Division of Infectious Diseases, Internal Medicine Department, Lampang Hospital, Lampang, Thailand.
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Immun Inflamm Dis. 2020 Dec;8(4):534-543. doi: 10.1002/iid3.337. Epub 2020 Aug 8.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes an ongoing outbreak of respiratory illness called coronavirus disease 2019 (COVID-19). The clinical course could be ranging from mild to severe illness especially the individuals with an immunocompromised condition such as solid organ transplant recipients.
We described a family cluster of COVID-19 patients who were admitted during 3rd April 2020 to 30th April 2020. COVID-19 was confirmed by a presence of SARS-CoV-2 ribonucleic acid in the respiratory specimens detected by a qualitative, real-time reverse transcription-polymerase chain reaction. The study focused on the clinical course and management of our cases.
A family cluster of four laboratory-confirmed COVID-19 patients, one of those carried an underlying kidney transplant (KT) receiving immunosuppressants. Clinical presentation and severity of our case series are variable depending on each individual immune status. By far, a KT recipient seems to develop more severity despite antiviral therapy, cessation of immunosuppressant, and aggressive intensive care support.
Our case series plausibly affirmed a person-to-person transmission and potentially severe disease in the transplant population. Clinicians who are encountering with transplant recipients should be aware of possible transmission among family members.
严重急性呼吸系统综合症冠状病毒 2 型（SARS-CoV-2）引发了一种称为 2019 年冠状病毒病（COVID-19）的呼吸道疾病的持续爆发。其临床病程可能从轻症到重症不等，特别是那些免疫功能低下的个体，例如实体器官移植受者。
我们描述了一组在 2020 年 4 月 3 日至 4 月 30 日期间入院的 COVID-19 患者的家族聚集性病例。通过定性实时逆转录-聚合酶链反应检测呼吸道标本中 SARS-CoV-2 核糖核酸的存在，确认 COVID-19 病例。本研究重点关注我们病例的临床病程和管理。
一组四个实验室确诊的 COVID-19 患者的家族聚集性病例中，其中一人有基础肾脏移植（KT）并接受免疫抑制剂治疗。根据每个人的免疫状态，我们的病例系列的临床表现和严重程度各不相同。到目前为止，尽管接受了抗病毒治疗、停止免疫抑制剂治疗和积极的重症监护支持，KT 受者似乎病情更严重。
我们的病例系列似乎证实了人与人之间的传播以及移植人群中潜在的严重疾病。遇到移植受者的临床医生应该意识到家庭成员之间可能发生的传播。
