风险因素和多病原体感染在脏移植接受者与Omicron变体肺炎的风险因素:一个追溯分析
Jing Chen1,2, Yuanbo Su1,2, Ming Lu3,4
1Department of Infectious Disease, Peking University Third Hospital, Beijing, 100191, China.
BMC infectious diseases
|June 4, 2024
概括
患有Omicron COVID-19的移植接受者 (KTRs) 经历了高的联合感染率,主要是Pneumocystis jirovecii. 心力衰竭,功能障碍和先前的机会性感染预测了严重的结果和重新住院.
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
- 病毒学 病毒学
背景情况:
- 移植接受者 (KTRs) 面临严重COVID-19结果的风险增加.
- SARS-CoV-2 Omicron 变种在像KTRs这样的免疫受损人群中提出了独特的挑战.
- 了解KTR与Omicron的共同感染和风险因素对于临床管理至关重要.
研究的目的:
- 在Omicron浪潮期间调查与KTRs中严重的COVID-19和多病原体感染相关的风险因素.
- 为了识别通常与SARS-CoV-2 Omicron一起感染KTR的病原体.
- 在这个脆弱群体中分析临床恶化和再住院的预测因素.
主要方法:
- 对KTRs被诊断为SARS-CoV-2 Omicron变种的回顾性分析.
- 病因评估,包括支气管镜检查和支气管膜洗,用于基因组下一代测序 (mNGS).
- 严重和中度病例之间的临床特征和风险因素的比较,以及有和没有进展的病例.
主要成果:
- 在KTR中观察到47%的共感染率,其中Pneumocystis jirovecii是最常见的共感染病原体.
- 严重的COVID-19病例显示C-反应蛋白和互白素-6水平显著上升.
- 较高的基线血清肌素,心力衰竭,急性功能障碍恶化和机会性感染史与疾病进展和住院有关.
结论:
- 肺囊 (Pneumocystis jirovecii) 是KTRs中与Omicron COVID-19共感染的主要病原体.
- 心力衰竭,功能障碍和先前的机会性感染是KTRs临床恶化的重要危险因素.
- 肺囊炎 (Pneumocystis jirovecii) 感染是KTRs在Omicron COVID-19后再住院率的关键决定因素.
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