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Case report: cerebral thromboembolism in an unconscious COVID-19 patient in intensive care

机译:案例报告:脑血栓栓塞在无意识的Covid-19患者中的重症监护

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摘要

Although the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. Acute respiratory distress syndrome due to SARS-CoV-2 (Severe Acute Respiratory Syndrome - Corona Virus 2) often requires intensive care follow-up. As well as respiratory failure, the SARS-CoV-2 may cause central nervous system (CNS) involvement. The pandemic has raised many challenges in managing critically ill older adults, a population preferentially killed by COVID-19. The mortality and morbidity rates are extremely high in critically ill patients with COVID-19. Recent studies have reported the potential development of a hypercoagulable state in COVID-19. Viral infections and hypoxia may cause these state. It is increasingly reported that thromboembolic events are associated with a poor prognosis. Due to these thromboembolic complications, COVID-19 patients often have neurological symptoms. These symptoms may not be observed in intensive care patients who are sedated. We report one case who was sedated COVID-19 pneumonia and who was later diagnosed with cerebral venous thrombosis with cranial imaging when he could not awaken even though sedation was discontinued. Since COVID-19 causes intense thrombotic susceptibility due to cytokine storm, cerebrovascular thromboembolic complications associated with COVID-19 infection should be considered first and foremost for unconsciousness ventilated patients. Severe and potentially cerebral thrombosis may prolong the patient´s stay in intensive care.
机译:虽然冠状病毒疾病的严重程度2019(Covid-19)更频繁地与急性呼吸窘迫综合征和急性心脏和肾损伤有关,但越来越多地报道了血栓栓塞事件。由于SARS-COV-2(严重急性呼吸综合征 - 电晕病毒2)导致急性呼吸窘迫综合征通常需要重症监护权。除了呼吸衰竭,SARS-COV-2可能导致中枢神经系统(CNS)参与。大流行在管理批评性老年人的情况下提出了许多挑战,这是由Covid-19杀死的人口。患有Covid-19的危重患者的死亡率和发病率极高。最近的研究报告了Covid-19中高凝状态的潜在发展。病毒感染和缺氧可能导致这些状态。据报道,血栓栓塞事件与预后差有关。由于这些血栓栓塞并发症,Covid-19患者通常具有神经系统症状。在镇静护理患者中可能无法观察到这些症状。我们举报了一个沉积的Covid-19肺炎的一个案例,后者稍后被诊断出脑静脉血栓形成,当时他不能唤醒时,他不能唤醒,即使镇静停止。由于Covid-19由于细胞因子风暴引起强烈的血栓形成敏感性,因此首先应考虑与Covid-19感染相关的脑血管血栓栓塞并发症,并且最重要的是无意识的通风患者。严重和潜在的脑血栓形成可能延长患者的重症监护。

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