COVID-19与肾梗死:是否需要抗凝治疗。

Clinical Nephrology. Case Studies Pub Date : 2021-11-09 eCollection Date: 2021-01-01 DOI:10.5414/CNCS110602
Chelsea Takamatsu, Paola Devis, Ramin Tolouian
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引用次数: 1

摘要

我们提出了一个独特的案例,男性退伍军人与Castleman病的历史,表现为多个动脉和静脉血管血栓形成在最近的冠状病毒(COVID-19)疾病诊断的设置。我们探讨了该患者的发病率与他的COVID-19诊断的血栓性并发症相关,这些并发症可能是可以避免的,通过对他的血栓风险进行全面的门诊评估,以及考虑到他的高风险,开始抗凝和/或抗血小板治疗。我们的病例强调需要对门诊患者进行标准化的临床检查,以评估与COVID-19感染相关的血管血栓形成风险,以指导医疗管理,以尽量减少不良后果、需要住院的并发症,以及需要额外但有限的医疗资源和干预措施。我们建议门诊临床医生在治疗轻度COVID-19时,根据他们的最佳临床判断,每日最低低剂量阿司匹林81 mg是一种合理的方法,而其他选择,如新型口服抗凝剂,正在进一步研究中。
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 and renal infarct: To be or not to be on anticoagulation.

COVID-19 and renal infarct: To be or not to be on anticoagulation.

We present a unique case of a male veteran with a history of Castleman disease, presenting with multiple arterial and venous vascular thromboses in the setting of recent Coronavirus (COVID-19)-disease diagnosis. We explore this patient's morbidity related to thrombotic complications of his COVID-19 diagnosis that were potentially avoidable with a comprehensive outpatient evaluation of his risk for thrombosis, as well as the initiation of anticoagulation and/or antiplatelet therapy given his high risk. Our case highlights the need for a standardized clinical workup of patients in the outpatient setting for risk assessment of vascular thrombosis associated with COVID-19 infection to direct medical management, in order to minimize adverse outcomes, complications requiring inpatient admission, and the need for additional yet limited medical resources and interventions. We propose a minimum of low-dose aspirin 81 mg daily as a reasonable approach for outpatient clinicians to consider, based on their best clinical judgement, when managing mild COVID-19, while other options, such as novel oral anticoagulants, are undergoing further investigation.

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