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10.1002/ctm2.44

http://scihub22266oqcxt.onion/10.1002/ctm2.44
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suck abstract from ncbi


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pmid32508062      Clin+Transl+Med 2020 ; 10 (2): e44
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  • COVID-19 critical illness pathophysiology driven by diffuse pulmonary thrombi and pulmonary endothelial dysfunction responsive to thrombolysis #MMPMID32508062
  • Poor HD; Ventetuolo CE; Tolbert T; Chun G; Serrao G; Zeidman A; Dangayach NS; Olin J; Kohli-Seth R; Powell CA
  • Clin Transl Med 2020[Jun]; 10 (2): e44 PMID32508062show ga
  • Patients with severe COVID-19 disease have been characterized as having the acute respiratory distress syndrome (ARDS). 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. Many 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, with evidence of markedly elevated dead-space ventilation who received tPA. All showed post treatment immediate improvements in gas exchange and/or hemodynamics. We suspect that severe COVID-19 pneumonia causes respiratory failure via pulmonary microthrombi and endothelial dysfunction. Treatment for COVID-19 pneumonia may warrant anticoagulation for milder cases and thrombolysis for more severe disease.
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