Pulmonary artery thrombosis in a patient with severe acute respiratory syndrome

Ng, Kenneth H. L.; Wu, Alan; Cheng, Vincent Chi-Chung; Tang, Bone Siu-Fai; Chan, C Y; Yung, Chi Wah; Luk, S H; Lee, T W; Chow, Louis T. C.; Yuen, Kwok‐Yung

doi:10.1136/pgmj.2004.030049

Cited by 67 publications

(74 citation statements)

References 18 publications

(5 reference statements)

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“…It was difficult to judge its effects, as the study was uncontrolled and pulsed steroid was also used concurrently [132]. Pulmonary artery thrombosis has been reported in a patient with SARS who was treated with ribavirin, steroid, lopinavir/ritonavir, IVIg and pentaglobulin [133]. It is possible that the IVIgor pentaglobulin-induced increase in viscosity may be consequential in patients with hypercoagulable states such as SARS [134].…”

Section: Ivig (Intravenous γ -Globulin) and Pentaglobulinmentioning

confidence: 99%

SARS: clinical presentation, transmission, pathogenesis and treatment options

2006

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SARS (severe acute respiratory syndrome) appeared as the first emerging infectious disease of this century. It is fortunate that the culprit virus can be grown without much difficulty from a commonly used cell line, allowing an unlimited supply of isolates for further molecular studies and leading to the development of sensitive diagnostic assays. How the virus has successfully jumped the species barrier is still a mystery. The superspreading events that occurred within hospital, hotel and high-density housing estate opens a new chapter in the mechanisms and routes of virus transmission. The old practice of quarantine proved to be still useful in controlling the global outbreak. Despite all the available sophisticated tests, alertness with early recognition by healthcare workers and prompt isolation of suspected cases is still the most important step for containing the spread of the infection. Although the rapidly evolving outbreak did not allow the conducting of systematic clinical trails to evaluate treatment options, the accumulated experience on managing SARS patients will improve the clinical outcome should SARS return. Although SARS led to more than 700 deaths worldwide, the lessons learnt have prepared healthcare systems worldwide to face future emerging and re-emerging infections.

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Section: Ivig (Intravenous γ -Globulin) and Pentaglobulinmentioning

confidence: 99%

SARS: clinical presentation, transmission, pathogenesis and treatment options

2006

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“…Diarrhea is the most common extrapulmonary manifestation, followed by hepatic dysfunction; dizziness, which may be related to diastolic cardiac impairment and pulmonary arterial thrombosis; abnormal urinalysis; petechiae; myositis; neuromuscular abnormalities; and epileptic fits (44,58,188,211,248,335,346,383). The elderly may present atypically without fever or respiratory symptoms (68,361).…”

Section: Clinical Featuresmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection

et al. 2007

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SUMMARY Before the emergence of severe acute respiratory syndrome (SARS) coronavirus (SARS-CoV) in 2003, only 12 other animal or human coronaviruses were known. The discovery of this virus was soon followed by the discovery of the civet and bat SARS-CoV and the human coronaviruses NL63 and HKU1. Surveillance of coronaviruses in many animal species has increased the number on the list of coronaviruses to at least 36. The explosive nature of the first SARS epidemic, the high mortality, its transient reemergence a year later, and economic disruptions led to a rush on research of the epidemiological, clinical, pathological, immunological, virological, and other basic scientific aspects of the virus and the disease. This research resulted in over 4,000 publications, only some of the most representative works of which could be reviewed in this article. The marked increase in the understanding of the virus and the disease within such a short time has allowed the development of diagnostic tests, animal models, antivirals, vaccines, and epidemiological and infection control measures, which could prove to be useful in randomized control trials if SARS should return. The findings that horseshoe bats are the natural reservoir for SARS-CoV-like virus and that civets are the amplification host highlight the importance of wildlife and biosecurity in farms and wet markets, which can serve as the source and amplification centers for emerging infections.

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“…1 Autopsy studies from the SARS outbreak of the early 2000s, caused by SARS-CoV-1 virus, have demonstrated pulmonary thrombi, pulmonary infarcts, and microthrombi in other organs. [5][6][7][8] It appears that SARS-CoV-2 is causing similar pathophysiological derangements. Although microthrombi are present in sepsis and classic forms of ARDS, they are unlikely to be the principal cause of respiratory failure and organ dysfunction.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

COVID-19 Critical Illness Pathophysiology Driven by Diffuse Pulmonary Thrombi and Pulmonary Endothelial Dysfunction Responsive to Thrombolysis

Poor

Ventetuolo

Tolbert

et al. 2020

Preprint

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Critically ill COVID-19 patients have relatively well-preserved lung mechanics despite severe gas exchange abnormalities, a feature not consistent with classical ARDS but more consistent with pulmonary vascular disease. Patients with severe COVID-19 also demonstrate markedly abnormal coagulation, with elevated D-dimers and higher rates of venous thromboembolism. We present four cases of patients with severe COVID-19 pneumonia with severe respiratory failure and shock who demonstrated immediate improvements in gas exchange and/or hemodynamics with systemic tPA.

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Pulmonary artery thrombosis in a patient with severe acute respiratory syndrome

Cited by 67 publications

References 18 publications

SARS: clinical presentation, transmission, pathogenesis and treatment options

SARS: clinical presentation, transmission, pathogenesis and treatment options

Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection

COVID-19 Critical Illness Pathophysiology Driven by Diffuse Pulmonary Thrombi and Pulmonary Endothelial Dysfunction Responsive to Thrombolysis

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