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一名新冠肺炎患者出现播散性血栓形成和心脏缺血的病例报告。

A Case Report of Disseminated Thromboses and Cardiac Ischemia in a Patient With COVID-19 Pneumonia.

作者信息

Guevara Nehemias A, Rakovica Loran, Pleitez Hector, Flores Chang Marjorie Mailing, Pino-Domenech Eduardo, Fulger Ilmana

机构信息

Internal Medicine, St. Barnabas Medical Center, Bronx, USA.

Internal Medicine, St. Barnabas Hospital Health System, Bronx, USA.

出版信息

Cureus. 2023 Jun 4;15(6):e39942. doi: 10.7759/cureus.39942. eCollection 2023 Jun.

DOI:10.7759/cureus.39942
PMID:37409207
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10319424/
Abstract

The novel coronavirus disease (COVID-19) pandemic caused by the SARS-CoV-2 virus started in December 2019 in the city of Wuhan, in China's Hubei province. This virus quickly spread worldwide, and on March 11, 2020, it was declared a pandemic. Thrombosis, as a hallmark of severe disease, was recognized early as a cause of death; however, the exact pathophysiological mechanism is still not fully understood. We are reporting the case of a 46-year-old patient who presented with multiple arterial thromboses in the setting of an acute COVID-19 infection requiring systemic thrombolytic therapy and thrombectomy.

摘要

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的新型冠状病毒病(COVID-19)大流行于2019年12月在中国湖北省武汉市爆发。这种病毒迅速在全球传播,并于2020年3月11日被宣布为大流行。血栓形成作为重症疾病的一个标志,很早就被确认为死亡原因;然而,确切的病理生理机制仍未完全明确。我们报告一例46岁患者,在急性COVID-19感染背景下出现多处动脉血栓形成,需要进行全身溶栓治疗和血栓切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/357b/10319424/f554d57a146f/cureus-0015-00000039942-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/357b/10319424/e961c247b873/cureus-0015-00000039942-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/357b/10319424/f554d57a146f/cureus-0015-00000039942-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/357b/10319424/e961c247b873/cureus-0015-00000039942-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/357b/10319424/f554d57a146f/cureus-0015-00000039942-i03.jpg

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本文引用的文献

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Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales.新型冠状病毒肺炎与主要动静脉血栓性疾病的相关性:一项针对英格兰和威尔士 4800 万成年人的基于人群的队列研究。
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Thromboembolic prevention and anticoagulant therapy during the COVID-19 pandemic: updated clinical guidance from the anticoagulation forum.COVID-19 大流行期间的血栓栓塞预防和抗凝治疗:抗凝论坛的最新临床指南。
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Lancet Infect Dis. 2022 Aug;22(8):1142-1152. doi: 10.1016/S1473-3099(22)00223-7. Epub 2022 May 13.
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Risk of arterial and venous thromboses after COVID-19.新冠病毒感染后动脉和静脉血栓形成的风险
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Thromb J. 2021 Dec 20;19(1):104. doi: 10.1186/s12959-021-00357-9.
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Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial.抗栓治疗对临床稳定有症状的 COVID-19 门诊患者临床结局的影响:ACTIV-4B 随机临床试验。
JAMA. 2021 Nov 2;326(17):1703-1712. doi: 10.1001/jama.2021.17272.
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Cardiovascular disease and COVID-19: a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA).心血管疾病与 COVID-19:ESC 冠状动脉病理生理学和微循环工作组、ESC 血栓形成工作组以及急性心血管护理协会(ACVC)与欧洲心律协会(EHRA)合作的共识文件。
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