A coronavirus patient thought he was recovering. Then doctors found blood clots in his lungs — a new and potentially deadly complication of the virus.

一名冠状病毒患者以为自己正在康复。然后医生在他的肺部发现了血块，这是一种新的、可能致命的病毒并发症。

ylee@businessinsider.com (Yeji Jesse Lee,Lydia Ramsey)ylee@businessinsider.com (Yeji Jesse Lee,Lydia Ramsey)

April 23, 2020, 1:38 AM GMT+8

2020年4月23日，格林威治标准时间上午1:38 +8

Michael Reagan at Mount Sinai Hospital in New York for blood-clot treatment on April 14.

4月14日，迈克尔·里根在纽约西奈山医院接受血块治疗。

Michael Reagan

迈克尔·里根

• Doctors are finding blood clots in the lungs, heart, and kidneys of coronaviruspatients. Some of them are critically ill, but others seem relatively stable.
• 医生在冠状病毒患者的肺、心脏和肾脏中发现了血块。其中一些已经病入膏肓，但其他的似乎相对稳定。
• Blood clots can travel and create blockages in veins, which could lead to strokes, heart attacks, and other issues.
• 血凝块会在静脉中流动并造成阻塞，这可能会导致中风、心脏病发作和其他问题。
• Without clinical trials or science-backed treatments, physicians are forced to figure out how to best treat these complications on "very weak but very compelling data," Dr. Alex Spyropoulos, an expert on blood clots at Northwell Health in New York, told Business Insider.
• 纽约诺斯威尔健康中心的血块专家亚历克斯·斯派罗普洛斯博士告诉商业内幕网，如果没有临床试验或有科学依据的治疗方法，医生们将不得不根据“非常薄弱但非常有说服力的数据”来找出最佳的治疗方法。
• Business Insider talked to Michael Reagan, a 49-year-old COVID-19 patient whose doctors recently discovered dozens of blood clots in his lungs.
• “Business Insider”采访了49岁的covid19患者迈克尔·里根(Michael Reagan)，他的医生最近在他的肺部发现了数十个血块。

More than 2 million people around the world have been infected with the novel coronavirus, but there's still a lot we don't know about how the disease affects the human body.

全世界有超过200万人感染了这种新型冠状病毒，但对于这种疾病如何影响人体，我们仍有很多不了解的地方。

Respiratory issues are one of the key symptoms of infection, but other complications — like kidney issues and heart problems — have more recently risen to the surface as physicians struggle to better understand how to treat their patients.

呼吸系统问题是感染的主要症状之一，但其他并发症——如肾脏问题和心脏问题——最近浮出水面，因为医生们努力更好地了解如何治疗他们的病人。

With COVID-19, the disease caused by the coronavirus, doctors are also seeing blood clots occurring in the lungs and bodies of patients. Clots can travel and create blockages in veins, leading to strokes, heart attacks, and other issues.

对于由冠状病毒引起的COVID-19疾病，医生们也看到病人的肺部和身体出现血块。血块会在静脉中流动并造成阻塞，导致中风、心脏病发作和其他问题。

Some of the patients with blood clots are in hospitals in critical condition while others diagnosed with the complications are otherwise healthy enough to be sent home.

一些有血块的病人住在医院，情况危急，而另一些被诊断出有并发症的病人则健康状况良好，可以出院回家。

That's what happened to Michael Reagan, a 49-year-old COVID-19 patient.

这就是49岁的COVID-19患者迈克尔·里根(Michael Reagan)的遭遇。

'It feels like a toxin is in my body'

“感觉就像我体内有一种毒素”

Reagan, who works for an international biomedical company in New York, was diagnosed with COVID-19 in late March and had been recovering at home in New York City for weeks. He was taking azithromycin, an antibiotic used to treat infections, and hydroxychloroquine, an anti-malarial medication, as a participant in a clinical trial.

在纽约一家国际生物医药公司工作的里根在3月底被诊断出患有COVID-19，他在纽约的家中休养了几个星期。他正在服用阿奇霉素(一种用于治疗感染的抗生素)和羟基氯喹(一种抗疟疾药物)作为临床试验的参与者。

His symptoms included breathing problems, a high fever, and coughing up blood. Reagan said he was starting to feel a little better early last week, until he suddenly began to experience a high fever once again, along with chest pains.

他的症状包括呼吸困难、高烧和咳血。里根说他上周早些时候开始感觉好一点了，直到他突然又开始发高烧，并伴有胸痛。

Never miss out on healthcare news. Subscribe to Dispensed, our weekly newsletter on pharma, biotech, and healthcare.

千万不要错过医疗新闻。订阅我们每周关于医药、生物技术和医疗保健的时事通讯Dispensed。

When he went into the hospital, Reagan said doctors told him coronavirus-related pneumonia has spread into both lungs. A pulmonologist later told him he had dozens of little blood clots throughout his lungs.

当他进入医院时，里根说医生告诉他，与冠状病毒相关的肺炎已经扩散到双肺。一位肺科医生后来告诉他，他的肺里有几十个小血块。

"It feels like a toxin is in my body," Reagan told Business Insider.

“感觉就像我体内有一种毒素，”里根告诉《商业内幕》。

Blood clots in recovering coronavirus patients are a new worry for doctors. In early autopsy data from Northwell Health, around 40% of coronavirus patients who died after leaving the hospital appeared to have experienced major clotting events like a massive heart attack or lung clots, as previously reported by Business Insider.

冠状病毒患者恢复过程中的血凝块是医生们新的担忧。根据诺斯威尔健康的早期尸检数据，约有40%的冠状病毒患者在出院后死亡，据《商业内幕》此前报道，他们似乎经历了大量的凝血事件，如心脏病发作或肺血栓。

In a recent observational study, Dutch researchers reported that around one-third of the 184 coronavirus patients they observed in the intensive care unit had a complication associated with a clot.

在最近的一项观察性研究中，荷兰研究人员报告说，他们在重症监护病房观察到的184名冠状病毒患者中，约有三分之一的患者出现了与血栓相关的并发症。

To treat his blood clots, Reagan ended up staying overnight in a hospital to receive tissue plasminogen activator (TPA), a protein used to treat heart attacks and strokes which helps break down blood clots. Reagan was then sent home with Eliquis, a blood thinner.

为了治疗血凝块，里根在医院里住了一夜，接受了组织纤溶酶原激活剂(TPA)的治疗。TPA是一种用于治疗心脏病和中风的蛋白质，有助于分解血凝块。里根随后和血液稀释剂Eliquis一起被送回家。

"I had no idea a blood clot could hurt so bad," Reagan said.

“我不知道血凝块会这么疼，”里根说。

Because the pain is so intense, Reagan said that he has trouble bending over or lifting his left arm.

由于疼痛剧烈，里根说他很难弯下腰或举起左臂。

"I'm just trying to be still and let myself heal," he said

“我只是试着让自己平静下来，让自己痊愈，”他说

Read more: The US is sprinting to develop a coronavirus vaccine or treatment. Here's how 19 top drugmakers are racing to tackle the pandemic.

阅读更多:美国正在研制一种冠状病毒疫苗或治疗方法。以下是19家顶级制药公司如何竞相应对这一流行病。

Figuring out the best way to treat coronavirus complications

找出治疗冠状病毒并发症的最佳方法

Blood clots can occur in severely ill patients in intensive care units, or even in patients who are hospitalized. While in the ICU, patients are typically on breathing support and sedated, which limits their ability to move as they heal. Staying still raises the risk of clots.

血凝块可发生在重症监护病房的重症病人身上，甚至在住院的病人身上。在ICU里，病人通常需要呼吸支持和镇静剂，这限制了他们在痊愈过程中的活动能力。呆着不动会增加血栓的风险。

Some doctors think there's something about the coronavirus that leads to more clotting issues, though.

一些医生认为冠状病毒会导致更多的凝血问题。

And in the absence of clinical trials or science-backed treatments, doctors are being forced to figure out how to best treat these complications with relatively little guidance, Dr. Alex Spyropoulos, an expert on blood clots at Northwell Health in New York told Business Insider.

在缺乏临床试验或科学支持的治疗方法的情况下，医生们被迫在相对较少的指导下找出治疗这些并发症的最佳方法。纽约诺斯威尔健康中心的血块专家亚历克斯·斯派罗普洛斯告诉商业内幕网。

Spyropoulos recently told Business Insider that he has been relying on his clinical experience to make decisions to prevent clotting complications in COVID-19 patients.

Spyropoulos最近告诉Business Insider，他一直依靠自己的临床经验来做出决定，以防止COVID-19患者出现凝血并发症。

"If you have a deep experience in this field you can make reasonable assumptions and extrapolations and observations from indirect data," he said.

“如果你在这个领域有很深的经验，你可以从间接数据中做出合理的假设、推断和观察，”他说。

For the past month, Spyropoulos has been working to step up preventive dosing of blood thinners for COVID-19 patients and ensuring that physicians are aware of signals that might indicate clotting, such as swelling in the legs of patients.

在过去的一个月里，Spyropoulos一直致力于加大对COVID-19患者的血液稀释剂的预防性剂量，并确保医生注意到可能表明凝血的信号，比如患者腿部的肿胀。

Read more: Experts just set out a playbook for how governors should reopen states, and it includes 2- to 3-week phases with distancing measures applied to places like restaurants and outdoor events

阅读更多:专家们刚刚为州长们应该如何重新开放各州制定了一个剧本，其中包括2到3周的阶段，对餐馆和户外活动等场所实施距离措施

Reagan's thermometer reading 101.9 degrees Fahrenheit.

里根的温度计显示华氏101.9度。

Michael Reagan

迈克尔·里根

Recovering is a slow journey 恢复是一个缓慢的过程

Reagan told Business Insider that the coronavirus is unlike any flu or pneumonia he's experienced. He said that whenever he's had those illnesses he's felt better after a few weeks, at least enough to go out and be active.

里根告诉《商业内幕》，这种冠状病毒与他经历过的任何流感或肺炎都不一样。他说，无论什么时候他患上了这些疾病，几周后他就会感觉好一些，至少可以出去活动活动了。

Reagan was diagnosed with the coronavirus over a month ago. He said he still gets exhausted just by doing small things, like getting dressed or taking a shower.

一个多月前，里根被诊断出感染了冠状病毒。他说，他仍然会因为一些小事而感到疲惫，比如穿衣服或洗澡。

"It really does feel like I've been poisoned," he said.

“我真的感觉像是中毒了，”他说。

Pointing to states like Georgia and Florida, whose governors have recently indicated that they want to ease stay at home orders, Reagan added that he hopes states don't rush to end shelter in place orders anytime soon.

以乔治亚州和佛罗里达州为例，这两个州的州长最近表示，他们希望放宽“居家安身”的规定。里根补充说，他希望各州不要急于结束“居家安身”的规定。

"I really believe it's socially irresponsible to be opening things back up," he said. "It's a deadly virus. It's not a simple flu and it can change your life."

他说:“我真的认为，重新开放是对社会的不负责任。”“这是一种致命的病毒。这不是简单的流感，它可以改变你的生活。”

Read more: The US is depending on tests that can tell if you've ever had the coronavirus to help reopen the economy. But millions are flooding the market and we don't know how accurate they really are.

阅读更多:美国正在依靠测试，它可以告诉你是否曾经有过冠状病毒来帮助恢复经济。但数百万人涌入市场，我们不知道他们到底有多准确。