Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Nephrology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Eur Urol. 2020 Aug;78(2):281-286. doi: 10.1016/j.eururo.2020.04.064. Epub 2020 May 6.
Coronavirus disease 2019 (COVID-19) is a novel and highly contagious disease caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Older adults and patients with comorbidities and immunosuppressive conditions may experience severe signs and symptoms that can lead to death. This case series assesses the clinical course, imaging features, and outcomes for 12 patients with COVID-19 and a history of kidney transplantation. Patients were evaluated for symptoms, laboratory data, imaging findings, and outcomes from February 2020 to April 2020. Fever, cough, and dyspnea were the most common clinical symptoms, noted in 75% (nine/12), 75% (nine/12), and 41.7% (five/12) of the patients, respectively. Most of the patients had a normal white blood cell count, while 33.3% (four/12) had leukopenia and 8.3% (one/12) had leukocytosis. A combination of consolidation and ground glass opacity was the most predominant (75%) pattern of lung involvement on computed tomography (CT). Eight patients died of severe COVID-19 pneumonia and acute respiratory distress syndrome and four were discharged. All recovered cases had a unilateral peripheral pattern of involvement limited to only one zone on initial chest CT. It seems that CT imaging has an important role in predicting COVID-19 outcomes for solid organ transplant recipients. Future studies with long-term follow up and more cases are needed to elucidate COVID-19 diagnosis, outcome, and management strategies for these patients.
2019 年冠状病毒病(COVID-19)是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的一种新型且高度传染性疾病。老年人以及合并症和免疫抑制状况的患者可能会出现严重的症状和体征,从而导致死亡。本病例系列评估了 12 例有 COVID-19 病史和肾移植病史的患者的临床过程、影像学特征和结局。患者于 2020 年 2 月至 2020 年 4 月接受了症状、实验室数据、影像学表现和结局的评估。发热、咳嗽和呼吸困难是最常见的临床症状,分别见于 75%(9/12)、75%(9/12)和 41.7%(5/12)的患者。大多数患者的白细胞计数正常,而 33.3%(4/12)的患者白细胞减少,8.3%(1/12)的患者白细胞增多。在 CT 上,实变和磨玻璃影的组合是最常见的肺部受累模式(75%)。8 例患者死于严重 COVID-19 肺炎和急性呼吸窘迫综合征,4 例患者出院。所有恢复的患者在初始胸部 CT 上均表现为单侧周围模式受累,仅局限于一个区域。CT 成像似乎在预测实体器官移植受者的 COVID-19 结局方面具有重要作用。需要进行未来的研究,包括长期随访和更多的病例,以阐明这些患者的 COVID-19 诊断、结局和管理策略。