在COVID-19大流行期间新发的补充介导性血栓微血管病变
Christof Aigner1, Martina Gaggl1, Sophie Schmidt1
1Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Kidney & blood pressure research
|October 22, 2024
概括
在易受感染的个体中,COVID-19感染和SARS-CoV-2疫苗接种可能会引发非典型的血溶性尿素性综合征 (aHUS) 或补充介导的血栓性微血管病变 (cTMA). COVID-19似乎是一个比疫苗接种更强的触发因素,尽管整体发病率保持稳定.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 冠状病毒疾病-19 (COVID-19),由SARS-CoV-2引起,与促炎状态相关,激活凝血和补充级联.
- 调查COVID-19大流行和SARS-CoV-2疫苗接种对新发的非典型血清性尿素综合征 (aHUS) 和补充介导的血栓性微血管病变 (cTMA) 的影响至关重要.
研究的目的:
- 为了确定COVID-19大流行对维也纳TMA队列中新发性cTMA/aHUS患者的影响.
- 评估COVID-19感染或SARS-CoV-2疫苗接种是否对cTMA/aHUS.的初始表现造成更大的风险.
主要方法:
- 利用维也纳TMA队列数据库来分析与COVID-19相关的和与SARS-CoV-2疫苗接种相关的aHUS/cTMA的流行率.
- 在一个大型的单中心队列中检查了COVID-19大流行前三年的数据.
主要成果:
- 七名患者在2020年3月至2023年5月期间经历了他们的第一个aHUS/cTMA事件.
- 三次TMA发作与COVID-19 (n=1) 或SARS-CoV-2疫苗接种 (n=2) 有关.
- 感染引发了一次TMA发作 (20%),而疫苗接种引发了两次 (10%);没有发现统计学上显著的差异 (p=0.52).
结论:
- 无论是SARS-CoV-2疫苗接种还是COVID-19感染,都可能在遗传倾向的个体中引发aHUS/cTMA.
- 与SARS-CoV-2疫苗相比,COVID-19感染可能代表aHUS/cTMA的较强触发因素.
- 在这个队列中,与大流行前的时代相比,新的aHUS病例的发生率没有变化.
相关概念视频
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
625
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
625
01:29Venous Thrombosis III: Interprofessional Care
2
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
2
01:25Endocarditis II: Clinical features and Diagnostic Tests
2
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
2
01:30Venous Thrombosis I: Introduction
2
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
2
01:24Disorders of Hemostasis
726
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
726