隐藏COVID-19在一个免疫抑制患者与迁移性肺入的肺入
Cristina Veintimilla1, Ana Álvarez-Uría Miyares1, Sergio Buenestado-Serrano1
1Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón. Madrid, Spain.
概括
在免疫功能低下的患者中,尽管COVID-19测试呈阴性结果,但持续的呼吸道症状可能表明隐性感染. 支气管支气管洗液测试对于准确的诊断和治疗至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
- 病毒学 病毒学
背景情况:
- 严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 感染在免疫抑制个体中可能会延长和严重.
- 接受免疫抑制疗法 (瑞图西马布,易布鲁替尼) 的地幔细胞淋巴瘤患者有复杂SARS-CoV-2呈现的风险.
研究的目的:
- 在免疫抑制患者中报告持续的SARS-CoV-2感染病例.
- 突出诊断挑战,并提出改进的测试策略隐藏的COVID-19.
主要方法:
- 一个患有地幔细胞淋巴瘤和SARS-CoV-2感染后复发性肺透症的患者的病例介绍.
- 重复负的鼻 (NP) RT-PCR测试.反复负的鼻 (NP) RT-PCR测试.
- 在支气管支气管洗液 (BAL) 中检测SARS-CoV-2.
- 初始和最终病毒菌株的全基因组测序.
主要成果:
- 患者经历了多次住院治疗肺透,尽管最初的SARS-CoV-2症状轻微,NP RT-PCR测试呈阴性.
- 通过BAL液体分析证实了SARS-CoV-2,导致用remdesivir治疗缓解症状.
- 整个基因组测序揭示了最终的病毒菌株是最初感染的持久,进化的形式,以15个单核酸多态不同.
结论:
- 隐藏的SARS-CoV-2感染应被怀疑在免疫受损的患者,无法解释的呼吸道症状和负的NP RT-PCR结果.
- 建议对这种人群进行系统的BAL液体检测,以确定COVID-19持续的确诊和有效管理.
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