在固体器官移植接受者中,COVID-19再感染的结果比第一次感染更好
Javier T Solera1, Berta G Árbol, Ankit Mittal
1Ajmera Transplant Centre, University Health Network, Toronto, ON, Canada.
Transplantation
|January 31, 2024
概括
经过COVID-19再感染的固体器官移植接受者经历的疾病比他们最初感染的疾病要轻微. 这表明交叉保护性免疫可能会减少SARS-CoV-2再感染后移植患者的严重结果.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 移植医学 移植医学 移植医学
背景情况:
- 固体器官移植接受者面临严重COVID-19和SARS-CoV-2再感染的高风险.
- 与非免疫受损个体不同,SARS-CoV-2重感染对移植受体的影响仍然不太清楚.
- 假设交叉保护性免疫能减轻一般人群中再感染的严重程度.
研究的目的:
- 为了调查SARS-CoV-2再感染是否表现出与初级COVID-19相比较轻微的症状,在固体器官移植接受者中.
- 为了在这个脆弱人群中比较COVID-19的初级和再感染病例之间的临床结果.
主要方法:
- 分析了COVID-19成年移植患者的潜在队列,以确定再感染.
- 倾向性得分匹配 (1:1最近邻居) 用于控制混因素,包括COVID-19变种.
- 在初级和再感染组之间比较了30天内氧气需求,住院和ICU入院等结果.
主要成果:
- 在2020-2023年期间,在1869名移植接受者中发生了103例SARS-CoV-2再感染 (2020-2023年发生率为2.7%).
- 与初级感染相比,再感染与住院率 (5.8%与19.4%) 和氧气需求 (3.9%与13.6%) 的显著降低有关.
- 患者内部分析显示,第二次COVID-19感染比第一次更温和,之前的严重感染预测了再感染的严重程度.
结论:
- 移植受体中COVID-19的再感染与比原发性感染更好的临床结果有关.
- 这些发现提供了支持固体器官移植接受者在SARS-CoV-2感染后发展交叉保护性免疫力的临床证据.
- 严重的初始COVID-19是这种队列中严重的再感染结果的关键预测因素.
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