与 COVID-19 相关的肺栓塞:临床、生化和 CT 成像发现。

Eduard Dumea, M. Lazar, Cristina-Emilia Chițu-Tișu, E. Barbu, D. Ion
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摘要

引言 严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染是 2019 年底出现的一种破坏性病理现象,对个人健康、卫生系统和世界经济产生了深远影响。我们的研究旨在评估临床、生化和计算机断层扫描(CT)参数值,以确定与 COVID-19 相关的肺栓塞(PE)的严重程度。结果在对 186 名 COVID-19 患者的研究中,我们发现 31 名患者(16.66%)患有肺栓塞。C反应蛋白、乳酸脱氢酶、血清铁蛋白、IL-6、血清肌红蛋白、NT-proBNP、D-二聚体、血清蛋白、转氨酶以及白细胞计数与肺栓塞患者存在显著相关性。肺栓塞患者的肺部受累程度更严重,血栓主要分布在肺下叶。我们的研究表明,乳酸脱氢酶、铁蛋白、IL-6、白细胞和 D-二聚体的高血浆值以及低蛋白血清水平与 COVID-19 相关性肺栓塞密切相关。
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COVID-19 associated pulmonary embolism: clinical, biochemical and CT imaging findings.
INTRODUCTION The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represented a disruptive pathology that emerged in late 2019 with profound implications ranging from individual health to health systems and world economy. Our study aimed to evaluate clinical, biochemical and computerized tomography (CT) parameters values in determining the severity of pulmonary embolism (PE) associated with COVID-19. METHODS We performed an observational cohort study evaluating demographic, clinical, biochemical, coagulation markers, as well as CT imaging parameters. RESULTS In our study on 186 patients with COVID-19, we found that 31 patients (16,66%) had pulmonary embolism. Significant correlations for the patients with PE were detected in C-reactive protein, lactate dehydrogenase, serum ferritin, IL-6, serum myoglobin, NT-proBNP, D-dimers, serum proteins, transaminases as well as white cell blood counts. Patients with pulmonary embolism had a more severe lung involvement, with thrombi distribution mainly involving the lower lobes. CONCLUSION Early identification of PE is an important step for timely and efficient treatment in the intensive care management of COVID-19 patients. Our study showed that high plasmatic values of lactate dehydrogenase, ferritin, IL-6, white blood cells and D-dimers and low proteins serum levels are strongly linked with COVID-19-associated pulmonary embolism.
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