摘要
在新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)中,血栓形成与急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)的发病机制及临床症状的进展有关。SARS-CoV-2感染后血管内皮细胞的严重损伤和相关的细胞因子风暴可导致血栓形成,并促发与其他感染性疾病相比更严重和独特的血栓形成。血栓更常见于危重患者。除肺血栓栓塞(PE)和深静脉血栓形成外,急性心肌梗死、外周动脉血栓形成和主动脉血栓形成也有报道。肺血栓栓塞在肺动脉和肺泡毛细血管中形成,这些与肺泡内纤维蛋白沉积一起,干扰肺部的有效气体交换,加剧COVID-19患者ARDS的临床症状。建议对所有住院患者进行药物血栓预防,以预防血栓形成和ARDS加重,以及其他器官衰竭。虽然儿童感染SARS-CoV-2后大多无症状或病情轻微,但有报道称一种影响心血管系统的新型炎症性疾病——儿童多系统炎症综合征(MIS-C)。与川崎病相似,急性心肌炎、冠状血管炎和动脉瘤通常见于MISC,但现在认为这两者是不同的疾病。在年轻成年男性中也观察到类似的急性心肌炎,这似乎与SARS-CoV-2感染后的过度炎症状态有关。据报道,接种COVID-19疫苗后有数种副作用,包括疫苗诱导的免疫性血栓性血小板减少症和急性心肌炎。虽然这些病例可能严重并危及生命,但非常罕见,因此免疫接种的益处仍然大于风险。
关键词: 新型冠状病毒肺炎,血栓形成,急性呼吸窘迫综合征,低分子肝素,心肌炎,疫苗诱导免疫性血栓性血小板减少症
Current Drug Targets
Title:COVID-19 and Thrombosis: Clinical Aspects
Volume: 23 Issue: 17
关键词: 新型冠状病毒肺炎,血栓形成,急性呼吸窘迫综合征,低分子肝素,心肌炎,疫苗诱导免疫性血栓性血小板减少症
摘要: In coronavirus disease 2019 (COVID-19), thrombus formation is related to the pathogenesis of acute respiratory distress syndrome (ARDS) and the progression of clinical symptoms. Severe damage to vascular endothelial cells and the associated cytokine storm after SARS-CoV-2 infection cause thrombogenesis and contribute to the development of more severe and unique thromboses compared to other infectious diseases. Thromboses occur more often in critically ill patients. In addition to pulmonary thromboembolism (PE) and deep vein thrombosis, acute myocardial infarction, peripheral arterial thrombosis, and aortic thrombosis have also been reported. In PE, thrombi develop in both pulmonary arteries and alveolar capillaries. These, together with intraalveolar fibrin deposition, interfere with effective gaseous exchange in the lungs and exacerbate the clinical symptoms of ARDS in patients with COVID-19. Pharmacological thromboprophylaxis is recommended for all hospitalized patients to prevent both thrombosis and aggravation of ARDS, and other organ failures. Although the pediatric population is mostly asymptomatic or develops mild disease after SARS-CoV-2 infection, a new inflammatory disorder affecting the cardiovascular system, multisystem inflammatory syndrome in children (MIS-C), has been reported. Similar to Kawasaki disease, acute myocarditis, coronary vasculitis, and aneurysms are typically seen in MISC, although these two are now considered distinct entities. A similar acute myocarditis is also observed in young male adults, in which a hyperinflammatory state after SARS-CoV-2 infection seems to be involved. Several side effects following vaccination against COVID-19 have been reported, including vaccine-induced immune thrombotic thrombocytopenia and acute myocarditis. Although these could be serious and life-threatening, the cases are very rare, thus, the benefits of immunization still outweigh the risks.
Export Options
About this article
Cite this article as:
COVID-19 and Thrombosis: Clinical Aspects, Current Drug Targets 2022; 23 (17) . https://dx.doi.org/10.2174/1389450123666221005092350
DOI https://dx.doi.org/10.2174/1389450123666221005092350 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
Call for Papers in Thematic Issues
New drug therapy for eye diseases
Eyesight is one of the most critical senses, accounting for over 80% of our perceptions. Our quality of life might be significantly affected by eye disease, including glaucoma, diabetic retinopathy, dry eye, etc. Although the development of microinvasive ocular surgery reduces surgical complications and improves overall outcomes, medication therapy is ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Peripheral and Central Mechanisms of Inflammatory Pain, with Emphasis on MAP Kinases
Current Drug Targets - Inflammation & Allergy A New Frontier in the Treatment of Cancer: NK-1 Receptor Antagonists
Current Medicinal Chemistry Common and Uncommon Features of Rheumatoid Arthritis and Chronic Obstructive Pulmonary Disease: Clues to a Future Therapy
Current Drug Targets - Immune, Endocrine & Metabolic Disorders L-Carnosine Modulates Respiratory Burst and Reactive Oxygen Species Production in Neutrophil Biochemistry and Function: May Oral Dosage Form of Non-Hydrolized Dipeptide L-Carnosine Complement Anti-Infective Anti-Influenza Flu Treatment, Prevention and Self-Care as an Alternative to the Conventional Vaccination?
Current Clinical Pharmacology Co-targeting EGFR and Autophagy Impairs Ovarian Cancer Cell Survival during Detachment from the ECM
Current Cancer Drug Targets Roles of Tumor Microenvironment in Hepatocelluar Carcinoma
Current Cancer Therapy Reviews COVID-19 Induces Cytokine Storm and Dysfunctional Hemostasis
Current Drug Targets Safer, Greener, and More Facile Alternatives for Synthesis with Organic Azides
Current Organic Synthesis Extracts of Bacopa monnieri (L) Pennell Down-Regulate the Expression of Leukotriene C<sub>4</sub> Synthase mRNA in HL-60 Cells and Suppress OVAInduced Inflammation in BALB/c Mice
Current Bioactive Compounds Safety and Tolerability of Agomelatine: Focus on Hepatotoxicity
Current Drug Metabolism The Heme Oxygenase System Selectively Modulates Proteins Implicated in Metabolism, Oxidative Stress and Inflammation in Spontaneously Hypertensive Rats
Current Pharmaceutical Design Potential Role of <i>In Vitro-In Vivo</i> Correlations (IVIVC) for the Development of Plant-Derived Anticancer Drugs
Current Drug Targets Role of Carbon Monoxide in Vascular Diseases
Current Pharmaceutical Biotechnology HMG-CoA Reductase Inhibitors (Statins) and their Drug Interactions Involving CYP Enzymes, P-glycoprotein and OATP Transporters-An Overview
Current Drug Metabolism Tendon Regeneration and Repair with Adipose Derived Stem Cells
Current Stem Cell Research & Therapy HMGB1-Directed Drug Discovery Targeting Cutaneous Inflammatory Dysregulation
Current Drug Metabolism NK Cell Function in HIV-1 Infection
Current HIV Research Nutritional and Pharmacological Management of Childhood Epilepsy: Ketogenic Diets and Common AEDs
Current Medicinal Chemistry - Immunology, Endocrine & Metabolic Agents Therapeutic Targeting of Developmental Signaling Pathways in Medulloblastoma: Hedgehog, Notch, Wnt and Myc
Current Signal Transduction Therapy Pharmacology of Rhein and Advancement in the Synthesis of Its Derivatives
Current Traditional Medicine