在无症状心脏移植接受者中进行手术前的SARS-CoV-2测试
Peter-Paul Zwetsloot1, Wouter L Smit2, Niels P Van der Kaaij3
1Department of Cardiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands.
Biomedicines
|August 26, 2023
概括
在心脏移植接受者中,针对严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 的术前查没有产生真正的阳性病例,因此可能会停止治疗. 由于患病率较低和Omicron变体免疫力,建议采用症状驱动的方法.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 移植医学 移植医学
背景情况:
- 自COVID-19大流行开始以来,国际指导方针建议进行心脏移植 (HTx) 的手术前严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 查.
- 增加的人口免疫力和SARS-CoV-2向Omicron变异的演变已经减少了与大流行有关的死亡率和发病率.
- 随着COVID-19的流行率的变化,假阳性查结果的可能性增加了.
研究的目的:
- 评估手术前的SARS-CoV-2查对心脏移植接受者的临床效用和影响.
- 评估该患者群体中真阳性和假阳性SARS-CoV-2测试结果的比率.
- 为未来的心脏移植候选人的查策略提供信息.
主要方法:
- 一项回顾性队列研究于2019年3月至2023年1月在乌得勒支大学医学中心进行.
- 分析了51名心脏移植患者的数据,包括手术前和手术后的SARS-CoV-2检测结果.
- 对评估为潜在心脏移植的患者进行的所有临床SARS-CoV-2测试进行了审查.
主要成果:
- 50名心脏移植接受者接受了SARS-CoV-2的查;49名测试结果呈阴性,其中一名产生了假阳性结果.
- 由于真正阳性SARS-CoV-2测试,没有任何心脏移植手术被取消.
- 单个错误的阳性结果可能会推迟心脏移植手术.
结论:
- 在无症状心脏移植接受者手术前的SARS-CoV-2查没有发现任何真正的阳性病例.
- 在2%的查患者中出现了假阳性测试结果,这可能会影响程序时间表.
- 鉴于目前的Omicron变种和低患病率,建议放弃常规的手术前SARS-CoV-2查,采用症状驱动的方法对心脏移植候选人进行病毒检测.
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