在COVID-19中出现不适当的抗尿素/低血症综合征
Alessandro Peri1,2, Laura Naldi3, Dario Norello4
1Pituitary Diseases and Sodium Alterations Unit, AOU Careggi, Florence, 50139, Italy. alessandro.peri@unifi.it.
Pituitary
|August 28, 2024
概括
低血症是住院患者的常见问题,影响COVID-19患者的20-40%. 用高血压盐水及时治疗可以改善这些患者的治疗结果.
科学领域:
- 内部医学 内部医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 低血是住院患者中最常见的电解质障碍.
- 它影响了20-40%的SARS-CoV-2 (COVID-19) 感染患者,通常与更差的预后有关.
- 潜在的原因包括不适当的抗尿路综合征 (SIAD),低皮质醇症和器官损伤.
研究的目的:
- 审查COVID-19患者中低血的原因和影响.
- 强调在这个人群中迅速和适当管理低血症的重要性.
主要方法:
- 关于COVID-19中低血症的当前文献的综述.
- 讨论假设的病因,包括IL-6或正压通风的二次性SIAD.
- 对低血量与临床结果相关性的分析.
主要成果:
- 低血是ICU转移,非侵入性通风和COVID-19患者死亡率的独立危险因素.
- 不适当抗尿素综合征 (SIAD) 是主要原因,可能由IL-6等细胞因子触发.
- 其他促成因素包括低皮质醇,恶心,吐和心脏/脏损伤.
结论:
- 在COVID-19患者的低血症往往是急性和有症状的,需要立即治疗.
- 建议的初始疗法是静脉注射高盐水 (3% NaCl),并仔细监测血清水平.
- 有效纠正低血症与COVID-19和其他疾病的改善结果有关.
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