Department of Vascular and Endovascular Surgery, Western Vascular Institute, University Hospital Galway, National University of Ireland, Newcastle Road, H91 YR71, Galway, Ireland.
Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
J Thromb Thrombolysis. 2022 Apr;53(3):586-593. doi: 10.1007/s11239-021-02593-2. Epub 2021 Nov 1.
This study aims to review the available literature pertinent to vascular complications in COVID-19. A systematic search was performed using PubMed and Google Scholar to identify all relevant studies based on our study objective. Multiple studies have reported widespread systemic inflammation and procoagulant/hypercoagulable state in COVID-19, including thrombotic microangiopathy, endothelial dysfunction, bleeding disorder, and thrombosis. However, large specialised studies on vascular complications are lacking despite current evidence indicating dysfunctional coagulation pathways. Furthermore, there are no clear and definitive recommendations regarding thromboprophylaxis or full therapeutic anticoagulation in COVID-19. Several studies have reported hypercoagulability and vascular complications as important predictors of patient outcome in COVID-19. Therefore, it is important to understand the pathogenesis, epidemiology, management, and outcomes of patients who develop venous or arterial thrombosis and those with a pre-existing thrombotic disease who contract COVID-19 for risk stratification, thromboprophylaxis, optimal antithrombotic therapy during active infection and long-term anticoagulation following discharge or recovery.
本研究旨在回顾与 COVID-19 相关的血管并发症的现有文献。通过使用 PubMed 和 Google Scholar 进行系统检索，根据我们的研究目的确定了所有相关研究。多项研究报告 COVID-19 中存在广泛的全身炎症和促凝/高凝状态，包括血栓性微血管病、内皮功能障碍、出血障碍和血栓形成。然而，尽管目前的证据表明凝血途径功能失调，但缺乏针对血管并发症的大型专门研究。此外，COVID-19 中没有关于血栓预防或充分的抗凝治疗的明确和明确建议。几项研究报告称，高凝状态和血管并发症是 COVID-19 患者预后的重要预测因素。因此，了解发生静脉或动脉血栓形成的患者以及患有先前存在的血栓性疾病且感染 COVID-19 的患者的发病机制、流行病学、管理和结局，对于风险分层、血栓预防、在活动性感染期间进行最佳抗血栓治疗以及出院或康复后的长期抗凝治疗非常重要。
