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急性肠系膜缺血与 COVID-19:文献综合回顾。

Acute mesenteric ischemia and COVID-19: an integrative review of the literature.

机构信息

- Centro Universitário Maurício de Nassau - Recife - PE - Brasil.

- Hospital Universitário Oswaldo Cruz - Recife - PE - Brasil.

出版信息

Rev Col Bras Cir. 2023 Mar 10;50:e20233334. doi: 10.1590/0100-6991e-20233334-en. eCollection 2023.

Abstract

The novel coronavirus disease 2019 (COVID-19) has spread rapidly around the world after the first cases were reported in December 2019 in China. Despite the prevention of the symptoms presented, extrapulmonary manifestations were identified. In particular, there was an increase in cases of Acute Mesenteric Ischemia (AMI), raising its incidence to 1.9%-3.8% in infected patients. The aim of this study was to investigate the existence of an association between IMA and COVID-19 through the literature. An Integrative Literature Review was carried out. The research question was "mesenteric ischemia in patients with COVID-19: coincidence or association?". After searching the database and applying the inclusion and exclusion criteria, 44 were selected for analysis. COVID-19 was confirmed by RT-PCR and imaging tests, gastrointestinal manifestations, alterations and primarily tomographic imaging findings were identified. Most patients were accelerated to laparotomy. As explanations include direct endothelial and injury by the binding of the ACE-2 virus, between hyperinflammation and hypercoagulability, dysregulation of the renin-angiotensin-aldosterone system and factors associated with the severity of the virus. IMA is an emergency with high associated morbidity and mortality, these cases may be a consequence mainly of the thromboinflammatory mechanism associated with SARS-CoV-2. An early diagnosis, diagnosis and diagnoses are crucial to clinical treatment; an assessment regime should be considered in accordance with current evidence and guidelines.

摘要

新型冠状病毒病 2019(COVID-19)自 2019 年 12 月在中国首次报告病例以来,已在全球迅速蔓延。尽管预防了出现的症状,但仍发现了肺外表现。特别是急性肠系膜缺血(AMI)的病例有所增加,使感染患者的发病率上升至 1.9%-3.8%。本研究旨在通过文献研究探讨 IMA 与 COVID-19 之间是否存在关联。进行了综合文献回顾。研究问题是“COVID-19 患者的肠系膜缺血:巧合还是关联?”。在搜索数据库并应用纳入和排除标准后,选择了 44 篇进行分析。通过 RT-PCR 和影像学检查确诊 COVID-19,识别出胃肠道表现、改变和主要的断层影像学发现。大多数患者被加速剖腹手术。解释包括直接内皮损伤和 ACE-2 病毒结合、高炎症和高凝状态、肾素-血管紧张素-醛固酮系统失调以及与病毒严重程度相关的因素。IMA 是一种具有高发病率和死亡率的急症,这些病例可能主要是与 SARS-CoV-2 相关的血栓炎症机制的后果。早期诊断、诊断和诊断对临床治疗至关重要;应根据现有证据和指南考虑评估方案。

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