在脏移植接受者中COVID-19疾病的特征
Emilija Zimnickaitė1, Ieva Kucinaitė1, Birutė Zablockienė2
1Faculty of Medicine, Vilnius University, M. K. Ciurlionio 21, 03101 Vilnius, Lithuania.
Medicina (Kaunas, Lithuania)
|February 24, 2024
概括
与非移植患者相比,COVID-19感染的移植接受者经历了更严重的疾病,包括更高的衰竭和死亡率. 这凸显了移植患者对严重COVID-19结果的脆弱性增加.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 移植接受者 (KTRs) 面临严重COVID-19的风险增加.
- 了解KTR中COVID-19的比较临床轨迹对于风险分层和管理至关重要.
研究的目的:
- 为了比较移植患者和非移植患者的对照组的COVID-19感染的临床过程和结果.
- 确定与KTRs中严重的COVID-19相关的特定风险因素和临床特征.
主要方法:
- 一项涉及150名住院COVID-19患者的比较研究,分为KTR (n=53) 和对照组 (n=97).
- 评估人口统计,并发病 (查尔森指数),临床表现,治疗和结果,包括重症监护室 (ICU) 的入院,功能衰竭和死亡率.
- 用多变量分析来确定死亡率的预测因素.
主要成果:
- KTRs具有更高的中位数查尔森并发症指数. 尽管初始低氧化和NEWS得分较低,但KTR显示了较高的轻度和严重严重的COVID-19发病率,更普遍的功能衰竭 (34.0%与1.0%相比),并增加了ICU转移 (22.6%与3.1%相比).
- 在KTR组中,死亡率明显高于KTR组 (18.9%对1.0%).
- 多变量分析表明ICU治疗比移植状态本身更强烈地预测死亡率 (HR=20.71).
结论:
- 与普通人群相比,COVID-19在移植接受者中呈现出异质且可能更严重的过程.
- KTRs可能会出现较少的初始症状,但患上并发症的风险更高,包括功能衰竭,ICU入院和死亡率.
- 进入重症监护室是一个关键因素,与这种脆弱人群的死亡率增加有关.
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