Coronavirus Disease 2019-Associated Thrombosis and Coagulopathy: Review of the Pathophysiological Characteristics and Implications for Antithrombotic Management.
Coronavirus Disease 2019-Associated Thrombosis and Coagulopathy: Review of the Pathophysiological Characteristics and Implications for Antithrombotic Management.
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DOI：
10.1161/jaha.120.019650
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发表时间：
2021-02-02
影响因子：
5.4
通讯作者：
Angiolillo DJ
中科院分区：
文献类型：
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作者：
Ortega-Paz L;Capodanno D;Montalescot G;Angiolillo DJ
2019冠状病毒病（COVID-19）是由严重急性呼吸道综合征冠状病毒2型引起的传染病，对全球健康构成重大威胁。虽然感染通常无症状或伴有轻度症状，但在一小部分患者中，它可产生强烈的炎症和血栓前状态，可导致急性呼吸窘迫综合征，多器官衰竭和死亡。血管紧张素转换酶2在呼吸系统中高度表达，已被确定为严重急性呼吸综合征冠状病毒2的功能性受体。值得注意的是，血管紧张素转换酶2也在心血管系统中表达，COVID-19对心血管系统有多种影响。心血管风险因素和心血管疾病与COVID-19患者的严重表现和不良预后相关。更重要的是，COVID-19患者可能存在血栓形成和凝血异常，促进高凝状态，导致血栓形成和血栓栓塞事件发生率增加。本综述将描述严重急性呼吸综合征冠状病毒-2感染后心血管受累的病理生理学特征，重点关注血栓形成和血栓栓塞表现以及抗血栓治疗的意义。
Coronavirus disease 2019 (COVID‐19) is an infectious disease caused by severe acute respiratory syndrome coronavirus‐2, which has posed a significant threat to global health. Although the infection is frequently asymptomatic or associated with mild symptoms, in a small proportion of patients it can produce an intense inflammatory and prothrombotic state that can lead to acute respiratory distress syndrome, multiple organ failure, and death. Angiotensin‐converting enzyme 2, highly expressed in the respiratory system, has been identified as a functional receptor for severe acute respiratory syndrome coronavirus‐2. Notably, angiotensin‐converting enzyme 2 is also expressed in the cardiovascular system, and there are multiple cardiovascular implications of COVID‐19. Cardiovascular risk factors and cardiovascular disease have been associated with severe manifestations and poor prognosis in patients with COVID‐19. More important, patients with COVID‐19 may have thrombotic and coagulation abnormalities, promoting a hypercoagulable state and resulting in an increased rate of thrombotic and thromboembolic events. This review will describe the pathophysiological characteristics of the cardiovascular involvement following infection by severe acute respiratory syndrome coronavirus‐2, with a focus on thrombotic and thromboembolic manifestations and implications for antithrombotic management.