肺移植接受者中Omicron变异引起的COVID-19:一个单一中心病例系列
Li Zhao1,2, Lijuan Guo1,2, Bin Xing1,3
1National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
感染严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2) Omicron 变种的肺移植接受者 (LTR) 面临二次感染和严重疾病的高风险. 较高的C-反应蛋白,真菌感染和间歇性肺病预测严重程度,而CD4+T细胞计数可能表明死亡风险.
科学领域:
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
- 移植手术 移植手术
背景情况:
- 冠状病毒病2019 (COVID-19) 继续影响全球健康,中国对肺移植接受者 (LTR) 的数据有限.
- 了解LTR中严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 感染的临床过程对于有效的管理至关重要.
研究的目的:
- 调查感染SARS-CoV-2的Omicron变种的LTRs的临床特征和结果.
- 为了确定与严重的COVID-19和死亡率相关的风险因素,在这个脆弱的人群中.
主要方法:
- 在2022年11月至2023年5月期间,对178名LTR感染Omicron变种的回顾性研究.
- 通过电子病历,问卷和电话跟踪收集的临床数据.
- 分析包括严重/危急疾病组与轻度/中度疾病组的比较,以及用于风险因素识别的后勤回归.
主要成果:
- 在LTR中观察到的感染率为78.4%. 在住院患者中,41.6%的病情进展为重症/危急性疾病.
- 严重/危急病例显示较高的C-反应蛋白 (CRP),红细胞沉积率,D-二次体和肺部细菌和真菌感染率,但CD4+ T淋巴细胞数量较低.
- 升高的CRP (>41.8 mg/L),肺真菌感染和间歇性肺病 (ILD) 被确定为严重疾病的高风险因素. CD4+ T 淋巴细胞计数成为死亡率的潜在预测因素.
结论:
- 在Omicron变种感染后,LTRs对二次肺部感染非常敏感.
- 在LTR中,严重的COVID-19的关键预测因素包括CRP升高,初级ILD和真菌共感染.
- CD4+ T 淋巴细胞计数可以作为评估COVID-19的LTRs死亡风险的有价值标志物.
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