William Harvey Hospital, UK.
William Harvey Hospital, UK.
Int J Infect Dis. 2021 Mar;104:568-571. doi: 10.1016/j.ijid.2021.01.040. Epub 2021 Jan 21.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2), a novel coronavirus, originated as an epidemic respiratory illness in Wuhan, China. COVID-19 eventually spread to almost all countries and has now been declared a global pandemic disease by the World Health Organisation. A plethora of research has explored the dynamics of different clinical entities related to SARS-COV-2, in particular, COVID-19 associated coagulopathy. A large scale of patients have been reported to have developed pulmonary embolism without any other standard triggers or risk factors, leading to speculation that COVID-19 is an independent risk factor for venous thromboembolism. In addition to the development of thromboembolic complications such as pulmonary embolism, COVID-19 has also been reported to have triggered disseminated intravascular coagulation (DIC); however, it is unclear whether pulmonary embolism was due to COVID-19-induced thrombosis or a result of coagulopathy secondary to DIC. We describe a unique case of a COVID-19 associated coagulopathy in a patient with confirmed pulmonary embolism along with an overt DIC. Following diagnosis, the challenge was to identify the appropriate treatment modality for this unique situation. The patient was treated with anticoagulants and steroids along with blood products. The patient's condition markedly improved and was clinically stable on discharge.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)是一种新型冠状病毒,最初在中国武汉爆发为一种流行的呼吸道疾病。COVID-19 最终传播到几乎所有国家,并已被世界卫生组织宣布为全球大流行疾病。大量研究探讨了与 SARS-CoV-2 相关的不同临床实体的动态,特别是与 COVID-19 相关的凝血障碍。大量报告显示,许多患者在没有任何其他标准诱因或危险因素的情况下发生了肺栓塞,这导致人们推测 COVID-19 是静脉血栓栓塞的独立危险因素。除了发生血栓栓塞并发症(如肺栓塞)外,COVID-19 还被报道引发弥漫性血管内凝血(DIC);然而,尚不清楚肺栓塞是由于 COVID-19 引起的血栓形成还是由于 DIC 引起的凝血障碍所致。我们描述了一例 COVID-19 相关凝血障碍合并明确肺栓塞的独特病例。在明确诊断后,挑战在于确定这种特殊情况下的适当治疗方式。该患者接受了抗凝药物和类固醇以及血液制品治疗。患者的病情显著改善,出院时临床情况稳定。