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与血液学异常相关的新型冠状病毒2型(SARS-CoV-2)的病理效应

Pathological Effects of SARS-CoV-2 Associated with Hematological Abnormalities.

作者信息

Mahmood Asif, Mehmood Shahid, Zhang Wen

机构信息

Department of Microbiology, School of Medicine, Jiangsu University, Zhenjiang 212013, China.

School of Material Science and Engineering, Jiangsu University, Zhenjiang 212013, China.

出版信息

Curr Issues Mol Biol. 2023 Aug 28;45(9):7161-7182. doi: 10.3390/cimb45090453.

Abstract

The SARS coronavirus 2 (SARS-CoV-2) is the causative agent of the 2019 coronavirus disease (COVID-19) pandemic that has claimed the lives of 6.9 million people and infected over 765 million. It has become a major worldwide health problem and is also known to cause abnormalities in various systems, including the hematologic system. COVID-19 infection primarily affects the lower respiratory tract and can lead to a cascade of events, including a cytokine storm, intravascular thrombosis, and subsequent complications such as arterial and venous thromboses. COVID-19 can cause thrombocytopenia, lymphopenia, and neutrophilia, which are associated with worse outcomes. Prophylactic anticoagulation is essential to prevent complications and death rates associated with the virus's effect on the coagulation system. It is crucial to recognize these complications early and promptly start therapeutic anticoagulation to improve patient outcomes. While rare, COVID-19-induced disseminated intravascular coagulation (DIC) exhibits some similarities to DIC induced by sepsis. Lactate dehydrogenase (LDH), D-dimer, ferritin, and C-reactive protein (CRP) biomarkers often increase in serious COVID-19 cases and poor prognosis. Understanding the pathophysiology of the disease and identifying risk factors for adverse outcomes is critical for effective management of COVID-19.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是2019冠状病毒病(COVID-19)大流行的病原体,该大流行已导致690万人死亡,感染人数超过7.65亿。它已成为一个主要的全球健康问题,并且已知会导致包括血液系统在内的各种系统出现异常。COVID-19感染主要影响下呼吸道,并可引发一系列事件,包括细胞因子风暴、血管内血栓形成以及随后的并发症,如动脉和静脉血栓形成。COVID-19可导致血小板减少、淋巴细胞减少和中性粒细胞增多,这些与更差的预后相关。预防性抗凝对于预防与病毒对凝血系统的影响相关的并发症和死亡率至关重要。早期识别这些并发症并及时开始治疗性抗凝以改善患者预后至关重要。虽然罕见,但COVID-19诱导的弥散性血管内凝血(DIC)与脓毒症诱导的DIC有一些相似之处。在严重的COVID-19病例和预后不良的情况下,乳酸脱氢酶(LDH)、D-二聚体、铁蛋白和C反应蛋白(CRP)生物标志物通常会升高。了解该疾病的病理生理学并识别不良结局的危险因素对于COVID-19的有效管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43be/10528388/7c821221c7ce/cimb-45-00453-g001.jpg

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