Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, North Carolina, United States.
Thromb Haemost. 2022 Jan;122(1):8-19. doi: 10.1055/a-1562-7599. Epub 2021 Sep 13.
Several viral infectious diseases have emerged or re-emerged from wildlife vectors that have generated serious threats to global health. Increased international travel and commerce increase the risk of transmission of viral or other infectious diseases. In addition, recent climate changes accelerate the potential spread of domestic disease. The coronavirus disease 2019 (COVID-19) pandemic is an important example of the worldwide spread, and the current epidemic will unlikely be the last. Viral hemorrhagic fevers, such as dengue and Lassa fevers, may also have the potential to spread worldwide with a significant impact on public health with unpredictable timing. Based on the important lessons learned from COVID-19, it would be prudent to prepare for future pandemics of life-threatening viral diseases. The key concept that connect COVID-19 and viral hemorrhagic fever is the coagulation disorder. This review focuses on the coagulopathy of acute viral infections since hypercoagulability has been a major challenge in COVID-19, but represents a different presentation compared with viral hemorrhagic fever. However, both thrombosis and hemorrhage are understood as the result of thromboinflammation due to viral infections, and the role of anticoagulation is important to consider.
几种由野生动物传播的病毒性传染病已经出现或再次出现，这对全球健康构成了严重威胁。国际旅行和贸易的增加增加了病毒或其他传染病传播的风险。此外，最近的气候变化加速了国内疾病传播的可能性。2019 年冠状病毒病（COVID-19）大流行是全球传播的一个重要例子，目前的疫情不太可能是最后一次。病毒性出血热，如登革热和拉沙热，也有可能在全球范围内传播，对公共卫生造成重大影响，而且时间难以预测。基于从 COVID-19 中吸取的重要教训，为可能危及生命的病毒性疾病的未来大流行做好准备是明智的。将 COVID-19 和病毒性出血热联系起来的关键概念是凝血障碍。本综述重点关注急性病毒感染的凝血障碍，因为高凝状态一直是 COVID-19 的主要挑战，但与病毒性出血热的表现不同。然而，血栓形成和出血都被理解为病毒感染引起的血栓炎症的结果，因此需要考虑抗凝治疗的作用。
