sanatorio de la Trinidad de Palermo, Buenos Aires, Argentina.

Servicio de Cardiología, Clínica Olivos, Buenos Aires, Argentina.

出版信息

Arch Cardiol Mex. 2021 Dec 20;91(Suplemento COVID):055-063. doi: 10.24875/ACM.20000251.

Abstract

There is a clear association between novel coronavirus 2 infection and the diagnosis of venous thromboembolic disease, as a cosequence of the development of a systemic inflammatory response syndrome due to the activation of the coagulation cascade. It occurs in 90% of patients with severe forms of the infection, evidencing the presence of pulmonary endovascular micro and macro thrombosis. This suggests a possible clinical benefit of thromboprophylaxis according to the patient’s clinical risk. The suspicion of venous thromboembolic disease in the context of this pandemic represents a diagnostic challenge due to the co-existence of similarities between both conditions in several different aspects. It should be noted that the diagnosis of acute pulmonary embolism does not exclude the possibility of simultaneous viral infection. The evaluation of patients with suspected acute pulmonary embolism in the context of the pandemic should be optimized in order to implement a rapid diagnosis and treatment to reduce the associated morbidity and mortality. This will help reducing infectious risk for health-care professionals and other patients.

摘要

新型冠状病毒2感染与静脉血栓栓塞性疾病的诊断之间存在明确关联,这是由于凝血级联激活导致全身炎症反应综合征发展的结果。它发生在90%的重症感染患者中,表明存在肺血管内微血栓和大血栓。这表明根据患者的临床风险进行血栓预防可能具有临床益处。在此次大流行背景下,对静脉血栓栓塞性疾病的怀疑构成了诊断挑战,因为这两种疾病在几个不同方面存在相似之处。应注意的是,急性肺栓塞的诊断并不排除同时存在病毒感染的可能性。在大流行背景下,对疑似急性肺栓塞患者的评估应进行优化,以便实施快速诊断和治疗,以降低相关的发病率和死亡率。这将有助于降低医护人员和其他患者的感染风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/134a/10161859/8214d21764fa/ACM-91-55-g001.jpg

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