冠状病毒感染(COVID-19)的血液学参数及其临床意义。

Rao Muhammad Waleed, Inbisat Sehar, Waleed Iftikhar, Huma Saeed Khan
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摘要

冠状病毒是一类包膜 RNA 病毒,可引起呼吸道感染,表现为发热、疲倦、干咳、腹泻、嗅觉或味觉丧失、胸痛和气短。2019年12月,武汉市分辨出多名神秘肺炎患者。经研究发现,这些来历不明的肺炎归因于一种新型冠状病毒,并将其描述为新型冠状病毒肺炎(NCP)。中国当局最初于 2019 年 12 月 31 日报告了这波神秘肺炎疫情,并于 2020 年 1 月 30 日将其宣布为国际关注疫情。为了更好地了解COVID-19(冠状病毒病)感染的血液学特征及其临床意义,我们对相关研究进行了系统检索,共发现了58篇主要研究文章,并对其进行了分析和讨论。本文中的所有研究结果都真实地反映了目前对 SARS-COV-2 疾病血液学研究结果的解读。考虑到血液学参数,可以更好地解释 COVID-19 疾病的病理生理学。COVID-19 患者的血液学特征(包括细胞因子风暴、凝血特征和嗜血栓性并发症)对临床的影响尚未得到充分认识。因此,本综述重点关注凝血谱、细胞因子风暴及其治疗方案。关于 COVID-19 患者原有血栓性疾病的作用及其如何导致该病的不良预后,也存在争议。最近的数据表明,高凝状态可能是导致 COVID-19 死亡的潜在原因。托西珠单抗、甲硝唑和乌利那他汀在抑制细胞因子风暴方面的潜在作用可能有助于治疗 SARS-COV-2 感染。本综述还强调了根据临床特征对 SARS-CoV-2 患者,尤其是孕妇进行血栓性疾病检测的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Hematologic parameters in coronavirus infection (COVID-19) and their clinical implications.

Coronaviruses are a class of enveloped RNA viruses that cause infections of the respiratory tract, characterized by fever, tiredness, dry cough, diarrhea, loss of smell or taste, chest pain and shortness of breath. Many patients with mysterious pneumonia were distinguished in December 2019 in Wuhan. The pneumonia of obscure origin was found to be ascribed to a novel coronavirus and described as novel coronavirus pneumonia (NCP). The Chinese authorities initially reported the wave of mysterious pneumonia on December 31st, 2019 and it was declared as an outbreak of international concern on January 30th, 2020. A systematic search of relevant research was conducted, and a total of 58 primary research articles were identified, analyzed, and debated to better understand the hematologic profile in COVID-19 (Coronavirus disease) infection and its clinical implications. All the findings in this article manifest a true impression of the current interpretation of hematological findings of the SARS-COV-2 disease. Pathophysiology of COVID-19 disease can be better interpreted by taking into consideration the hematologic parameters. Clinical implications of the hematologic profile of COVID-19 patients including cytokine storm, coagulation profile, and thrombophilic complications are under-recognized. Therefore, this review focuses on the coagulation profile, cytokine storm, and its treatment options. The role of pre-existing thrombophilia in COVID-19 patients and how it could result in the poor prognosis of the disease is also debated. The recent data suggests that hypercoagulability could be the potential cause of fatalities due to COVID-19. Potential effects of tocilizumab, metronidazole, and ulinastatin in suppressing cytokine storm may help to treat SARS-COV-2 infection. This review also highlights the significance of thrombophilia testing in SARS-CoV-2 patients depending on the clinical features and especially in pregnant women.

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