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严重急性呼吸综合征冠状病毒2感染:肺栓塞模式的调节因子

SARS-CoV-2 Infection: Modulator of Pulmonary Embolism Paradigm.

作者信息

Akhter Mohammad Suhail, Hamali Hassan A, Mobarki Abdullah A, Rashid Hina, Oldenburg Johannes, Biswas Arijit

机构信息

Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia.

Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia.

出版信息

J Clin Med. 2021 Mar 4;10(5):1064. doi: 10.3390/jcm10051064.

Abstract

Pulmonary embolism (PE) is a life-threatening complication arising from venous thromboembolism with a difficult diagnosis and treatment and is often associated with increased mortality and morbidity. PE had a significantly low incidence prior to the COVID-19 epidemic. This condition saw a sharp surge during the COVID-19 pandemic, indicating an evident viral influence on PE's pathophysiology in COVID-19 patients. The hypercoagulable state induced by the viral load seems to be the major contributor, and the classical causative factors seem to play a lesser role. PE in COVID-19 infection has become a mammoth challenge since the diagnosis is quite challenging due to overlapping symptoms, lack of prior-known predisposing risk factors, limited resources, and viral transmittance risk. Numerous factors arising out of the viral load or treatment lead to an increased risk for PE in COVID-19 patients, besides the fact that certain unknown risk factors may also contribute to the incidence of PE in COVID-19 patients. The management of PE in COVID-19 infection mainly comprises thromboprophylaxis and anticoagulant therapy with mechanical ventilation, depending on the risk stratification of the patient, with a post-COVID-19 management that prevents recurrent PE and complications. This review aims to discuss various aspects of COVID-19-infection-associated PE and major differential aspects from non-COVID-19 PE.

摘要

肺栓塞(PE)是静脉血栓栓塞引起的一种危及生命的并发症,诊断和治疗困难,且常与死亡率和发病率增加相关。在2019冠状病毒病(COVID-19)疫情之前,PE的发病率极低。在COVID-19大流行期间,这种情况急剧激增,表明病毒对COVID-19患者PE的病理生理学有明显影响。病毒载量诱导的高凝状态似乎是主要因素,而经典的致病因素似乎作用较小。由于症状重叠、缺乏先前已知的易感危险因素、资源有限以及病毒传播风险,COVID-19感染中的PE诊断颇具挑战性,已成为一项巨大挑战。除了某些未知危险因素可能也导致COVID-19患者发生PE外,病毒载量或治疗引发的众多因素也会增加COVID-19患者发生PE的风险。COVID-19感染中PE的管理主要包括根据患者的风险分层进行血栓预防和抗凝治疗以及机械通气,还有COVID-19后的管理以防止复发性PE和并发症。本综述旨在讨论与COVID-19感染相关的PE的各个方面以及与非COVID-19 PE的主要鉴别要点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/488d/7961449/5c1e2624432f/jcm-10-01064-g001.jpg

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