冠状病毒感染和慢性肺异位移植功能障碍:一个回顾性队列研究
Lydia Canham1, Carolin Steinack1, René Hage1
1Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
人类冠状病毒 (HCoV) 感染在肺移植接受者中,即使是无症状的,也会显著增加患慢性肺异位移植功能障碍的风险. 早期检测和管理对于长期生存至关重要.
科学领域:
- 移植医学 移植医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 慢性肺异位移植功能障碍 (CLAD) 是肺移植接受者的长期生存的主要限制.
- 呼吸道感染是已知的CLAD发展的触发因素.
研究的目的:
- 为了确定肺移植接受者10年的CLAD发病率.
- 调查人类冠状病毒 (HCoV) 感染与CLAD发展之间的关联.
- 在这个队列中检查HCoV感染和全因死亡率之间的联系.
主要方法:
- 一项对259名肺移植接受者 (2010-2020) 的10年后期队列研究.
- 通过多重PCR对HCoV亚型 (229E,HKU1,NL63,OC43) 进行了测试.
- 使用调整后的考克斯回归分析CLAD,临床数据,感染参数和肺功能.
主要成果:
- 57.8%的幸存的接受者在711.4个患者年中至少经历过一次HCoV感染.
- 人类冠状病毒感染的平均发病率为0.53个患者年,无症状个体的发病率为32.9%.
- 在45.8%的接受者中发生了CLAD;HCoV感染显著增加了CLAD风险 (aHR=2.52,p=0.005).
结论:
- 无症状的HCoV感染可以提高肺移植接受者随后CLAD的风险.
- 人类冠状病毒感染与C-反应蛋白的暂时增加有关,但没有立即的肺功能下降.
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