Division of Infectious Disease, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Clin Infect Dis. 2021 Jan 27;72(2):340-350. doi: 10.1093/cid/ciaa863.
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused significant morbidity and mortality for patients and stressed healthcare systems worldwide. The clinical features and outcomes of COVID-19 among immunosuppressed patients, who are at presumed risk of more severe disease but who may also have decreased detrimental inflammatory responses, are not well characterized. We review the existing literature on COVID-19 among immunocompromised populations ranging from patients with cancer and solid-organ transplant recipients to patients with HIV and those receiving immunomodulatory therapy for autoimmune disease. Patients with malignancy and solid-organ transplant recipients may be at increased risk of severe COVID-19 disease and death, whereas for those with other types of immunocompromise, current evidence is less clear. Overall, further prospective controlled studies are needed to determine the attributable risk of immunocompromising conditions and therapies on COVID-19 disease prognosis.
由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的 2019 年冠状病毒病(COVID-19)大流行,给患者和世界各地的医疗保健系统造成了重大的发病率和死亡率。免疫功能低下患者的 COVID-19 的临床特征和结局,这些患者被认为疾病更严重,但炎症反应也可能减弱,目前尚未得到很好的描述。我们回顾了范围广泛的有关免疫功能低下人群 COVID-19 的现有文献,包括癌症患者和实体器官移植受者以及 HIV 患者和接受免疫调节治疗自身免疫性疾病的患者。恶性肿瘤和实体器官移植受者的患者可能有发生严重 COVID-19 疾病和死亡的风险增加,而对于其他类型的免疫功能低下患者,目前的证据不太明确。总体而言,需要进一步前瞻性对照研究来确定免疫功能低下的情况和治疗对 COVID-19 疾病预后的归因风险。