Choi Mira, Bachmann Friederike, Naik Marcel Ganesh, Duettmann Wiebke, Duerr Michael, Zukunft Bianca, Schwarz Tatjana, Corman Victor Max, Liefeldt Lutz, Budde Klemens, Halleck Fabian
Department of Nephrology and Medical Intensive Care, Charité- Universitätsmedizin Berlin, 13353 Berlin, Germany.
Institute of Virology, Charité-Universitätsmedizin Berlin, German Center for Infection Research (DZIF), and Berlin Institute of Health, 10117 Berlin, Germany.
J Clin Med. 2020 Oct 23;9(11):3401. doi: 10.3390/jcm9113401.
The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 denotes a global health issue. Data regarding COVID-19 incidence in kidney transplant recipients (KTR) are sparse. From 19 March to 19 May 2020, we performed a systematic screening for COVID-19 in KTR. Tests included serum analysis for SARS-CoV-2 antibodies using S protein-based immunofluorescence, anti-SARS-CoV-2 S1 immunoglobulin G (IgG) and immunoglobulin A (IgA) enzyme-linked immunosorbent assays (ELISA), and/or quantitative reverse transcription polymerase chain reaction (qRT-PCR) from nasal-throat swabs. Outpatient serum samples from KTR with PCR confirmed COVID-19, and swab samples from recipients (+donors) undergoing kidney transplantation were analyzed. Out of 223 samples from outpatients, 13 patients were positive with solely anti-SARS-CoV-2-IgA and 3 with both anti-IgA and anti-IgG. In total, 53 patients were symptomatic in the past, but positive results could be found in both symptomatic and asymptomatic patients. After an in depth analysis using immunofluorescence and neutralization tests in 2 KTR, recent COVID-19 infection remained highly suspicious. Apart from outpatient visits, only 5 out of 2044 KTR were symptomatic and tested positive via PCR, of which 4 recovered and one died. All patients showed seroconversion during the course of the disease. This study demonstrated a low seroprevalence in a German KTR cohort, and seroconversion of IgA and IgG after COVID-19 could be demonstrated. Effective containment strategies enabled us to continue our transplant program.
由严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）大流行是一个全球性的健康问题。关于肾移植受者（KTR）中COVID-19发病率的数据很少。在2020年3月19日至5月19日期间，我们对KTR进行了COVID-19的系统筛查。检测包括使用基于S蛋白的免疫荧光法检测SARS-CoV-2抗体的血清分析、抗SARS-CoV-2 S1免疫球蛋白G（IgG）和免疫球蛋白A（IgA）酶联免疫吸附测定（ELISA），以及/或者来自鼻咽拭子的定量逆转录聚合酶链反应（qRT-PCR）。对PCR确诊为COVID-19的KTR门诊血清样本，以及接受肾移植的受者（+供者）的拭子样本进行了分析。在223份门诊患者样本中，13例仅抗SARS-CoV-2-IgA呈阳性，3例抗IgA和抗IgG均呈阳性。过去共有53例患者有症状，但在有症状和无症状患者中均能检测到阳性结果。在对2例KTR进行免疫荧光和中和试验的深入分析后，近期COVID-19感染仍高度可疑。除门诊就诊外，2044例KTR中只有5例有症状并通过PCR检测呈阳性，其中4例康复，1例死亡。所有患者在病程中均出现血清转化。本研究表明德国KTR队列中的血清阳性率较低，并且可以证明COVID-19后IgA和IgG的血清转化。有效的防控策略使我们能够继续我们的移植项目。
