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一例尽管接受预防性抗凝治疗仍并发静脉血栓栓塞症的新型冠状病毒肺炎病例

A Case of COVID-19 Complicated by Venous Thromboembolism Despite Being on Prophylactic Anticoagulation.

作者信息

Rout Amit, Chan Abigail

机构信息

Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.

出版信息

J Med Cases. 2020 Jul;11(7):189-191. doi: 10.14740/jmc3500. Epub 2020 Jun 18.

Abstract

The coronavirus disease 2019 (COVID-19) presents with variable clinical syndromes, from asymptomatic disease to acute respiratory failure. Complications such as acute respiratory distress syndrome (ARDS), secondary infection, acute cardiac injury, liver failure, renal failure, coagulable disorders and in many cases, death have been recognized. Venous thromboembolism (VTE) was found to be present in up to one-third of critically ill COVID-19 patients. Our case demonstrated a patient with COVID-19 who developed a massive pulmonary embolism leading to cardiac arrest, despite having an initial normal D-dimer level, normal chest imaging, and while maintained on appropriate VTE prophylaxis during hospitalization.

摘要

2019冠状病毒病(COVID-19)表现出多种临床综合征,从无症状感染到急性呼吸衰竭。已认识到诸如急性呼吸窘迫综合征(ARDS)、继发感染、急性心脏损伤、肝衰竭、肾衰竭、凝血障碍等并发症,在许多情况下还会导致死亡。研究发现,高达三分之一的重症COVID-19患者存在静脉血栓栓塞(VTE)。我们的病例显示,一名COVID-19患者发生了大面积肺栓塞,导致心脏骤停,尽管其最初D-二聚体水平正常、胸部影像学检查正常,且在住院期间一直接受适当的VTE预防治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e4/8383626/b60f05a130f6/jmc-11-189-g001.jpg

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