肺移植后的立即术后COVID-19感染:系统性审查和病例系列
Jack K Donohue1, Eric J Hyzny1, Sarah Clifford1
1Division of Thoracic Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Suite C-900, Pittsburgh, PA 15213, USA.
Journal of clinical medicine
|November 25, 2023
概括
最近的肺移植接受者的COVID-19是具有挑战性的,但可以治疗的. 快速的抗病毒疗法,免疫疗法和免疫抑制调整导致四名患者完全康复,突出了这种脆弱人群的有效管理策略.
科学领域:
- 医学 医学 医学 医学 医学
- 免疫学 免疫学 免疫学
- 肺部病理学 肺部病理学
背景情况:
- COVID-19 构成了持续的威胁,特别是对于免疫力低下的个人,如肺移植接受者.
- 在指数录取期间了解COVID-19的表现和最近的肺移植接受者的最佳管理是至关重要的,但记录不良.
- 新变种挑战现有的预防措施,需要适应性治疗策略.
研究的目的:
- 调查肺移植受体在他们的直接术后期 (指数入院) 中的COVID-19临床过程和管理.
- 确定有效的治疗策略,包括免疫抑制调整和抗病毒/免疫疗法,用于COVID-19在这个高风险患者群体.
- 通过系统性审查,将发现与现有文献进行综合.
主要方法:
- 在一个机构的索引入院期间,对COVID-19肺移植接受者的回顾性分析.
- 从2020年1月到2023年8月,PubMed对肺移植接受者的COVID-19在索引录取期间的系统文献综述.
- 对临床表现,治疗干预和结果的分析.
主要成果:
- 在手术后立即报告了四例COVID-19肺炎病例,所有患者都完全康复和出院.
- 常见的症状包括咳,呼吸障碍和疲劳. 大多数患者的抗代谢物免疫抑制降低或维持.
- 主要治疗方法包括雷梅西维尔 (63%) 和单克隆抗体 (38%).
结论:
- 快速的抗病毒/免疫疗法,加上免疫抑制降级和呼吸困难管理 (例如,用Decadron),在我们的队列中被证明是有效的.
- 虽然文献表明死亡率高,但及时和量身定制的干预措施可以在最近的肺移植接受者中带来有利的结果.
- 这项研究强调了在这个弱势群体中针对COVID-19的积极和个性化治疗方案的重要性.
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