A Case Report of a Patient on Therapeutic Warfarin Who Died of COVID-19 Infection with a Sudden Rise in D-Dimer.
A Case Report of a Patient on Therapeutic Warfarin Who Died of COVID-19 Infection with a Sudden Rise in D-Dimer.
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DOI：
10.3390/biomedicines9101382
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发表时间：
2021-10-03
期刊：
影响因子：
4.7
通讯作者：
Tripathi MK
中科院分区：
文献类型：
--
作者：
Agarwal RN;Aggarwal H;Verma A;Tripathi MK
严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）感染已经扰乱了全球的社会和经济生活。由这种新型SARS-CoV-2引起的全球大流行性COVID-19表现出多变的临床表现，并因细胞因子风暴、合并感染和凝血障碍而进一步复杂化，导致严重病例和死亡。血栓性并发症的出现是由于冠状病毒与宿主细胞、炎症反应和凝血系统之间复杂而独特的相互作用。肝素及其衍生物是世界卫生组织（WHO）推荐用于中度和重度冠状病毒病19（COVID-19）的抗凝剂，也可以通过干扰硫酸乙酰肝素依赖性结合血管紧张素转换酶2（ACE 2）受体来抑制病毒粘附到细胞膜上。肝素还具有抗炎、免疫调节、抗病毒和抗补体活性，这在限制病毒和微生物感染性以及免疫血栓形成系统的抗凝方面提供了益处。在这里，我们提出了一个病例研究的病理生理学意外COVID-19凝血病的肥胖非洲裔美国人的病人。虽然自入院以来一直在接受华法林治疗，但由于D-二聚体值从1.1突然升高至>20后心肺骤停，他的结局令人沮丧。这表明，对于这类患有“中度COVID 19综合征”的长期华法林抗凝治疗患者，与肝素及其衍生物相比，华法林抗凝治疗可能不适合。应进行进一步研究，以了解肝素及其衍生物与华法林相比对COVID-19患者的有益作用。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has disrupted social and economic life globally. The global pandemic COVID-19 caused by this novel SARS-CoV-2 shows variable clinical manifestations, complicated further by cytokine storm, co-infections, and coagulopathy, leading to severe cases and death. Thrombotic complications arise due to complex and unique interplay between coronaviruses and host cells, inflammatory response, and the coagulation system. Heparin and derivatives are World Health Organization (WHO) recommended anticoagulants for moderate and severe Corona Virus Disease 19 (COVID-19), that can also inhibit viral adhesion to the cell membrane by interfering with heparan sulfate-dependent binding to angiotensin-converting enzyme 2 (ACE2) receptor. Heparin also possesses anti-inflammatory, immunomodulatory, antiviral, and anti-complement activity, which offers a benefit in limiting viral and microbial infectivity and anticoagulation from the immune-thrombosis system. Here we present a case study of the pathophysiology of unexpected COVID-19 coagulopathy of an obese African American patient. While being on therapeutic warfarin since admission, he had a dismal outcome due to cardio-pulmonary arrest after the sudden rise in D-dimer value from 1.1 to >20. This indicates that for such patients on chronic warfarin anticoagulation with “moderate COVID 19 syndromes”, warfarin anticoagulation may not be suitable compared to heparin and its derivatives. Further research should be done to understand the beneficial role of heparin and its derivatives compared to warfarin for COVID-19 inflicted patients.
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影响因子：
4.6
作者：
Vaz de Paula CB;de Azevedo MLV;Nagashima S;Martins APC;Malaquias MAS;Miggiolaro AFRDS;da Silva Motta Júnior J;Avelino G;do Carmo LAP;Carstens LB;de Noronha L
通讯作者：
de Noronha L
影响因子：
2.2
作者：
Maduzia, D.;Ceranowicz, P.;Warzecha, Z.
通讯作者：
Warzecha, Z.
DOI：
10.15557/pimr.2020.0003
发表时间：
2020-01-01
影响因子：
3.6
作者：
通讯作者：
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影响因子：
168.9
作者：
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通讯作者：
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影响因子：
4.6
作者：
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通讯作者：
Warzecha, Zygmunt