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COVID-19 的血液学表现和并发症。

Hematological manifestations and complications of COVID-19.

机构信息

Department of Internal Medicine, Brookdale University Hospital and Medical Center, New York, USA.

Department of Hematology and Oncology, Brookdale University Hospital and Medical Center, New York, USA.

出版信息

Adv Clin Exp Med. 2021 Jan;30(1):101-107. doi: 10.17219/acem/130604.

Abstract

The virus SARS-CoV-2 commonly causes self-resolving, flu-like illnesses in the majority of patients, but a critical illness can be seen in 5% of cases - especially in the elderly population or in patients with multiple comorbidities. When COVID-19 is severe, it can cause pneumonia and hypoxemic respiratory failure, and can progress to viremia involving multiple organ systems. It causes significant cytopenia, mainly severe lymphopenia, and excessive exhaustion of CD8+ T cells, resulting in an immunocompromised state and cytokine storm. Furthermore, COVID-19 can commonly be complicated with acute thrombotic events, including venous thromboembolism, acute stroke, acute myocardial infarction, clotting of hemodialysis and extracorporeal membrane oxygenation (ECMO) catheters, and acute limb ischemia. This makes SARS-COV-2 a unique virus with an undiscovered pathophysiology. Therefore, patients with COVID-19 need close monitoring of their symptoms and laboratory parameters, and early hospitalization and treatment in severe cases. Early identification of severe cases and the abovementioned complications of COVID-19 could decrease the morbidity and mortality caused by the disease. In the study, we summarize what is currently known about the hematological manifestations and complications of COVID-19.

摘要

病毒 SARS-CoV-2 通常在大多数患者中引起自限性、类似流感的疾病,但在 5%的病例中可出现重症疾病 - 特别是在老年人群体或患有多种合并症的患者中。当 COVID-19 严重时,它可引起肺炎和低氧性呼吸衰竭,并可进展为涉及多个器官系统的病毒血症。它会导致明显的细胞减少症,主要是严重的淋巴细胞减少症和 CD8+T 细胞过度耗竭,导致免疫功能低下和细胞因子风暴。此外,COVID-19 通常可并发急性血栓事件,包括静脉血栓栓塞、急性中风、急性心肌梗死、血液透析和体外膜氧合 (ECMO) 导管的凝血以及急性肢体缺血。这使得 SARS-CoV-2 成为一种具有未知病理生理学的独特病毒。因此,COVID-19 患者需要密切监测其症状和实验室参数,并在重症病例中及早住院和治疗。早期识别重症病例和 COVID-19 的上述并发症可降低该疾病的发病率和死亡率。在本研究中,我们总结了目前已知的 COVID-19 的血液学表现和并发症。

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