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COVID-19 相关肺栓塞:临床、生化和 CT 影像学表现。

COVID-19 associated pulmonary embolism: clinical, biochemical and CT imaging findings.

机构信息

1Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, No. 37, Dionisie Lupu Street, Sector 2, 020021 Bucharest, Romania.

2"Prof. Dr. Matei Bals" National Institute for Infectious Diseases, No. 1, Calistrat Grozovici Street, Sector 2, 021105 Bucharest, Romania.

出版信息

Rom J Intern Med. 2024 Apr 19;62(3):307-322. doi: 10.2478/rjim-2024-0017. Print 2024 Sep 1.

Abstract

INTRODUCTION

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represented a disruptive pathology that emerged in late 2019 with profound implications ranging from individual health to health systems and world economy. Our study aimed to evaluate clinical, biochemical and computerized tomography (CT) parameters values in determining the severity of pulmonary embolism (PE) associated with COVID-19.

METHODS

We performed an observational cohort study evaluating demographic, clinical, biochemical, coagulation markers, as well as CT imaging parameters.

RESULTS

In our study on 186 patients with COVID-19, we found that 31 patients (16,66%) had pulmonary embolism. Significant correlations for the patients with PE were detected in C-reactive protein, lactate dehydrogenase, serum ferritin, IL-6, serum myoglobin, NT-proBNP, D-dimers, serum proteins, transaminases as well as white cell blood counts. Patients with pulmonary embolism had a more severe lung involvement, with thrombi distribution mainly involving the lower lobes.

CONCLUSION

Early identification of PE is an important step for timely and efficient treatment in the intensive care management of COVID-19 patients. Our study showed that high plasmatic values of lactate dehydrogenase, ferritin, IL-6, white blood cells and D-dimers and low proteins serum levels are strongly linked with COVID-19-associated pulmonary embolism.

摘要

简介

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染是一种破坏性的病理学,于 2019 年末出现,对个人健康、医疗体系和世界经济都产生了深远的影响。我们的研究旨在评估与 COVID-19 相关的肺栓塞(PE)的临床、生化和计算机断层扫描(CT)参数值,以确定其严重程度。

方法

我们进行了一项观察性队列研究,评估了人口统计学、临床、生化、凝血标志物以及 CT 影像学参数。

结果

在我们对 186 例 COVID-19 患者的研究中,发现 31 例(16.66%)患者患有肺栓塞。在患有 PE 的患者中,C 反应蛋白、乳酸脱氢酶、血清铁蛋白、IL-6、血清肌红蛋白、NT-proBNP、D-二聚体、血清蛋白、转氨酶以及白细胞计数均存在显著相关性。患有肺栓塞的患者肺部受累更严重,血栓分布主要累及下叶。

结论

早期识别 PE 是 COVID-19 患者在重症监护管理中进行及时、有效的治疗的重要步骤。我们的研究表明,乳酸脱氢酶、铁蛋白、IL-6、白细胞和 D-二聚体的血浆值升高以及血清蛋白水平降低与 COVID-19 相关的肺栓塞密切相关。

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