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刚果一名镰状细胞病婴儿感染严重急性呼吸综合征冠状病毒 2 后并发深静脉血栓形成和急性心包炎:病例报告。

Deep venous thrombosis and acute pericarditis associated with severe acute respiratory syndrome coronavirus 2 infection in a Congolese infant with sickle cell disease: a case report.

机构信息

Department of Pediatrics, University of Lubumbashi, Lubumbashi, Democratic Republic of the Congo.

Department of Pediatrics, CMDC Clinic, Lubumbashi, Democratic Republic of the Congo.

出版信息

J Med Case Rep. 2022 Aug 10;16(1):307. doi: 10.1186/s13256-022-03459-8.

Abstract

BACKGROUND

Since the beginning of the pandemic, no severe pediatric coronavirus disease 2019 cases have been described in Congo.

CASE

We studied a 3-month-old male child of Congolese origin who was admitted to the pediatric department with 7-day history of fever, unilateral lower leg swelling, and dyspnea. There was no known history of contact with a coronavirus disease 2019 patient, and all the family members were asymptomatic. Nasopharyngeal swabs done at admission did not detect severe acute respiratory syndrome coronavirus 2. However, serology tests for severe acute respiratory syndrome coronavirus 2 antibodies were positive for immunoglobulin M and negative for immunoglobulin G. Hemoglobin electrophoresis showed hemoglobin A1, hemoglobin A2, hemoglobin F, and hemoglobin S of 46.2%, 2.5%, 19.9%, and 38.4%, respectively. Chest X-ray showed retrocardiac pneumonia in the left lung, and Doppler ultrasound of the left lower limb showed a recent total femoropopliteal venous thrombosis. At day 10 of hospitalization, our patient had classical signs of cardiac tamponade with a voluminous pericardial effusion seen on echocardiographic examination and elevated C-reactive protein, compatible with a diagnosis of constrictive pericarditis. To the best of the authors' knowledge, this is the first report of a case of plausible severe acute respiratory syndrome coronavirus 2 infection associated with venous thrombosis and acute pericarditis in Congo.

CONCLUSION

We hypothesized that this case of venous thrombosis and acute pericarditis in a Congolese child with heterozygous sickle cell disease was related to severe acute respiratory syndrome coronavirus 2 infection.

摘要

背景

自疫情开始以来,刚果尚未出现严重的小儿 2019 年冠状病毒病病例。

病例

我们研究了一名 3 个月大的男性刚果儿童,他因发热、单侧小腿肿胀和呼吸困难入院,病程为 7 天。他没有与 2019 年冠状病毒病患者接触的已知病史,且所有家庭成员均无症状。入院时进行的鼻咽拭子未检测到严重急性呼吸综合征冠状病毒 2。然而,严重急性呼吸综合征冠状病毒 2 抗体的血清学检测结果为免疫球蛋白 M 阳性,免疫球蛋白 G 阴性。血红蛋白电泳显示血红蛋白 A1、血红蛋白 A2、血红蛋白 F 和血红蛋白 S 分别为 46.2%、2.5%、19.9%和 38.4%。胸部 X 线显示左肺心后肺炎,左下肢多普勒超声显示新近发生的全股腘静脉血栓形成。住院第 10 天,我们的患者出现典型的心包填塞体征,超声心动图检查可见大量心包积液,C 反应蛋白升高,符合缩窄性心包炎的诊断。据作者所知,这是刚果首例疑似严重急性呼吸综合征冠状病毒 2 感染合并静脉血栓形成和急性心包炎的病例。

结论

我们假设,这名患有杂合子镰状细胞病的刚果儿童发生静脉血栓形成和急性心包炎与严重急性呼吸综合征冠状病毒 2 感染有关。

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本文引用的文献

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Sickle cell disease and COVID-19: Susceptibility and severity.镰状细胞病与2019冠状病毒病:易感性与严重程度
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COVID-19 and sickle cell disease in Bahrain.巴林的 COVID-19 和镰状细胞病。
Int J Infect Dis. 2020 Dec;101:14-16. doi: 10.1016/j.ijid.2020.09.1433. Epub 2020 Sep 24.
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