From the Duke Medical Scientist Training Program, Department of Pharmacology and Cancer Biology and.
Department of Surgery, Duke University School of Medicine, Durham, North Carolina.
A A Pract. 2021 Mar 30;15(4):e01432. doi: 10.1213/XAA.0000000000001432.
The role of concurrent illness in coronavirus disease 2019 (COVID-19) is unknown. Patients with leukemia may display altered thromboinflammatory responses. We report a 53-year-old man presenting with acute leukemia and COVID-19 who developed thrombotic complications and acute respiratory distress syndrome. Multiple analyses, including rotational thromboelastometry and flow cytometry on blood and bronchoalveolar lavage, are reported to characterize coagulation and immune profiles. The patient developed chemotherapy-induced neutropenia that may have protected his lungs from granulocyte-driven hyperinflammatory acute lung injury. However, neutropenia also alters viral clearing, potentially enabling ongoing viral propagation. This case depicts a precarious equilibrium between leukemia and COVID-19.
合并症在 2019 年冠状病毒病（COVID-19）中的作用尚不清楚。患有白血病的患者可能表现出改变的血栓炎症反应。我们报告了一位 53 岁的男性，患有急性白血病和 COVID-19，出现血栓并发症和急性呼吸窘迫综合征。多项分析，包括血液和支气管肺泡灌洗的旋转血栓弹性测定和流式细胞术，用于描述凝血和免疫特征。患者发生了化疗诱导的中性粒细胞减少症，这可能使他的肺部免受粒细胞驱动的过度炎症性急性肺损伤。然而，中性粒细胞减少症也改变了病毒的清除，可能使病毒持续繁殖。该病例描述了白血病和 COVID-19 之间脆弱的平衡。
