Angiology Division, Heart and Vessels Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Hepatology, Department for Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Switzerland; Hepatology, Department of Biomedical Research, University of Bern, Bern, Switzerland.
Dig Liver Dis. 2021 Aug;53(8):937-949. doi: 10.1016/j.dld.2021.05.021. Epub 2021 May 26.
There is increasing evidence that coronavirus disease 2019 (COVID-19) is associated with a significant risk of venous thromboembolism. While information are mainly available for deep vein thrombosis of the lower limb and pulmonary embolism, scarce data exist regarding acute splanchnic vein thrombosis (SVT) in this setting. PubMed, EMBASE and Google Scholar English-language articles published up to 30 January 2021 on SVT in COVID-19 were searched. Overall, 21 articles reporting equal number of patients were identified. 15 subjects presented with portal vein thrombosis, 11 with mesenteric vein thrombosis, four with splenic vein thrombosis, and two with Budd-Chiari syndrome. Male sex was prevalent (15 patients), and median age was 43 years (range 26-79 years). Three patients had a history of liver disease, while no subject had known myeloproliferative syndrome. Clinical presentation included mainly gastrointestinal symptoms. Anticoagulation was started in 16 patients. Three patients underwent bowel resection. Ten subjects developed gastric or bowel ischemia, seven of whom underwent bowel resection, and four died after SVT diagnosis. Although rare, SVT should be seen as a complication of COVID-19. Patients with severe gastrointestinal symptoms should be screened for SVT, as rapid recognition and correct management are essential to improve the outcome of these patients.
越来越多的证据表明,2019 年冠状病毒病(COVID-19)与静脉血栓栓塞的风险显著相关。虽然主要信息可用于下肢深静脉血栓形成和肺栓塞,但在这种情况下,关于急性内脏静脉血栓形成(SVT)的数据很少。检索了截至 2021 年 1 月 30 日在 COVID-19 中发表的关于 SVT 的 PubMed、EMBASE 和 Google Scholar 英文文章。总体上,确定了 21 篇报道相同数量患者的文章。15 例患者表现为门静脉血栓形成,11 例患者表现为肠系膜静脉血栓形成,4 例患者表现为脾静脉血栓形成,2 例患者表现为布加综合征。男性患者居多(15 例),中位年龄为 43 岁(范围 26-79 岁)。3 例患者有肝病病史,无已知骨髓增生异常综合征患者。临床表现主要为胃肠道症状。16 例患者开始抗凝治疗。3 例患者接受了肠切除术。10 例患者发生胃或肠缺血,其中 7 例接受了肠切除术,4 例在 SVT 诊断后死亡。尽管罕见,但 SVT 应被视为 COVID-19 的并发症。有严重胃肠道症状的患者应筛查 SVT,因为快速识别和正确治疗对于改善这些患者的预后至关重要。