VASKULARNE KOMPLIKACIJE KOD SINDROMA PRODUŽENOG COVIDA SU JAKO RETKE
Ključne reči:
vaskularne komplikacije, tromboza, ishemija, pulmonarni embolizam, venska tromboza, arterijska tromboza, embolija, produženi COVID
Sažetak
U zavisnosti od metodologije tromboze tokom akutne infekcije COVIDom su zabeleženu u 20-85% bolesnika. Nakon akutne faze određena grupa pacijenata sa ima različite simptome nespecifične prirode koji mogu trajati i mesecima te se takvo stanje naziva produženim COVID-om. Imajući u vidu mehanizme nastanka i učestalost vaskularnih komplikacija tokom COVID infekcije kao i patogenezu produženog COVID-a očekivali bi da i ovde dominiraju trombotski procesi kako na arterijskom tako i na venskom sistemu.
Sproveli smo opsežni pregled literature tražeći naučne radove koji opisuju trombotske, arterijske ili venske, komplikacija u produženom COVID sindromu, više od četiri nedelje nakon akutne epizode. Istraživanja koja se bave produženim COVIDom su uglavnom fokusirana na simptome i laboratorijske rezultate dok rezultati koji se bave trombotskim komplikacijama uglavnom nedostaju ili su retke. Jako je malo kardiovaskularnih manifestacija dok su vrednosti D Dimera procenjivane u samo dve studije. Jedna od malobrojnih istraživanja koja porede efekte drugih virusnih infekcija i COVIDa je pokazala da je u produženom COVIDu učeastalost trombotskih komplikacija nešto veća. Posebno je osetljiva grupa hroničnih kardiovaskularnih bolesnika kod kojih je učestalost trombotskih događaja znatno veća-
Vaskularne komplikacije produženog COVIDa su retke u dostupnoj literaturi, posebno u poređenju sa ulogom trombotskih događaja u akutnoj COVID infekciji. Buduća istraživanja će nadamo se pokazati uzrok i potencijalne mehanizme za ovakvu razliku.
Reference
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13. Natarajan A, Zlitni S, Brooks EF, Vance SE, Dahlen A, Hedlin H, et al. Gastrointestinal symptoms and fecal shedding of SARS-COV-2 RNA suggest prolonged gastrointestinal infection. Med. 2022;3(6).
14. Peluso MJ, Deitchman AN, Torres L, Iyer NS, Munter SE, Nixon CC, et al. Long-term SARS-COV-2-specific immune and inflammatory responses in individuals recovering from covid-19 with and without post-acute symptoms. Cell Reports. 2021;36(6):109518.
15. Littlefield KM, Watson RO, Schneider JM, Neff CP, Yamada E, Zhang M, et al. SARS-COV-2-specific T cells associate with inflammation and reduced lung function in pulmonary post-acute sequalae of SARS-COV-2. PLOS Pathogens. 2022;18(5).
16. Jing H, Wu X, Xiang M, Liu L, Novakovic VA, Shi J. Pathophysiological mechanisms of thrombosis in acute and long COVID-19. Frontiers in Immunology. 2022;13.
17. Fogarty H, Townsend L, Morrin H, Ahmad A, Comerford C, Karampini E, et al. Persistent endotheliopathy in the pathogenesis of Long Covid syndrome. Journal of Thrombosis and Haemostasis. 2021;19(10):2546–53.
18. Kell DB, Laubscher GJ, Pretorius E. A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications. Biochem J. 2022 Feb 17;479(4):537-559.
19. Katsoularis I, Fonseca-Rodríguez O, Farrington P, Jerndal H, Lundevaller EH, Sund M, et al. Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: Nationwide self-controlled cases series and matched Cohort Study. BMJ. 2022;
20. Marjenberg Z, Leng S, Tascini C, Garg M, Misso K, El Guerche Seblain C, et al. Risk of long COVID main symptoms after SARS-COV-2 infection: A systematic review and meta-analysis. Scientific Reports. 2023;13(1).
21. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo P, Cuapio A, et al. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. 2021;
22. Mandal S, Barnett J, Brill SE, Brown JS, Denneny EK, Hare SS, et al. ‘long-COVID’: A cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2020;76(4):396–8.
23. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in Covid‐19. Journal of Thrombosis and Haemostasis. 2020;18(9):2103–9.
24. Baldini T, Asioli GM, Romoli M, Carvalho Dias M, Schulte EC, Hauer L, et al. Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus‐2 infection: A systematic review and meta‐analysis. European Journal of Neurology. 2021;28(10):3478–90.
25. Wretborn J, Jörg M, Benjaminsson Nyberg P, Wilhelms DB. Risk of venous thromboembolism in a Swedish healthcare system during the COVID‐19 pandemic: A retrospective cross‐sectional study. Journal of the American College of Emergency Physicians Open. 2021;2(5).
26. Giannis D, Goldin M, Rahman H, Sison CP, Lesser ML, Ngu S, et al. Risk factors for postdischarge major thromboembolism and mortality in hospitalized patients with COVID-19 with cardiovascular comorbidities: Insights from the CORE-19 Registry. Thrombosis and Haemostasis. 2023;123(11):1089–99.
27. Yong SJ, Liu S. Proposed subtypes of post‐covid‐19 syndrome (or long‐covid) and their respective potential therapies. Reviews in Medical Virology. 2021;32(4).
28. Patell R, Bogue T, Koshy A, Bindal P, Merrill M, Aird WC, et al. Postdischarge thrombosis and hemorrhage in patients with covid-19. Blood. 2020;136(11):1342–6.
29. Sjoland H, Lindgren M, Toska T, Hansson PO, Sandblad KG, Alex C, et al. Pulmonary embolism and deep venous thrombosis after COVID-19: long-term risk in a population-based cohort study. European Heart Journal. 2023;7(5):100284.
30. Engelen MM, Vandenbriele C, Balthazar T, Claeys E, Gunst J, Guler I, et al. Venous thromboembolism in patients discharged after COVID-19 hospitalization. Seminars in Thrombosis and Hemostasis. 2021;47(04):362–71.
31. Remy-Jardin M, Duthoit L, Perez T, Felloni P, Faivre J-B, Fry S, et al. Assessment of pulmonary arterial circulation 3 months after hospitalization for SARS-COV-2 pneumonia: Dual-energy CT (DECT) angiographic study in 55 patients. EClinicalMedicine. 2021;34:100778.
32. Fan BE, Umapathi T, Chua K, Chia YW, Wong SW, Tan GW, et al. Delayed catastrophic thrombotic events in young and asymptomatic post COVID-19 patients. Journal of Thrombosis and Thrombolysis. 2020;51(4):971–7.
2. Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thrombosis Research. 2020;191:145–7.
3. Helms J, Tacquard C, Severac F, Leonard-Lorant I, Ohana M, Delabranche X, et al. High risk of thrombosis in patients with severe SARS-COV-2 infection: A multicenter prospective cohort study. Intensive Care Medicine. 2020;46(6):1089–98.
4. Perini P, Nabulsi B, Massoni CB, Azzarone M, Freyrie A. Acute limb ischaemia in two young, non-atherosclerotic patients with covid-19. The Lancet. 2020;395(10236):1546.
5. Llitjos J, Leclerc M, Chochois C, Monsallier J, Ramakers M, Auvray M, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID‐19 patients. Journal of Thrombosis and Haemostasis. 2020;18(7):1743–6.
6. Yousefi P, Soltani S, Siri G, Rezayat SA, Gholami A, Zafarani A, et al. Coagulopathy and thromboembolic events a pathogenic mechanism of COVID‐19 associated with mortality: An updated review. Journal of Clinical Laboratory Analysis. 2023;37(11–12).
7. Venkatesan P. Nice guideline on Long Covid. The Lancet Respiratory Medicine. 2021;9(2):129.
8. Tenforde MW, Kim SS, Lindsell CJ, Billig Rose E, Shapiro NI, Files DC, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020. MMWR Morbidity and Mortality Weekly Report. 2020;69(30):993–8.
9. Daher A, Balfanz P, Cornelissen C, Müller A, Bergs I, Marx N, et al. Follow up of patients with severe coronavirus disease 2019 (COVID-19): Pulmonary and extrapulmonary disease sequelae. Respiratory Medicine. 2020;174:106197.
10. Klein H, Asseo K, Karni N, Benjamini Y, Nir-Paz R, Muszkat M, et al. Onset, duration and unresolved symptoms, including smell and taste changes, in mild COVID-19 infection: A cohort study in Israeli patients. Clinical Microbiology and Infection. 2021;27(5):769–74.
11. Mehandru S, Merad M. Pathological sequelae of long-haul COVID. Nature Immunology. 2022;23(2):194–202.
12. Joy G, Artico J, Kurdi H, Seraphim A, Lau C, Thornton GD, et al. Prospective case-control study of cardiovascular abnormalities 6 months following mild COVID-19 in healthcare workers. JACC: Cardiovascular Imaging. 2021;14(11):2155–66.
13. Natarajan A, Zlitni S, Brooks EF, Vance SE, Dahlen A, Hedlin H, et al. Gastrointestinal symptoms and fecal shedding of SARS-COV-2 RNA suggest prolonged gastrointestinal infection. Med. 2022;3(6).
14. Peluso MJ, Deitchman AN, Torres L, Iyer NS, Munter SE, Nixon CC, et al. Long-term SARS-COV-2-specific immune and inflammatory responses in individuals recovering from covid-19 with and without post-acute symptoms. Cell Reports. 2021;36(6):109518.
15. Littlefield KM, Watson RO, Schneider JM, Neff CP, Yamada E, Zhang M, et al. SARS-COV-2-specific T cells associate with inflammation and reduced lung function in pulmonary post-acute sequalae of SARS-COV-2. PLOS Pathogens. 2022;18(5).
16. Jing H, Wu X, Xiang M, Liu L, Novakovic VA, Shi J. Pathophysiological mechanisms of thrombosis in acute and long COVID-19. Frontiers in Immunology. 2022;13.
17. Fogarty H, Townsend L, Morrin H, Ahmad A, Comerford C, Karampini E, et al. Persistent endotheliopathy in the pathogenesis of Long Covid syndrome. Journal of Thrombosis and Haemostasis. 2021;19(10):2546–53.
18. Kell DB, Laubscher GJ, Pretorius E. A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications. Biochem J. 2022 Feb 17;479(4):537-559.
19. Katsoularis I, Fonseca-Rodríguez O, Farrington P, Jerndal H, Lundevaller EH, Sund M, et al. Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: Nationwide self-controlled cases series and matched Cohort Study. BMJ. 2022;
20. Marjenberg Z, Leng S, Tascini C, Garg M, Misso K, El Guerche Seblain C, et al. Risk of long COVID main symptoms after SARS-COV-2 infection: A systematic review and meta-analysis. Scientific Reports. 2023;13(1).
21. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo P, Cuapio A, et al. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. 2021;
22. Mandal S, Barnett J, Brill SE, Brown JS, Denneny EK, Hare SS, et al. ‘long-COVID’: A cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2020;76(4):396–8.
23. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in Covid‐19. Journal of Thrombosis and Haemostasis. 2020;18(9):2103–9.
24. Baldini T, Asioli GM, Romoli M, Carvalho Dias M, Schulte EC, Hauer L, et al. Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus‐2 infection: A systematic review and meta‐analysis. European Journal of Neurology. 2021;28(10):3478–90.
25. Wretborn J, Jörg M, Benjaminsson Nyberg P, Wilhelms DB. Risk of venous thromboembolism in a Swedish healthcare system during the COVID‐19 pandemic: A retrospective cross‐sectional study. Journal of the American College of Emergency Physicians Open. 2021;2(5).
26. Giannis D, Goldin M, Rahman H, Sison CP, Lesser ML, Ngu S, et al. Risk factors for postdischarge major thromboembolism and mortality in hospitalized patients with COVID-19 with cardiovascular comorbidities: Insights from the CORE-19 Registry. Thrombosis and Haemostasis. 2023;123(11):1089–99.
27. Yong SJ, Liu S. Proposed subtypes of post‐covid‐19 syndrome (or long‐covid) and their respective potential therapies. Reviews in Medical Virology. 2021;32(4).
28. Patell R, Bogue T, Koshy A, Bindal P, Merrill M, Aird WC, et al. Postdischarge thrombosis and hemorrhage in patients with covid-19. Blood. 2020;136(11):1342–6.
29. Sjoland H, Lindgren M, Toska T, Hansson PO, Sandblad KG, Alex C, et al. Pulmonary embolism and deep venous thrombosis after COVID-19: long-term risk in a population-based cohort study. European Heart Journal. 2023;7(5):100284.
30. Engelen MM, Vandenbriele C, Balthazar T, Claeys E, Gunst J, Guler I, et al. Venous thromboembolism in patients discharged after COVID-19 hospitalization. Seminars in Thrombosis and Hemostasis. 2021;47(04):362–71.
31. Remy-Jardin M, Duthoit L, Perez T, Felloni P, Faivre J-B, Fry S, et al. Assessment of pulmonary arterial circulation 3 months after hospitalization for SARS-COV-2 pneumonia: Dual-energy CT (DECT) angiographic study in 55 patients. EClinicalMedicine. 2021;34:100778.
32. Fan BE, Umapathi T, Chua K, Chia YW, Wong SW, Tan GW, et al. Delayed catastrophic thrombotic events in young and asymptomatic post COVID-19 patients. Journal of Thrombosis and Thrombolysis. 2020;51(4):971–7.
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2023/12/19
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