[感染COVID-19的免疫功能低下患者的临床特征]
1Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing100044, China.
概括
与免疫能力低下的人相比,住院治疗COVID-19的免疫功能低下患者的病情更严重,死亡率更高. 较低的淋巴细胞计数和升高的炎症标志物表明这个脆弱群体的预后较差.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 住院免疫受损患者面临COVID-19的风险增加.
- 了解临床差异对于管理严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) 在脆弱人群中至关重要.
研究的目的:
- 为了比较COVID-19的临床特征,结果和实验室发现,免疫功能低下患者与免疫能力较强的住院患者.
- 为了确定免疫功能低下的COVID-19患者死亡率的预测因素.
主要方法:
- 一项对213名COVID-19住院患者进行的回顾性观察研究.
- 临床数据,实验室结果和免疫受损和免疫能力较强组之间的淋巴细胞子集的比较.
- 在免疫功能低下组内对死亡率的子组分析.
主要成果:
- 与免疫能力低下的患者相比,免疫能力低下的患者的严重/危急疾病率 (47.1%) 和死亡率 (17.6%) 显著更高 (分别为40.5%和9.0%).
- 在免疫受损组中观察到较低的疫苗接种率,更高的并发病 (高血压,脏疾病) 患病率,以及CT扫描上的巩固率增加.
- 在免疫功能低下的患者中,发现炎症标志物 (LDH,PCT,IL-6,费里丁) 的升高和病毒分泌的延长. 淋巴细胞 (CD4 +,CD8 +,B细胞) 减少和D-二次体升高表明预后不佳.
结论:
- 患有COVID-19的免疫功能低下的患者具有更高的严重疾病,死亡率和病毒清除受损的风险.
- 淋巴细胞子集枯竭和炎症标志物升高是这一群体预后不佳的关键指标.
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