病态肥胖患者新冠肺炎合并急性肺栓塞1例在家戏剧性逆转管理

Yasser Mohammed Hassanain Elsayed
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摘要

理由:2019年12月,中国武汉出现了一种新型新冠肺炎伴严重急性呼吸综合征。血栓栓塞是新冠肺炎患者公认的重要临床实体。有趣的是,新冠肺炎感染血栓栓塞对新冠肺炎患者的发病率和死亡率都有风险影响。在新冠肺炎肺炎伴血栓栓塞的情况下,病态肥胖可能会增加显著的风险值。患者关注:中年家庭主妇女性新冠肺炎病态肥胖患者因单侧肺炎疑似急性肺栓塞到医生门诊就诊。诊断:新冠肺炎合并急性肺栓塞的病态肥胖。介入治疗:CT肺动脉造影,非对比胸部CT扫描,心电图和氧合。结果:临床和放射学都有显著改善。经验教训:病态肥胖、QTc延长与新冠肺炎感染的结合是血栓栓塞风险过高的指标。这意味着抗凝血药、抗血小板药物、抗感染药物和类固醇在患有单侧肺炎和病态肥胖急性肺栓塞的新冠肺炎患者中的作用是有效的治疗方法。对于病态肥胖患者,增加低分子肝素和口服抗凝剂的剂量是合理的。
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Covid-19 Pneumonia with Acute Pulmonary Embolism in a Morbidly Obese Patient; At Home Dramatic Reversal Management
Rationale: A novel COVID-19 with the severe acute respiratory syndrome had arisen in Wuhan, China in December 2019 Thromboembolism is a critical clinical entity commonly recognized sequel in COVID-19 patients. Interestingly, the presentation of COVID-19 infection with thromboembolism has a risk impact on both morbidity and mortality in COVID-19 patients. Morbid obesity may add over significant risk value in the presence of COVID-19 pneumonia with thromboembolism. Patient concerns: Middle-aged housewife female COVID-19 morbid obese patient presented to physician outpatient clinic with unilateral pneumonia suspected acute pulmonary embolism. Diagnosis: COVID-19 pneumonia with acute pulmonary embolism in morbid obesity. Interventions: CT pulmonary angiography, non- contrasted chest CT scan, electrocardiography, and oxygenation. Outcomes: Dramatic of both clinical and radiological improvement had happened. Lessons: The combination of morbid obesity, QTc prolongation with COVID-19 infection is an indicator of the over-risk of thromboembolism. It signifies the role of anticoagulants, antiplatelet, anti-infective drugs, and steroids in COVID-19 patients with unilateral pneumonia and acute pulmonary embolism in morbid obesity are effective therapies. An increasing the dose of both low-molecular heparin and oral anticoagulant with a morbidly obese patient was reasonable.
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