Clinical Course, Imaging Features, and Outcomes of COVID-19 in Kidney Transplant Recipients
Clinical Course, Imaging Features, and Outcomes of COVID-19 in Kidney Transplant Recipients
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DOI：
10.1016/j.eururo.2020.04.064
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发表时间：
2020-08-01
期刊：
影响因子：
23.4
通讯作者：
Taheri, Morteza Sanei
中科院分区：
文献类型：
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作者：
Abrishami, Alireza;Samavat, Shiva;Taheri, Morteza Sanei
冠状病毒病2019 （COVID-19）是由严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）引起的一种新型高传染性疾病。老年人和患有合并症和免疫抑制疾病的患者可能出现严重的体征和症状，可导致死亡。本病例系列评估了12例有肾移植史的COVID-19患者的临床病程、影像学特征和预后。从2020年2月到2020年4月，对患者的症状、实验室数据、影像学发现和结果进行评估。发热、咳嗽和呼吸困难是最常见的临床症状，分别占75%（9 /12）、75%（9 /12）和41.7%（5 /12）的患者。大多数患者白细胞计数正常，33.3%（4 /12）有白细胞减少，8.3%（1 /12）有白细胞增多。实变和磨玻璃影的组合是计算机断层扫描（CT）上最主要（75%）的肺部受累模式。重症肺炎合并急性呼吸窘迫综合征死亡8例，出院4例。所有恢复的病例在最初的胸部CT上均有单侧外周型受累，仅局限于一个区域。CT成像在预测实体器官移植受者COVID-19预后方面似乎具有重要作用。未来需要长期随访和更多病例的研究来阐明这些患者的COVID-19诊断、预后和管理策略。(c) 2020年由Elsevier B.V.代表欧洲泌尿外科协会出版。
Coronavirus disease 2019 (COVID-19) is a novel and highly contagious disease caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Older adults and patients with comorbidities and immunosuppressive conditions may experience severe signs and symptoms that can lead to death. This case series assesses the clinical course, imaging features, and outcomes for 12 patients with COVID-19 and a history of kidney transplantation. Patients were evaluated for symptoms, laboratory data, imaging findings, and outcomes from February 2020 to April 2020. Fever, cough, and dyspnea were the most common clinical symptoms, noted in 75% (nine/12), 75% (nine/12), and 41.7% (five/12) of the patients, respectively. Most of the patients had a normal white blood cell count, while 33.3% (four/12) had leukopenia and 8.3% (one/12) had leukocytosis. A combination of consolidation and ground glass opacity was the most predominant (75%) pattern of lung involvement on computed tomography (CT). Eight patients died of severe COVID-19 pneumonia and acute respiratory distress syndrome and four were discharged. All recovered cases had a unilateral peripheral pattern of involvement limited to only one zone on initial chest CT. It seems that CT imaging has an important role in predicting COVID-19 outcomes for solid organ transplant recipients. Future studies with long-term follow up and more cases are needed to elucidate COVID-19 diagnosis, outcome, and management strategies for these patients. (c) 2020 Published by Elsevier B.V. on behalf of European Association of Urology.