J Emerg Nurs. 2022 Jul;48(4):348-365. doi: 10.1016/j.jen.2022.05.002. Epub 2022 May 13.
Immunoglobulin A vasculitis is historically more commonly found in children after certain viral infections such as Epstein-Barr, varicella virus, and parvovirus B19. COVID-19 has not been formally established in literature as a trigger for immunoglobulin A vasculitis. However, a main pathogenetic mechanism of COVID-19 is vascular damage, which makes it likely that vasculitis associated with COVID-19 (ie, COVID-19-mediated immunoglobulin A vasculitis) could be biologically plausible, with serious implications, especially for adults. The purpose of this review is to assist emergency nurses in gaining knowledge on the pathophysiology, symptoms, and treatment of COVID-19-mediated immunoglobulin A vasculitis.
A systematic search for case reports of COVID-19-associated immunoglobulin A vasculitis was conducted in the PubMed and Scopus electronic databases. The search terms used were COVID-19, coronavirus 2019, SARS COVID-19, and IgA vasculitis, case reports. The following were the inclusion criteria: publication dates between December 1, 2019, and December 1, 2021; full-text article, clinical case studies, and letters to the editor available electronically in English. The following were exclusion criteria: a summary of reports and newspaper publications.
Only 13 clinical cases met the inclusion criteria. The median age of patients described in the case reports were 38.1 years. Of them, 3 children were less than 5 years old. Twelve patients were male. In 7 of 13 cases of immunoglobulin A vasculitis, renal involvement was found.
The analysis of published clinical cases showed that COVID-19-associated immunoglobulin A vasculitis affected mostly adults and was characterized by a more severe course because of renal involvement. COVID-19 may be a possible trigger for immunoglobulin A-related disorders. More research is needed to better understand the relationship between immunoglobulin A vasculitis and COVID-19.
免疫球蛋白 A 血管炎在历史上更常见于某些病毒感染（如 EBV、水痘病毒和细小病毒 B19）后的儿童。COVID-19 在文献中尚未被正式确定为免疫球蛋白 A 血管炎的诱因。然而，COVID-19 的主要发病机制是血管损伤，这使得 COVID-19 相关的血管炎（即 COVID-19 介导的免疫球蛋白 A 血管炎）可能具有生物学上的合理性，并具有严重影响，尤其是对成年人。本综述的目的是帮助急诊护士了解 COVID-19 介导的免疫球蛋白 A 血管炎的病理生理学、症状和治疗方法。
在 PubMed 和 Scopus 电子数据库中对 COVID-19 相关免疫球蛋白 A 血管炎的病例报告进行了系统检索。使用的检索词包括 COVID-19、冠状病毒 2019、SARS COVID-19 和 IgA 血管炎、病例报告。纳入标准为：2019 年 12 月 1 日至 2021 年 12 月 1 日发表的日期；全文文章、临床病例研究和可在电子方式获得的社论；排除标准：报告摘要和报纸出版物。
仅有 13 例临床病例符合纳入标准。病例报告中描述的患者的中位年龄为 38.1 岁。其中 3 例儿童小于 5 岁。12 例患者为男性。在 13 例免疫球蛋白 A 血管炎中，有 7 例发现肾脏受累。
对已发表的临床病例的分析表明，COVID-19 相关免疫球蛋白 A 血管炎主要影响成年人，且由于肾脏受累，其病程更为严重。COVID-19 可能是免疫球蛋白 A 相关疾病的一个可能诱因。需要进一步研究以更好地了解免疫球蛋白 A 血管炎与 COVID-19 之间的关系。
