Bệnh lý đông máu thứ phát sau Covid-19: Một bài tổng quan y văn

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Tác giả: Thượng Vũ Lê, Tự Phương Thúy Lê

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.10

Bộ sưu tập: Metadata

ID: 339374

Thêm vào giỏ Liên kết toàn văn

- Mở đầu: Bệnh COVID-19 do virus SARS-CoV2 gây ra là một đại dịch bắt đầu vào cuối năm 2019 và đã lây nhiễm cho khoảng 600 triệu người và giết chết hơn 6 triệu người. Ngoài tổn thương phổi phổ biến nhất, bệnh lý đông máu do COVID-19 từng được báo cáo. Tầm quan trọng bệnh lý đông máu do COVID-19 như thế nào
bệnh nên được chẩn đoán và điều trị ra sao là những mục tiêu của bài tổng quan này.- Bệnh nhân và Phương pháp: Tổng quan y văn, tất cả những bài báo trên PubMed từ 12/2019 đến 4/2022 có các từ khóa COVID-19 hoặc SARS-CoV2 kèm hoặc bệnh lý đông máu, huyết khối động mạch, bệnh thuyên tắc huyết khối tĩnh mạch, đông máu nội mạch lan tỏa, hội chứng kháng phospholipid hoặc bệnh vi mạch huyết khối được sử dụng. - Kết quả và Bàn luận: Bệnh lý đông máu ở COVID-19 là phổ biến, gây ra gánh nặng bệnh tật và tử vong cao. Có nhiều biểu hiện lâm sàng khác nhau, từ bệnh lý mạch máu lớn như bệnh thuyên tắc huyết khối tĩnh mạch, huyết khối động mạch đến bệnh mạch nhỏ như đông máu nội mạch lan tỏa (disseminated intravascular coagulation - DIC), bệnh vi mạch huyết khối (thrombotic microangiopathy - TMA). Trong khi hiểu biết về bệnh rối loạn đông máu COVID-19 vẫn còn sơ khai và đang được làm sáng tỏ, các nghiên cứu tìm phương pháp điều trị mới đang được tiến hành thông qua các nghiên cứu phân bố ngẫu nhiên đối chứng mù đôi sẽ giúp tìm ra các liệu pháp hiệu quả hơn. Chúng tôi sẽ trình bày tất cả các dạng lâm sàng khác nhau về rối loạn đông máu và cập nhật chúng về tần suất, gánh nặng, cơ chế bệnh sinh, chẩn đoán và điều trị. Chúng tôi sẽ mô tả xem những biến chứng này gặp phải hầu hết là giai đoạn COVID-19 cấp tính hoặc trong giai đoạn COVID-19 sau cấp tính (COVID-19 kéo dài hoặc hậu COVID-19).- Kết luận: COVID-19 cần được tiếp cận như một bệnh nhiễm trùng và đồng thời là một bệnh nội khoa với các biến chứng đông máu đa dạng và phức tạp. Tiếp cận toàn diện như vậy có thể giúp cải thiện tử vong và tật bệnh.Abstract- Introduction: COVID-19 caused by SARS-CoV2 is a pandemic that started at the end of 2019 and has infected about 600 million people and killed over 6 million people. In addition to the most common lung injury, COVID-19 coagulopathy contributes significantly to morbidity and mortality.- Patients and method: Literature review- Results and discussion: Coagulopathy in COVID-19 is common, causing a high burden of morbidity and mortality. There are many clinical presentations varying from macrovascular diseases such as venous thrombo-embolism, arterial thrombosis to small vessel disease such as disseminated intravascular coagulation (DIC), thrombotic microangiopathy (TMA). While the understanding of COVID-19 coagulopathy is still in its infancy and being elucidated, researches for new treatments are underway through double - blind randomiased controlled studies that will help find more effective therapies. We will present all the different presentations of coagulopathy and update them on the frequency, burden, pathogenesis, diagnosis, and treatment. We will describe if these complications be encountered mostly acute COVID-19 phase or in the post - acute COVID-19 phase (long COVID-19 or post COVID-19).- Conclusion: COVID-19 needs to be approached as an infection disease and by the sametime as a medical disease with diverse and complex coagulation complications. Such a comprehensive approach might help improve mortality and morbidity. DOI: 10.59715/pntjmp.1.4.2

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