COVID-19 in kidney transplant recipients
COVID-19 in kidney transplant recipients
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DOI：
10.1111/ajt.15967
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发表时间：
2020-05-27
影响因子：
8.8
通讯作者：
Molmenti, Ernesto P.
中科院分区：
文献类型：
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作者：
Nair, Vinay;Jandovitz, Nicholas;Molmenti, Ernesto P.
关于免疫功能低下个体中的 2019 年冠状病毒病 (COVID-19) 的信息很少。我们研究了 12 家成人护理医院治疗的 10 名患者。 10 名肾移植受者通过聚合酶链反应检测出严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 呈阳性，其中 9 人入院。中位年龄为 57 岁（四分位距 [IQR] 47-67），其中 60% 为男性，40% 为白种人，30% 为黑人/非裔美国人。从移植到进行 COVID-19 检测的中位时间为 2822 天 (IQR 1272-4592)。最常见的症状是发烧，其次是咳嗽、肌痛、发冷和疲劳。最常见的胸部 X 射线和计算机断层扫描异常是多灶性斑片状混浊。 3名患者均未发现异常。 20%的患者出现白细胞减少，50%的患者同种异体移植物功能稳定。 9 名患者服用他克莫司和霉酚类抗代谢药，70% 服用泼尼松。住院患者已停止使用抗代谢药物。所有住院患者均接受羟氯喹和阿奇霉素治疗。 3 名患者死亡 (30%)，5 名患者 (50%) 出现急性肾损伤。在免疫抑制降低的情况下，应密切监测感染 COVID-19 的肾移植受者。大多数个体需要住院治疗，并且表现出的症状与非移植个体相似。
There is minimal information on coronavirus disease 2019 (COVID-19) in immunocompromised individuals. We have studied 10 patients treated at 12 adult care hospitals. Ten kidney transplant recipients tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by polymerase chain reaction, and 9 were admitted. The median age was 57 (interquartile range [IQR] 47-67), 60% were male, 40% Caucasian, and 30% Black/African American. Median time from transplant to COVID-19 testing was 2822 days (IQR 1272-4592). The most common symptom was fever, followed by cough, myalgia, chills, and fatigue. The most common chest X-ray and computed tomography abnormality was multifocal patchy opacities. Three patients had no abnormal findings. Leukopenia was seen in 20% of patients, and allograft function was stable in 50% of patients. Nine patients were on tacrolimus and a mycophenolic antimetabolite, and 70% were on prednisone. Hospitalized patients had their antimetabolite agent stopped. All hospitalized patients received hydroxychloroquine and azithromycin. Three patients died (30%), and 5 (50%) developed acute kidney injury. Kidney transplant recipients infected with COVID-19 should be monitored closely in the setting of lowered immunosuppression. Most individuals required hospitalization and presenting symptoms were similar to those of nontransplant individuals.