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2019冠状病毒病对止血的影响:凝血异常及管理观点

Impacts of COVID-19 on hemostasis: coagulation abnormalities and management perspectives.

作者信息

Obeagu Emmanuel Ifeanyi, Tukur Muhammad, Akaba Kingsley

机构信息

Department of Medical Laboratory Science.

Department of Science Education, Faculty of Education, Kampala International University, Kampala, Uganda.

出版信息

Ann Med Surg (Lond). 2024 Jul 2;86(10):5844-5850. doi: 10.1097/MS9.0000000000002237. eCollection 2024 Oct.

Abstract

The COVID-19 pandemic caused by SARS-CoV-2 has transcended its initial characterization as a respiratory illness, revealing substantial implications for hemostasis and coagulation pathways. COVID-19-associated coagulopathies have emerged as critical determinants of disease severity and prognosis, presenting a multifaceted challenge in clinical management. This paper aims to elucidate the intricate interplay between COVID-19 and hemostasis, delving into the underlying mechanisms of coagulation abnormalities, exploring the spectrum of thrombotic complications, and discussing evolving management strategies. Therapeutic interventions and anticoagulation strategies tailored for managing COVID-19-related coagulopathies form a significant focus, encompassing prophylactic and therapeutic approaches, heparin-based therapies, and individualized treatment paradigms. This paper underscores the imperative for ongoing research endeavors to refine diagnostic modalities, identify novel therapeutic targets, and ascertain long-term sequelae of COVID-19-induced coagulation abnormalities. Ultimately, a comprehensive understanding of the intricate relationship between COVID-19 and hemostasis is pivotal in devising effective management strategies to mitigate thrombotic risks, improve clinical outcomes, and pave the way for tailored interventions in affected individuals.

摘要

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)大流行已超越其最初作为一种呼吸道疾病的特征,揭示了其对止血和凝血途径的重大影响。与COVID-19相关的凝血病已成为疾病严重程度和预后的关键决定因素,在临床管理中提出了多方面的挑战。本文旨在阐明COVID-19与止血之间的复杂相互作用,深入探讨凝血异常的潜在机制,探索血栓形成并发症的范围,并讨论不断演变的管理策略。针对管理与COVID-19相关的凝血病的治疗干预措施和抗凝策略是一个重要重点,包括预防性和治疗性方法、基于肝素的疗法以及个体化治疗模式。本文强调持续研究努力的必要性,以完善诊断方式、确定新的治疗靶点并确定COVID-19诱导的凝血异常的长期后遗症。最终,全面了解COVID-19与止血之间的复杂关系对于制定有效的管理策略以降低血栓形成风险、改善临床结局并为受影响个体的个体化干预铺平道路至关重要。

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