Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.
Department of Nephrology & Transplantation, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom.
Transplant Proc. 2021 May;53(4):1160-1168. doi: 10.1016/j.transproceed.2020.11.007. Epub 2020 Dec 17.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised concern for the health of immunocompromised individuals, who are potentially at higher risk of more severe infection and poorer outcomes. As a large London transplant center serving a diverse patient population, we report the outcomes of SARS-CoV-2 infection in our cohort of 2848 kidney and/or pancreas transplant patients.
Data were obtained retrospectively for all transplant patients who attended hospital during the peak of the pandemic and had a positive nasopharyngeal SARS-CoV-2 test.
Sixty-six patients were found to be positive for SARS-CoV-2. Twenty percent were treated as outpatients, 59% were admitted to the general ward, and 21% required intensive care. Treatment consisted of reduced immunosuppression, antibiotics for pneumonia or sepsis, and other supportive treatments. Within our cohort, 12 patients died (18%), with an overall mortality of 0.4%. Predictive risk factors for COVID-19 severity were explored.
Severe disease was associated with lower hemoglobin prior to COVID-19 diagnosis and lower lymphocyte count at the time of diagnosis but not age, sex, ethnicity, or preexisting comorbidities. Lower glomerular filtration rate and higher C-reactive protein were associated with more severe disease. Despite no use of hydroxychloroquine, azithromycin, antiviral, or immunomodulatory medications, our mortality rate (kidney and pancreas transplant patients) is similar to current international rates.
新型严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）大流行引起了人们对免疫功能低下者健康的关注，这些人可能面临更严重感染和更差结局的风险更高。作为一个为多样化患者群体服务的大型伦敦移植中心，我们报告了在我们的 2848 例肾和/或胰腺移植患者队列中 SARS-CoV-2 感染的结局。
我们回顾性地获取了在大流行高峰期到医院就诊且鼻咽 SARS-CoV-2 检测呈阳性的所有移植患者的数据。
发现 66 例患者 SARS-CoV-2 检测呈阳性。20%的患者接受门诊治疗，59%的患者收治在普通病房，21%的患者需要重症监护。治疗包括减少免疫抑制、肺炎或败血症的抗生素治疗以及其他支持性治疗。在我们的队列中，有 12 例患者（18%）死亡，总死亡率为 0.4%。探索了 COVID-19 严重程度的预测风险因素。
在诊断 COVID-19 之前，较低的血红蛋白和诊断时较低的淋巴细胞计数与严重疾病相关，但与年龄、性别、种族或并存的合并症无关。较低的肾小球滤过率和较高的 C 反应蛋白与更严重的疾病相关。尽管未使用羟氯喹、阿奇霉素、抗病毒或免疫调节药物，我们的死亡率（肾和胰腺移植患者）与当前国际水平相似。
