1例铁粒幼细胞性贫血患者出现COVID-19相关呼吸衰竭并伴有心包积液。
COVID-19 associated respiratory failure complicating a pericardial effusion in a patient with sideroblastic anemia.
作者信息
Sayad Edouard, Hammoud Mohamad, Khreis Dima, El Shami Maher, Matar Maroun, Farah Roula
机构信息
Gilbert and Rose-Marie Chagoury School of Medicine and LAU Medical Center-Rizk Hospital, Department of Pediatrics, Lebanese American University, Beirut, Lebanon.
American University of Beirut Medical Center, Department of Pediatrics, Beirut, Lebanon.
出版信息
Respir Med Case Rep. 2021;34:101543. doi: 10.1016/j.rmcr.2021.101543. Epub 2021 Nov 6.
BACKGROUND
COVID-19 disease has been associated with several cardiovascular complications that rarely occur in the acute phase of the disease.
CASE REPORT
A 13-year-old pediatric patient with congenital sideroblastic anemia associated with YARS2 mutation presenting with COVID-19 infection and worsening pericardial effusion followed by a respiratory failure refractory to supplemental oxygen therapy leading to cardiac arrest.
DISCUSSION
This case highlights the rapid deterioration that can occur in children with serious hematologic disorders in the context of COVID-19 especially when complicated with pericardial effusion.
CONCLUSION
The importance of pericardiocentesis early in order to allow better ventilation in any significant pericardial effusion case associated with COVID-19 infection and the need for prompt care escalation to centers where ECMO is available.
背景
2019冠状病毒病（COVID-19）已与多种心血管并发症相关，这些并发症在疾病急性期很少发生。
病例报告
一名13岁的儿科患者，患有与YARS2突变相关的先天性铁粒幼细胞贫血，感染COVID-19后出现心包积液恶化，随后出现对补充氧气治疗无效的呼吸衰竭，导致心脏骤停。
讨论
该病例突出了在COVID-19背景下，患有严重血液系统疾病的儿童可能会迅速恶化，尤其是并发心包积液时。
结论
对于任何与COVID-19感染相关的大量心包积液病例，早期进行心包穿刺以实现更好的通气非常重要，并且需要迅速将治疗升级到有体外膜肺氧合（ECMO）设备的中心。
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