COVID-19和长期COVID血栓症:从临床和基础科学到治疗学
Francesco Violi1,2, Job Harenberg3, Pasquale Pignatelli1,2
1Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
Thrombosis and haemostasis
|November 15, 2023
概括
冠状病毒传染病-19 (COVID-19) 在急性和长期阶段都会导致危险的血栓. 了解这些血栓事件对于开发更好的治疗方法来改善患者的治疗结果至关重要.
科学领域:
- 心血管医学 心血管医学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 冠状病毒传染病-19 (COVID-19) 是一种流行病,与严重的肺部疾病和高发生率的血栓事件有关.
- 血栓形成,影响静脉和动脉循环,在需要重症监护的严重COVID-19病例中更为普遍,并且与血小板和凝固系统的激活有关.
- 长期的COVID-19,后急性感染后续,也可以表现为反复发生的血栓事件,表明持续的风险.
研究的目的:
- 阐明急性和长期COVID-19中血栓形成背后的机制.
- 审查当前治疗策略,以管理COVID-19患者的血栓事件.
- 确定对急性和长期COVID-19中血栓形成的优化治疗方法的需求.
主要方法:
- 审查有关COVID-19和血栓事件的现有文献.
- 分析涉及血管酶转化酶2和细胞因子风暴的拟议机制.
- 对抗凝血剂和抗血小板疗法的疗效的评估.
主要成果:
- COVID-19中的血栓形成涉及影响内皮细胞,白细胞和血小板的复杂相互作用,导致凝固激活.
- 抗凝固药疗法在急性COVID-19中显示出好处,但仍然存在残留风险,需要进一步调查最佳剂量.
- 初步数据表明,抗血小板治疗可能对长期的COVID-19有益,但患者选择用于血栓性预防的情况尚不清楚.
结论:
- 在COVID-19中血栓形成的机制是多方面的,涉及病毒相互作用和宿主炎症反应.
- 虽然抗凝剂在急性COVID-19中是有益的,但残留的血栓形成风险凸显了需要精细治疗策略的需要.
- 需要进一步的研究来确定长期COVID-19中血栓事件的最佳预防和治疗方法.
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