Mene-Afejuku Tuoyo O, Jeyashanmugaraja Gini P, Akinlonu Adedoyin A, Osman Mohammed, Hoq Mahfuz
Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA.
Internal Medicine, Yale New Haven Health System/Bridgeport Hospital, Bridgeport, USA.
Cureus. 2020 Dec 26;12(12):e12295. doi: 10.7759/cureus.12295.
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) which results in coronavirus disease 2019 (COVID-19) has had a devastating impact globally. Not much is fully understood about this disease. Acute respiratory distress syndrome (ARDS) appears to be the commonest complication among patients with COVID-19. However, venous thromboembolism (VTE) appears to be a common complication among patients with COVID-19 even with adequate anticoagulation during hospitalization. VTE may confer a poor outcome on its own or may exacerbate other common complications such as ARDS or cardiac injury. There are several diagnostic dilemmas with regards confirming VTE among patients with COVID-19 as there is a move to reduce the transfer of patients for angiographic studies or even venous Doppler ultrasonography because of the high transmissibility SARS-CoV-2. There is also the risk of worsening ARDS following fluid administration to prevent contrast nephropathy after angiographic studies. It is, therefore, crucial to understand the timing of VTE occurrence in the setting of COVID-19, identify strategies for early diagnosis of VTE, therapeutic options as well as prognostic implications of VTE in the setting of COVID-19.
导致2019冠状病毒病（COVID-19）的新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在全球造成了毁灭性影响。人们对这种疾病的了解还很有限。急性呼吸窘迫综合征（ARDS）似乎是COVID-19患者中最常见的并发症。然而，即使在住院期间进行了充分的抗凝治疗，静脉血栓栓塞（VTE）似乎也是COVID-19患者中的常见并发症。VTE本身可能导致不良后果，或可能加重其他常见并发症，如ARDS或心脏损伤。在确诊COVID-19患者的VTE方面存在一些诊断难题，因为由于SARS-CoV-2的高传播性，目前倾向于减少患者进行血管造影研究甚至静脉多普勒超声检查的转运。在血管造影研究后为预防造影剂肾病而进行补液时，也存在ARDS恶化的风险。因此，了解COVID-19背景下VTE发生的时间、确定VTE的早期诊断策略、治疗选择以及VTE在COVID-19背景下的预后意义至关重要。
