Multiple arterielle tromboembolier etter covid-19

Spreadbury, Matthew; Gubberud, Espen; Halvorsen, Henrik; Bjørkum, Jon; Butter, Antje

doi:10.4045/tidsskr.21.0289

Cited by 3 publications

(3 citation statements)

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“…Although thrombus formation within the right atrium, right ventricle can lead to consecutive pulmonary embolism, this issue is under-reported in the scientific literature and clinical guidelines [ 22 , 23 , 24 , 25 ]. There are also few data on aortic thrombosis in COVID-19 and its combination with venous thrombosis [ 24 , 26 , 27 , 28 , 29 , 30 ]. The results of our study demonstrated that in situ pulmonary artery thrombosis is the most common thrombotic complication identified postmortem.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Thrombotic Complications in Fatal Cases of COVID-19: Focus on Pulmonary Artery Thrombosis In Situ

Babkina

Yadgarov

Волков

et al. 2023

Viruses

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COVID-19-related thrombosis affects the venous and arterial systems. Data from 156 autopsies of COVID-19 patients were retrospectively analyzed to investigate the pattern of thrombotic complications and factors associated with pulmonary artery thrombosis and thromboembolism. Thrombotic complications were observed in a significant proportion (n = 68, 44%), with pulmonary artery thrombosis the most frequently identified thrombotic event (42, 27%). Multivariate analysis revealed that the length of hospital stay (OR 1.1, p = 0.004), neutrophil infiltration in the alveolar spaces (OR 3.6, p = 0.002), and the absence of hyaline membranes (OR 0.1, p = 0.01) were associated with thrombotic complications. Neutrophil infiltration in the alveolar spaces (OR 8, p < 0.001) and the absence of hyaline membranes (OR 0.1, p = 0.003) were also independent predictors of pulmonary artery thrombosis. The association of pulmonary artery thrombosis with an absence of hyaline membranes suggests it occurs later in the course of COVID-19 infection. As neutrophil infiltration in the alveolar spaces may indicate bacterial infection, our studies suggest the consideration of bacterial infections in these critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Spectrum of Thrombotic Complications in Fatal Cases of COVID-19: Focus on Pulmonary Artery Thrombosis In Situ

Babkina

Yadgarov

Волков

et al. 2023

Viruses

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“…Во-вторых, имея тропность к эндотелиоцитам, SARS-CoV-2 провоцирует воспаление в этих клетках с развитием эндотелиита [20][21][22][23][24]. В-третьих, с дальнейшим нарастанием коагулопатии, провоцируемой вирусными агентами, данный субстрат становится зоной пристеночного, а затем окклюзионного тромбоза, что вызывает острую ишемию [25][26][27][28][29]. В той ситуации, когда речь идет о пациентах с мультифокальным атеросклерозом, наличие атеросклеротической бляшки (АСБ) может ускорить процесс потери просвета сосуда.…”

Section: Discussionunclassified

“…В той ситуации, когда речь идет о пациентах с мультифокальным атеросклерозом, наличие атеросклеротической бляшки (АСБ) может ускорить процесс потери просвета сосуда. SARS-CoV-2 дестабилизирует ее "покрышку", что может приводить не только к разрыву АСБ с дистальной эмболией, но и к диссекции артерии [25][26][27][28][29]. Необходимо отметить, что в рамках нашего исследования ретромбоз у пациентов развивался в первые часы после операции.…”

Section: Discussionunclassified

Results of thrombectomy in lower-extremity ischemia in patients with COVID-19 and respiratory failure of different severity

et al. 2022

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Aim. To analyze the results of thrombectomy in lower-extremity ischemia in patients with coronavirus disease 2019 (COVID-19) and respiratory failure of different severity.Material and methods. This retrospective, cohort, comparative study for the period from May 1, 2020 to March 1, 2022 included 305 patients with acute lower-extremity ischemia and COVID-19. Depending on the type of oxygen support, three groups of patients were formed: group 1 (n=168) — nasal oxygen insufflation; group 2 (n=92) — non-invasive ventilation (NIV); group 3 (n=45) — artificial ventilation (AV). Thrombectomy was carried out according to the standard technique using Fogarty catheters (3F-6F — depending on the vessel size). After the diagnosis was established before and after the start of surgical treatment, all patients received the following therapy: Unfractionated IV heparin infusion at an initial rate of 1000 U/r, adjusted to maintain the activated partial thromboplastin time at 2-3 times the normal value; 2. Oral acetylsalicylic acid 125 mg; 3. Analgesics.Results. Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5,3%, n=9; group 2: 72,8%, n=67; group 3: 100%, n=45; p<0,0001), retrombosis (group 1 : 18,4%, n=31; group 2: 69,5%, n=64; group 3: 91,1%, n=41; p<0,0001) and limb amputations (group 1: 9,5%, n=16; group 2: 56,5%, n=52; group 3: 91,1%, n=41; p<0,0001) was recorded in group 3 patients.Conclusion. In patients receiving mechanical ventilation, COVID-19 have more aggressive course, which is expressed in an increase in laboratory para- meters (C-reactive protein, ferritin, interleukin-6, D-dimer), the severity of pneumonia and location of thrombosis in the tibial arteries. Among patients with COVID-19 receiving mechanical ventilation, the greatest number of rethromboses (91,1%), limb amputations (91,1%), and deaths (100%) are noted, which suggests the expediency of abandoning open thrombectomy in favor of anticoagulant/antiplatelet therapy in this cohort of patients. The development of arterial thrombosis in patients with COVID-19 receiving mechanical ventilation is an indicator of a high risk of death. Open thrombectomy in combination with anticoagulant/antiplatelet therapy is most effective in patients on nasal oxygen insufflation or NIV.

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The results of thrombectomy from the arteries of the lower extremities in patients infected with SARS-CoV-2 Omicron variant with different severity of respiratory failure

et al. 2023

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Goal Analysis of the results of thrombectomy from the arteries of the lower extremities in patients with COVID-19 against the background of different severity of respiratory failure. Materials and Methods This retrospective, cohort, comparative study for the period from 05/01/2022 to 20/07/2022 included 305 patients with acute thrombosis of the arteries of the lower extremities against the background of the course of COVID-19 (SARS-CoV-2 Omicron variant). Depending on the type of oxygen support, 3 groups of patients were formed: group 1 ( n = 168) – oxygen insufflation through nasal cannulas; group 2 ( n = 92) – non-invasive lung ventilation; and group 3 ( n = 45) – artificial lung ventilation. Results Myocardial infarction and ischemic stroke were not detected in the total sample. The highest number of deaths (group 1: 5.3%, n = 9; group 2: 72.8%, n = 67; group 3: 100%, n = 45; p < 0.0001), rethrombosis (group 1 : 18.4%, n = 31; group 2: 69.5%, n = 64; group 3: 91.1%, n = 41; p < 0.0001), and limb amputations (group 1: 9.5%, n = 16; group 2: 56.5%, n = 52; group 3: 91.1%, n = 41; p < 0.0001) was recorded in group 3 (ventilated) patients. Conclusion In patients infected with COVID-19 and on artificial lung ventilation, a more aggressive course of the disease is noted, expressed in an increase in laboratory parameters (C-reactive protein, ferritin, interleukin-6, and D-dimer) of the degree of pneumonia (CT-4 in overwhelming number) and localization of thrombosis of the arteries of the lower extremities, mainly in the tibial arteries.

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Multiple arterielle tromboembolier etter covid-19

Cited by 3 publications

References 1 publication

Spectrum of Thrombotic Complications in Fatal Cases of COVID-19: Focus on Pulmonary Artery Thrombosis In Situ

Spectrum of Thrombotic Complications in Fatal Cases of COVID-19: Focus on Pulmonary Artery Thrombosis In Situ

Results of thrombectomy in lower-extremity ischemia in patients with COVID-19 and respiratory failure of different severity

The results of thrombectomy from the arteries of the lower extremities in patients infected with SARS-CoV-2 Omicron variant with different severity of respiratory failure

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