A Case of COVID-19 Related Coagulopathy Complications and Heparin Resistance.
A Case of COVID-19 Related Coagulopathy Complications and Heparin Resistance.
复制标题
DOI：
10.7759/cureus.18265
复制
发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Carroll S
中科院分区：
文献类型：
--
作者：
Chowdhry E;Moshman J;Carroll S
COVID-19凝血功能障碍的机制已被推测，但尚未明确了解；目前的推测是，炎症和止血系统之间存在复杂的串扰，这导致COVID-19背景下血栓形成风险总体增加，导致高凝状态。一些文献报道了在使用肝素抗凝治疗的情况下，COVID-19患者伴血栓栓塞事件并发症出现明显肝素耐药的病例。这种肝素耐药现象已在活动性、重症COVID-19感染患者中观察到。然而，我们描述了一个独特的病例，该患者最近从轻度COVID-19感染中康复，不需要住院治疗，但表现为急性肢体缺血，并表现出肝素抵抗。患者由血管外科专家、重症医师、心脏病专家、血液学专家、物理医学和康复（PMR）专家管理。我们报告了一例成功从COVID-19中康复的患者，但出现了与凝血功能障碍和肝素抵抗相关的COVID-19后并发症。
Mechanisms of COVID-19 coagulopathy have been speculated and are not definitively understood; the current speculation is that there is elaborate crosstalk between the inflammatory and hemostatic systems which contributes to the overall increased thrombotic risk in the setting of COVID-19 resulting in a hypercoagulable state. A few documented reports regarding cases of apparent heparin resistance in patients with COVID-19 with complications of thromboembolic events occurring in the setting of heparin anticoagulation have been described. This phenomenon of heparin resistance has been observed in patients with active, severe COVID-19 infection. However, we describe a unique case of a patient who had recovered from a recent, mild COVID-19 infection that did not require hospitalization and presented with acute limb ischemia and demonstrated heparin resistance. The patient was managed by specialists in vascular surgery, intensivists, cardiologists, hematology, and physical medicine and rehabilitation (PMR). We present the case of a patient who had successfully recovered from COVID-19 yet demonstrated post-COVID-19 complications related to coagulopathy and heparin resistance.