Department of Liver Research Center, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Oncology, Fuzhou Pulmonary Hospital, Fuzhou, China.
Am J Transplant. 2020 Jul;20(7):1879-1881. doi: 10.1111/ajt.15896. Epub 2020 Apr 17.
Coronavirus Disease 2019 (COVID-19) has become a pandemic since March 2020. We describe here 2 cases of COVID-19 infection in a posttransplant setting. First one is a 59-year-old renal transplant recipient; the second is a 51-year-old allogeneic bone marrow transplant recipient. Both patients were on immunosuppressant therapy and had stable graft function before COVID-19 infection. After the diagnosis of COVID-19, immunosuppressive agents were discontinued and methylprednisolone with prophylactic antibiotics were initiated, however, the lung injury progressed. The T cells were extremely low in both patients after infection. Both patients died despite the maximal mechanical ventilatory support. Therefore, the prognosis of COVID-19 pneumonia following transplantation is not optimistic and remains guarded. Lower T cell count may be a surrogate for poor outcome.
自 2020 年 3 月以来，2019 年冠状病毒病（COVID-19）已成为一种大流行疾病。我们在此描述了 2 例移植后 COVID-19 感染病例。第一例是 59 岁的肾移植受者；第二例是 51 岁的异基因骨髓移植受者。这两名患者在 COVID-19 感染前均接受免疫抑制剂治疗，移植物功能稳定。COVID-19 诊断后，停用了免疫抑制剂，并开始使用甲基强的松龙和预防性抗生素，但肺部损伤仍在进展。感染后，两名患者的 T 细胞均极低。尽管给予了最大的机械通气支持，两名患者仍死亡。因此，移植后 COVID-19 肺炎的预后并不乐观，仍需警惕。T 细胞计数降低可能是预后不良的替代指标。
