不要忘记新冠病毒肺炎患者的动脉血栓形成：病例系列
Don't forget arterial thrombosis in patients with COVID-19: A case series.
作者信息
Gold Daniel D, Kurd Ramzi, Einav Sharon
机构信息
Emergency Department, Shaare Zedek Medical Center and Hebrew University, Faculty of Medicine, Jerusalem, Israel.
Department of Internal Medicine, Shaare Zedek Medical Center and Hebrew University, Faculty of Medicine, Jerusalem, Israel.
出版信息
Thromb Update. 2021 Dec;5:100065. doi: 10.1016/j.tru.2021.100065. Epub 2021 Aug 4.
INTRODUCTION
The acute disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS COV-2) is accompanied by a hypercoagulable state. Multiple publications have described the venous thromboembolic events associated with coronavirus disease 2019 (COVID-19) but arterial thromboembolic events have yet to be described.
CASES DESCRIPTION
We describe five COVID-19 patients that developed severe morbidity as a result of occlusive arterial thromboembolic events occurring despite treatment with low molecular weight heparin. All cases presented with an acute confusional state and were accompanied by rapid elevations of lactate and D-dimers and leukocytes. The end organs involved were the kidneys, spleen, liver, lungs, central nervous system, intestines and limbs. Only one of the five patients survived.
CONCLUSION
COVID-19 is associated with not only venous but also arterial thromboembolic events. Further research is required to clarify the incidence, causes and possible modes of prevention of this potentially lethal disease complication.
引言
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的急性疾病伴有高凝状态。多篇文献描述了与2019冠状病毒病（COVID-19）相关的静脉血栓栓塞事件，但动脉血栓栓塞事件尚未见报道。
病例描述
我们描述了5例COVID-19患者，尽管接受了低分子量肝素治疗，但仍因闭塞性动脉血栓栓塞事件而出现严重发病情况。所有病例均表现为急性意识模糊状态，并伴有乳酸、D-二聚体和白细胞迅速升高。受累的终末器官包括肾脏、脾脏、肝脏、肺、中枢神经系统、肠道和四肢。5例患者中仅1例存活。
结论
COVID-19不仅与静脉血栓栓塞事件有关，还与动脉血栓栓塞事件有关。需要进一步研究以阐明这种潜在致命性疾病并发症的发生率、病因和可能的预防方式。
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