Heterotope Ossifikationen nach Langzeitbeatmung bei COVID-19

ZUSAMMENFASSUNG

Während pneumologische, kardiovaskuläre und neurologische Komplikationen einer SARS-CoV-2-Infektion schon gut erforscht sind, ist über Einflüsse auf das muskulo-skelettale System bisher noch relativ wenig bekannt.

Vorgestellt wird ein 65-jähriger Patient, der eine Humeruskopffraktur erlitt, die konservativ behandelt wurde. Sechs Wochen nach dem Unfallereignis traten Husten und Fieber auf, und es wurde COVID-19 diagnostiziert. Es entwickelte sich ein schwerer Verlauf mit ARDS, Lungenarterienembolien, multiplen Hirninfarkten und Hemiparese links, der eine mehrwöchige Beatmung erforderlich machte. In der Folge bildeten sich ausgeprägte Ossifikationen im Bereich der linken Schulter und des linken Ellenbogens aus.

Heterotope Ossifikationen nach Schädel-Hirn-Traumen, nach Verletzungen des Rückenmarks oder längerfristiger Beatmung sind bekannt. Zur Beantwortung der Frage, ob die heterotopen Ossifikationen durch proinflammatorische Prozesse im Rahmen der Immobilisierung und Beatmung oder durch noch unbekannte Pathomechanismen direkt durch SARS-CoV-2 entstanden sind, besteht noch Forschungsbedarf.

ABSTRACT

While pneumological, cardiovascular and neurological complications of a SARS-CoV-2 infection are already well researched, relatively little is known about influences on the musculoskeletal system.

The case of a 65-year-old patient is reported who suffered a fracture of the humeral head that was treated conservatively. Six weeks after injury he developed cough and temperature and CoVID-19 was diagnosed. He developed a severe course of COVID-19 with ARDS, pulmonary artery embolism, multiple strokes und left-sided hemiparesis, requiring artificial respiration for several weeks. Subsequently, pronounced ossifications developed around the left shoulder and the left elbow.

Heterotopic ossifications after craniocerebral trauma, after spinal cord injuries or long-term artificial respiration are known. Further research is still needed to answer the question whether the heterotopic ossifications are caused by proinflammatory processes due to immobilisation and long-time artificial respiration or by still unknown pathomechanisms as a direct consequence of SARS-CoV-2.

Schlüsselwörter

SARS-CoV-2 - COVID-19 - Langzeit-Beatmung - heterotope Ossifikation

Key words

SARS-CoV-2 - COVID-19 - longterm weaning - heterotopic ossification

Publication History

Article published online:
18 March 2021

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