在严重的Covid-19之后,晚期结核病的重新激活
Tom Dormans1, Eric Zandijk1, Frans Stals2
1Department of Intensive Care, Zuyderland Medical Centre, Heerlen, The Netherlands.
概括
肺结核的重新激活可能发生在严重的COVID-19后长达两年,即使在患病率较低的国家. 这凸显了SARS-CoV-2感染和治疗后潜结核病患者长期监测的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 肺部病理学 肺部病理学
背景情况:
- 严重的COVID-19治疗涉及皮质类固醇和抗IL-6受体单克隆抗体,可以抑制免疫系统.
- 免疫抑制增加了对二次感染的易感性,包括结核病在特有地区的重新激活.
- 在COVID-19后已经记录了潜在结核病的重新激活,这引起了重大的临床关注.
研究的目的:
- 在严重的COVID-19后两年报告晚期结核病重新激活的病例.
- 强调严重的SARS-CoV-2感染后潜伏结核病患者长期随访的重要性.
- 讨论COVID-19治疗对潜伏结核病重新激活的影响.
主要方法:
- 一个70岁的女性病例报告,她有严重的COVID-19病史,接受了皮质类固醇和沙利卢马布治疗.
- 肺部感染和脑膜炎的临床表现 两年后COVID-19康复.
- 活跃结核病的诊断和随后的临床过程.
主要成果:
- 该患者在从严重的COVID-19中恢复后两年,患有严重的肺和神经表现的活跃结核病 (TB).
- 尽管接受了适当的抗生素治疗,但患者的病情迅速恶化,导致死亡.
- 这一案例表明,结核病的再激活延迟,比之前报告的时间要晚得多.
结论:
- 潜伏性结核病的重新激活可能发生在严重的COVID-19后的两年内,无论地理上是否流行.
- 对于已经从严重的COVID-19中恢复过来的潜在结核病患者,特别是那些接受免疫抑制疗法治疗的患者,长期随访至关重要.
- 在COVID-19后,结核病再激活的发生率可能被低估,因此需要加强临床警和监测.
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