Suwanwongse Kulachanya, Shabarek Nehad
Internal Medicine, Lincoln Medical Center, New York City, USA.
Cureus. 2020 Jun 18;12(6):e8691. doi: 10.7759/cureus.8691.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious pathogen causing the novel coronavirus disease 2019 (COVID-19), the ongoing unprecedented pandemic in 2020. SARS-CoV-2 primarily targets the respiratory systems, so acute respiratory distress syndrome is the major cause of death. Clinical courses of COVID-19 are variable and unpredictable, while some epidemiologic and clinical factors have been found to have a negative impact on the disease prognosis. Despite a growing report on clinical characteristics and prognosis of patients with COVID-19, the data in the special population, including transplant recipients, is still limited. Herein we report on the clinical features and fatal outcome of COVID-19 in a dual pancreas-kidney transplant recipient (with failure of the pancreas graft). Our case illustrates the similarities and differences of the COVID-19 disease course between transplant recipients and the general population. We proposed that the pre-existing T-cell dysfunction from the long-term use of immunosuppressive agents in organ transplant recipients adversely affects COVID-19 prognosis and worsens COVID-19 mortality.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是一种极具传染性的病原体，可引发2019年新型冠状病毒病（COVID-19），这是一场在2020年持续肆虐的前所未有的大流行病。SARS-CoV-2主要侵袭呼吸系统，因此急性呼吸窘迫综合征是主要死因。COVID-19的临床病程多变且难以预测，尽管已发现一些流行病学和临床因素会对疾病预后产生负面影响。尽管关于COVID-19患者临床特征和预后的报道日益增多，但包括移植受者在内的特殊人群的数据仍然有限。在此，我们报告一例双胰腺-肾脏移植受者（胰腺移植物失功）感染COVID-19的临床特征及致命结局。我们的病例说明了移植受者与普通人群中COVID-19病程的异同。我们认为，器官移植受者长期使用免疫抑制剂导致的既往T细胞功能障碍会对COVID-19的预后产生不利影响，并使COVID-19死亡率升高。
