Division of General Internal Medicine, Department of Medicine, University of Cincinnati School of Medicine, 231 Albert Sabin Way, MSB 6065, Cincinnati, OH 45267, USA.
Division of Cardiology, The Christ Hospital, 2139 Auburn Avenue, Cincinnati, OH 45219, USA.
Crit Care Clin. 2022 Jul;38(3):491-504. doi: 10.1016/j.ccc.2022.03.003. Epub 2022 Mar 25.
Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are prone to venous, cerebrovascular, and coronary thrombi, particularly those with severe coronavirus disease 2019 (COVID-19). The pathogenesis is multifactorial and likely involves proinflammatory cascades, development of coagulopathy, and neutrophil extracellular traps, although further investigations are needed. Elevated levels of D-dimers are common in patients with COVID-19 and cannot be used in isolation to predict venous thromboembolism in people with SARS-CoV-2. If given early in hospital admission, therapeutic-dose heparin improves clinical outcomes in patients with moderate COVID-19. To date, antithrombotics have not improved outcomes in patients with severe COVID-19.
严重急性呼吸综合征冠状病毒 2 （SARS-CoV-2）患者易发生静脉、脑血管和冠状动脉血栓，尤其是那些患有严重 2019 年冠状病毒病（COVID-19）的患者。发病机制是多因素的，可能涉及促炎级联反应、凝血功能障碍和中性粒细胞细胞外陷阱的发展，尽管还需要进一步的研究。COVID-19 患者的 D-二聚体水平升高很常见，不能孤立地用于预测 SARS-CoV-2 患者的静脉血栓栓塞。如果在住院早期给予，治疗剂量的肝素可改善中 COVID-19 患者的临床结局。迄今为止，抗血栓药物并未改善重症 COVID-19 患者的结局。
