PDF(Pubmed)
Abstract：
COVID-19 infection caused by the new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an infection with symptoms and results ranging from mild flu-like symptoms to severe respiratory failure leading to death. The risk of thrombosis increases due to hypercoagulation in COVID-19 infection. All causes (endothelial injury, stasis, and hypercoagulopathy) known as Virchow\'s triad contribute to thrombosis in COVID-19 infection. However, the pathogenesis of hypercoagulability in COVID-19 is still unknown. In this article, we discuss the unique multiple thrombosis events following recovery from COVID-19 infection and our treatment strategy for pulmonary thrombosis. The patient had symptoms of dry cough, fever, and myalgia two months ago. His polymerase chain reaction (PCR) test for COVID-19 was positive, but there was no need for hospitalization. His symptoms resolved within seven days. But, thrombosis of the superior mesenteric artery (SMA) occurred one month after the COVID-19 infection, and bowel resection was performed. He was admitted to our hospital with dyspnea, chest pain, palpitations, and hoarseness. Further evaluation showed tachycardia, hypotension, tachypnea, and anxiety. Peripheral oxygen saturation (SpO2) was 86% at room air. He had hemodynamic instability, right ventricular (RV) dysfunction, and D-Dimer elevation. Pulmonary Embolism Severity Index (PESI) was calculated as 149. The patient was in the high-risk group. Our Pulmonary Embolism Response Team (PERT) decided to apply catheter-directed thrombolysis (CDT) for the treatment of pulmonary thrombosis. The EkoSonic™ Endovascular System (EKOS) (Boston Scientific Corporation, Marlborough, USA) was used for the treatment.
摘要：
由称为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的新型冠状病毒引起的COVID-19感染是一种症状和结果从轻度流感样症状到严重呼吸衰竭导致死亡的感染。由于COVID-19感染的高凝，血栓形成的风险增加。所有原因（内皮损伤，stasis,和高凝血症）被称为Virchow的三联征导致COVID-19感染中的血栓形成。然而,COVID-19高凝的发病机制尚不清楚。在这篇文章中,我们讨论了COVID-19感染恢复后独特的多发血栓事件以及我们对肺血栓形成的治疗策略.病人有干咳的症状,发烧,两个月前肌痛.他的COVID-19聚合酶链反应（PCR）检测呈阳性，但是没有必要住院。他的症状在7天内消失。但是,肠系膜上动脉（SMA）血栓形成发生在COVID-19感染后一个月，并进行了肠切除术。他因呼吸困难入院,胸痛,心悸,和声音嘶哑。进一步评估显示心动过速,低血压,呼吸急促,和焦虑。室内空气中的外周血氧饱和度（SpO2）为86％。他有血流动力学不稳定,右心室（RV）功能障碍，和D-Dimer标高。肺栓塞严重程度指数(PESI)计算为149。患者属于高危人群。我们的肺栓塞反应小组（PERT）决定应用导管定向溶栓（CDT）治疗肺血栓。EkoSonic™血管内系统(EKOS)(波士顿科学公司，马尔伯勒,美国）用于治疗。
