在尸检时,COVID-19感染的致命胃肠道表现
John D Gilbert1, Stephen Wills1, Roger W Byard1,2
1Forensic Science SA, Adelaide, Australia.
Medicine, science, and the law
|June 4, 2025
概括
COVID-19可能会导致罕见的,致命的急性介质缺血症,特别是在老年人中. 这种情况涉及肠道缺血和微血管纤维素血栓,即使没有主要的血管阻塞.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 病理学 病理学 病理学
背景情况:
- COVID-19 (SARS-CoV-2) 感染通常会出现胃肠道症状.
- 致命的胃肠道并发症,如急性介肠缺血症,在COVID-19患者中经常被忽视.
- 急性中肠缺血是一种罕见但高死亡率的事件,特别是在老年人中.
研究的目的:
- 报告两例COVID相关的急性介质缺血病死亡病例.
- 要强调考虑COVID-19在患有不明原因肠道缺血症的患者的重要性.
- 描述病理发现,包括微血管纤维素血栓,在这些情况下.
主要方法:
- 对两名死于COVID-19感染的老年女性患者的尸检检查.
- 肠道和介质组织的组织学分析,以确定炎症,亡和血栓.
- 对SARS-CoV-2进行呼吸道病毒核酸检测.
主要成果:
- 两名患者都出现了腹部症状,并死于急性介质缺血症的次要多器官衰竭.
- 尸体解剖显示了肠道中广泛的缺血变化,主要的中肠动脉被发现.
- 组织学显示急性炎症,粘膜 necrosis,和纤维素微血栓在粘膜内和粘膜下血管,与COVID-19相关的凝血病.
结论:
- 应考虑COVID-19在急性中肠缺血的差异诊断中,特别是在有胃肠道症状且没有阻塞性血管病变的老年患者中.
- 仔细的组织学检查微血管纤维素凝血和适当的病毒检测对于诊断至关重要.
- 早期识别和管理COVID相关的介质缺血可能会改善患者的治疗结果.
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