COVID-19 infection in kidney transplant recipients at the epicenter of pandemics.
COVID-19 infection in kidney transplant recipients at the epicenter of pandemics.
复制标题
肾脏移植受者的Covid-19感染在大流行病的中心。
DOI：
10.1016/j.kint.2020.10.004
复制
发表时间：
2020-12
影响因子：
19.6
通讯作者：
Akalin E
中科院分区：
文献类型：
--
作者：
Azzi Y;Parides M;Alani O;Loarte-Campos P;Bartash R;Forest S;Colovai A;Ajaimy M;Liriano-Ward L;Pynadath C;Graham J;Le M;Greenstein S;Rocca J;Kinkhabwala M;Akalin E
我们调查了纽约布朗克斯（COVID-19的震中之一）肾移植受者的COVID-19患病率和临床结局。2020年3月16日至6月2日期间，132名肾移植受者通过SARS-CoV-2 RT-PCR检测呈阳性。2020年5月3日至7月29日，912名肾移植受者在常规门诊访视期间接受了SARS-CoV-2 IgG抗体筛查，其中16.6%的检测结果呈阳性。152名患者中有55人此前通过RT-PCR检测呈阳性，其余97人没有明显症状，此前也没有进行过RT-PCR检测。在975例患者中，通过RT-PCR或SARS-CoV-2 IgG检测SARS-CoV-2感染的患病率为23.4%。与SARS-CoV-2 IgG相比，老年患者和血清肌酐水平较高的患者更有可能通过RT-PCR进行诊断。69例RT-PCR阳性患者在诊断后中位数44天（四分位数间距31-58）进行了SARS-CoV-2 IgG抗体筛查，80%为阳性。总死亡率为20.5%，但需要住院治疗的患者的死亡率显著较高（37.8%）。23%的住院患者需要肾脏替代治疗，6.3%的患者失去了移植物。在多变量分析中，年龄较大，接受死亡供体移植，前一年缺乏流感疫苗接种和较高的血清白细胞介素-6水平与死亡率相关。因此，42%的肾移植患者和COVID-19患者在抗体检测中被诊断为没有明显的临床症状; 80%的RT-PCR阳性患者发展为SARS-CoV-2 IgG，需要住院治疗的患者死亡率很高。
We investigated the prevalence and clinical outcomes of COVID-19 in recipients of kidney transplants in the Bronx, New York, one of the epicenters of the pandemic. Between March 16 and June 2, 2020, 132 kidney transplant recipients tested positive by SARS-CoV-2 RT-PCR. From May 3 to July 29, 2020, 912 kidney transplant recipients were screened for SARS-CoV-2 IgG antibodies during routine clinic visits, of which 16.6% tested positive. Fifty-five of the 152 patients had previously tested positive by RT-PCR, while the remaining 97 did not have significant symptoms and had not been previously tested by RT-PCR. The prevalence of SARS-CoV-2 infection was 23.4% in the 975 patients tested by either RT-PCR or SARS-CoV-2 IgG. Older patients and patients with higher serum creatinine levels were more likely diagnosed by RT-PCR compared to SARS-CoV-2 IgG. Sixty-nine RT-PCR positive patients were screened for SARS-CoV-2 IgG antibodies at a median of 44 days post-diagnosis (Inter Quartile Range 31-58) and 80% were positive. Overall mortality was 20.5% but significantly higher (37.8%) in the patients who required hospitalization. Twenty-three percent of the hospitalized patients required kidney replacement therapy and 6.3% lost their allografts. In multivariable analysis, older age, receipt of deceased-donor transplantation, lack of influenza vaccination in the previous year and higher serum interleukine-6 levels were associated with mortality. Thus, 42% of patients with a kidney transplant and with COVID-19 were diagnosed on antibody testing without significant clinical symptoms; 80% of patients with positive RT-PCR developed SARS-CoV-2 IgG and mortality was high among patients requiring hospitalization.
登录
查看更多内容
影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
13.6
作者：
Clarke, Candice;Prendecki, Maria;Willicombe, Michelle
通讯作者：
Willicombe, Michelle
DOI：
10.34067/kid.0003672020
发表时间：
2020-08-01
期刊：
KIDNEY360
影响因子：
--
作者：
Fisher, Molly;Yunes, Milagros;Coco, Maria
通讯作者：
Coco, Maria
影响因子：
2.6
作者：
Mehta, Sapna A.;Leonard, Jeanette;Ali, Nicole M.
通讯作者：
Ali, Nicole M.
影响因子：
5.4
作者：
Nguyen, Austin;David, Julianne K.;Thompson, Reid F.
通讯作者：
Thompson, Reid F.