COVID-19 in solid organ transplant recipients: a single-center experience
COVID-19 in solid organ transplant recipients: a single-center experience
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DOI：
10.1111/tri.13662
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发表时间：
2020-06-26
影响因子：
3.1
通讯作者：
Hesselink, Dennis A.
中科院分区：
文献类型：
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作者：
Hoek, Rogier A. S.;Manintveld, Olivier C.;Hesselink, Dennis A.
实体器官移植受者可能面临严重新冠肺炎的风险。有关免疫抑制患者新冠肺炎临床病程的数据有限，这些患者的有效治疗策略尚不清楚。我们描述了我们在国有企业与新冠肺炎合作的制度经验。人口统计、临床和治疗数据是从电子患者档案中提取的。共有23例SOT移植患者并发新冠肺炎(心脏3例，肾脏15例，心后肾1例，肺3例，肝移植1例)。出现的症状与非免疫功能低下的患者相似。83%(19/23)的患者需要住院，但其中只有两人被转移到重症监护病房。5名患者死于新冠肺炎；所有患者的临床虚弱评分都很高。在其中四名患者中，机械通气被认为是无效的。在57%的患者中，免疫抑制治疗没有改变，只有3名患者接受了氯喹治疗。大多数患者在没有进行实验性抗病毒治疗的情况下痊愈。对于患有中到重度新冠肺炎的SOT接受者，单独修改免疫抑制方案可能是一种治疗选择。先前存在的脆弱与新冠肺炎的死亡有关。
Solid organ transplant (SOT) recipients may be at risk for severe COVID-19. Data on the clinical course of COVID-19 in immunosuppressed patients are limited, and the effective treatment strategy for these patients is unknown. We describe our institutional experience with COVID-19 in SOT. Demographic, clinical, and treatment data were extracted from the electronic patient files. A total of 23 SOT transplant recipients suffering from COVID-19 were identified (n = 3 heart;n = 15 kidney;n = 1 kidney-after-heart;n = 3 lung, andn = 1 liver transplant recipient). The presenting symptoms were similar to nonimmunocompromised patients. Eighty-three percent (19/23) of the patients required hospitalization, but only two of these were transferred to the intensive care unit. Five patients died from COVID-19; all had high Clinical Frailty Scores. In four of these patients, mechanical ventilation was deemed futile. In 57% of patients, the immunosuppressive therapy was not changed and only three patients were treated with chloroquine. Most patients recovered without experimental antiviral therapy. Modification of the immunosuppressive regimen alone could be a therapeutic option for SOT recipients suffering from moderate to severe COVID-19. Pre-existent frailty is associated with death from COVID-19.