Cerebral Venous Thrombosis Associated with COVID-19
Cerebral Venous Thrombosis Associated with COVID-19
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DOI：
10.3174/ajnr.a6644
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发表时间：
2020-08-01
影响因子：
3.5
通讯作者：
Nelson, P. K.
中科院分区：
文献类型：
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作者：
Cavalcanti, D. D.;Raz, E.;Nelson, P. K.
尽管2019冠状病毒病（COVID-19）的严重程度更多地与急性呼吸窘迫综合征和急性心脏和肾脏损伤相关，但血栓栓塞事件的报道越来越多。我们报告了一系列独特的年轻COVID-19患者，表现为脑静脉系统血栓形成。3例年龄小于41岁的确诊严重急性呼吸综合征冠状病毒2 （SARS-Cov-2）感染患者出现与脑静脉血栓相关的神经系统症状。他们在2020年3月至4月的短短10天内被录取，并在大城市的学术机构进行管理。1例患者在浅表和深部系统均有血栓形成；另一例受累于直窦、盖伦静脉和脑内静脉；第三个病人有深髓静脉血栓。2例患者出现出血性静脉梗死。从COVID-19症状到血栓形成事件的中位时间为7天（范围2-7天）。1例诊断为新发糖尿病酮症酸中毒，1例使用口服避孕药。2例患者同时使用羟氯喹和阿奇霉素；其中一组用洛匹那韦-利托那韦治疗。所有患者的结局都是致命的。严重和可能致命的深部脑血栓形成可能使COVID-19的初始临床表现复杂化。我们敦促注意这种非典型表现。作者报告了一系列独特的年轻COVID-19患者，表现为脑静脉系统血栓形成。3例年龄小于41岁的确诊严重急性呼吸综合征冠状病毒2型感染患者出现与脑静脉血栓相关的神经系统症状。
Despite the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 (SARS-Cov-2) infection had neurologic findings related to cerebral venous thrombosis. They were admitted during the short period of 10 days between March and April 2020 and were managed in an academic institution in a large city. One patient had thrombosis in both the superficial and deep systems; another had involvement of the straight sinus, vein of Galen, and internal cerebral veins; and a third patient had thrombosis of the deep medullary veins. Two patients presented with hemorrhagic venous infarcts. The median time from COVID-19 symptoms to a thrombotic event was 7 days (range, 2-7 days). One patient was diagnosed with new-onset diabetic ketoacidosis, and another one used oral contraceptive pills. Two patients were managed with both hydroxychloroquine and azithromycin; one was treated with lopinavir-ritonavir. All patients had a fatal outcome. Severe and potentially fatal deep cerebral thrombosis may complicate the initial clinical presentation of COVID-19. We urge awareness of this atypical manifestation.The authors report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 infection had neurologic findings related to cerebral venous thrombosis.