Department of Infectious Epidemiology and Surveillance, National Institute of Public Health NIH - National Research Institute.
7 Naval Hospital with SP ZOZ Clinic in Gdańsk.
Przegl Epidemiol. 2023;77(2):172-184. doi: 10.32394/pe.77.17.
COVID-19 is a disease caused by the SARS-CoV-2 virus, which, after entering a living organism, uses the ACE-2 protein as a receptor and several other proteins as cofactors of infection. Disease symptomatology is extensive, involving mostly predominant respiratory symptoms, as well as those of the nervous, gastrointestinal, circulatory and other systems. Incidence of COVID-19 also results in markedly different laboratory findings on the hemostatic system with the predominant feature of increased D-dimer levels. In the pathogenesis of thromboembolic complications in COVID-19, all elements of Virchow's triad are involved: endothelial damage, coagulation disorders and blood flow disorders. Coagulopathy increases with the severity of the clinical course of COVID-19. One of the causes of mortality associated with COVID-19 is pulmonary embolism. SARS-CoV-2 infection increases the risk of thromboembolic complications not only in the acute period of the disease. Also in the period of about a month after recovery, there is an increased risk of venous thrombosis and consequently, life-threatening pulmonary embolism. The classic biomarker of pulmonary embolism in the general population is D-dimers. Among imaging studies, the gold standard for diagnosing this disease is computed tomography of the pulmonary arteries (CTPA). Other useful diagnostic tests are ventilation-perfusion lung scintigraphy (VQ Scans) or echocardiography. Currently reviewed guidelines and recommendations recommend extens ive thromboprophylaxis in COVID-19 patients in both acute and chronic phases of the disease. Keywords: COVID-19, pulmonary embolism, laboratory and imaging diagnostics, thromboprophylaxis.
新型冠状病毒肺炎(COVID-19)是由严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)引起的疾病,该病毒进入活细胞后,利用血管紧张素转换酶 2(ACE-2)蛋白作为受体,并利用几种其他蛋白作为感染的辅助因子。疾病的临床症状广泛,主要表现为呼吸道症状,以及神经系统、胃肠道、循环系统等其他系统的症状。COVID-19 的发病还会导致止血系统出现明显不同的实验室发现,其主要特征是 D-二聚体水平升高。在 COVID-19 的血栓栓塞并发症发病机制中,涉及到 Virchow 三联征的所有要素:内皮损伤、凝血障碍和血流紊乱。凝血功能障碍随着 COVID-19 临床病程的严重程度而增加。与 COVID-19 相关的死亡原因之一是肺栓塞。SARS-CoV-2 感染不仅在疾病的急性期增加了血栓栓塞并发症的风险。在疾病恢复后的大约一个月内,静脉血栓形成的风险也会增加,进而导致危及生命的肺栓塞。在普通人群中,肺栓塞的经典生物标志物是 D-二聚体。在影像学研究中,诊断该病的金标准是肺动脉计算机断层摄影术(CTPA)。其他有用的诊断测试是通气灌注肺闪烁显像(VQ 扫描)或超声心动图。目前审查的指南和建议建议在 COVID-19 患者的急性和慢性阶段进行广泛的血栓预防。
COVID-19,肺栓塞,实验室和影像学诊断,血栓预防。