Covid-19感染与伯格氏综合征1例报告

A. Hovhannisyan, V. Asoyan, N. Gyulazyan, A.A. Madatyan, A.H. Poghosyan, M. Mohammadi, E.S. Barseghyan
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引用次数: 1

摘要

由严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)引起的COVID-19是最近全球大流行的原因,全球报告的病例数量不断增加。随着我们对这种新型呼吸道病毒的认识不断加深,越来越清楚的是,它的影响超出了呼吸系统,可以扩展到几乎所有的器官系统。SARS-CoV-2会引起肺部炎症,在最严重的情况下会发展为细胞因子风暴。COVID-19患者肺部表现为广泛的肺泡和间质炎症。COVID-19引起一系列并发症,经常累及止血系统,住院的COVID-19患者,特别是重症患者,静脉血栓栓塞的发生率很高。目前有证据表明,微血管病变诱发的COVID-19可导致广泛的组织病理和临床并发症,如川崎病、伯格氏综合征和其他全身性炎症性疾病。血栓闭塞性脉管炎(TAO)或伯格氏病是一种动脉和静脉的节段性闭塞性炎症,其特征是受影响血管的血栓形成和再通。诊断时肢体感染与截肢风险增加4倍相关。戒烟与较低的血管事件和截肢率密切相关。TAO似乎更可能是一种全身性疾病,而不是局部血管病变。因此,基于TAO患者全身治疗的治疗方案可能比局部治疗(如搭桥手术和血管内手术)更有帮助。我们报告一例53岁男性,SARS-CoV-2 PCR检测阳性。进一步检查显示患者为肺炎,并根据双相扫描结果确诊为血栓闭塞性脉管炎(TAO)或伯格氏病。这种疾病本身与血栓形成的高风险有关,并与COVID-19一起可能导致不可预测的后果。患者接受了全天观察,并接受了适当的治疗,于11日顺利出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Covid-19 infection and Buerger`s syndrome: A case report
COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the recent global pandemic, with increasing number of cases reported globally. Our understanding of this novel respiratory virus deepens, it is increasingly clear that its effects extend beyond that of the respiratory system and can be extended to the almost all organ systems. SARS-CoV-2 causes lung inflammation which progresses to cytokine storm in the most severe cases. The lungs of patients with COVID-19 show extensive alveolar and interstitial inflammation. COVID-19 causes a spectrum of complications, with frequent involvement of the hemostatic system and there is a high incidence of venous thromboembolism in hospitalized COVID-19 patients, particularly those with severe illness. There is evidence of current body knowledge that COVID-19 induced by microvascular angiopathy can lead to a wide range of tissue pathology and clinical complications, such as Kawasaki disease, Buerger’s syndrome and other systemic inflammatory disorders. Thromboangiitis obliterans (TAO) or Buerger’s disease is a segmental occlusive inflammatory condition of arteries and veins, characterized by thrombosis and recanalization of the affected vessels. Limb infection at diagnosis was associated with a 4-fold higher risk of amputation. Smoking cessation was strongly associated with a lower rate of vascular events and amputation. TAO appears more likely to be a systemic disorder rather than a localized vasculopathy. Therefore, treatment protocols based on systemic treatment of TAO patients may be more helpful than localized treatment, such as bypass surgery and endovascular procedures. We present a case of a 53-years-old male with positive SARS-CoV-2 PCR test. Furter examination showed that patient had pneumonia, moreover, based on the duplex scan results the diagnosis of thromboangiitis obliterans (TAO) or Buerger’s disease was confirmed. This disease itself is associated with a high risk of thrombosis and alongside with COVID-19 can cause unpredictable outcome. Patient underwent the day-round observation, received the appropriate treatment and was successfully discharged from the hospital on the day 11.
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