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一名中国肾移植受者的2019冠状病毒病(COVID-19):病例报告

Coronavirus disease 2019 (COVID-19) in a Chinese renal transplant recipient: a case report.

作者信息

Wu Jian, Xiong Liangkun, Li Peng

机构信息

Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.

Department of Hepatobiliary Surgery, Renmin Hospital of Wuhan University, Wuhan, China.

出版信息

Transl Androl Urol. 2021 May;10(5):2140-2148. doi: 10.21037/tau-21-314.

Abstract

Since December 2019, a novel coronavirus that caused viral pneumonia broke out and became global pandemic. Coronavirus disease 2019 (COVID-19) is caused by the SARS-CoV-2 virus. Reports on the clinical manifestations in solid organ transplant (SOT) recipients are rare. We report the clinical features and treatment of a Chinese renal transplant recipient with COVID-19. A 46-year-old Chinese woman, who had a renal transplant in 2006 due to chronic glomerulonephritis, was admitted to Renmin Hospital of Wuhan University for fever, cough, and expectoration for more than 10 days and diarrhea for 3 days. At admission, her body temperature was 38.2 °C and pulse oxygen saturation was 96% under oxygen inhalation. There were decreased breath sounds bilaterally. Laboratory data revealed normal leucocyte count, a normal percentage of neutrophils, a normal percentage of lymphocytes, decreased lymphocyte count, elevated procalcitonin and C-reactive protein (CRP), and increased levels of urea, creatinine, and estimated glomerular filtration rate. COVID-19 was confirmed by nasopharyngeal swab and sputum which were positive for SARS-CoV-2 by real-time reverse transcription PCR (RT-PCR). Chest CT revealed multiple patchy and flake ground-glass shadows in bilateral lung fields, and strip shadows in bilateral lower lobes. Treatment included antiviral (umifenovir, hydroxychloroquine), antibacterial (moxifloxacin), and other support therapies. Her symptoms, laboratory data, and chest CT showed trends of gradual improvement, while nasopharyngeal swabs were always positive for SARS-CoV-2. She was finally discharged from hospital on her 70th day of hospitalization when 2 consecutive nasopharyngeal swabs were negative for SARS-CoV-2. This is a rare report on COVID-19 in a renal transplant recipient, which can help enhance the understanding and treatment of COVID-19 in renal transplant recipients.

摘要

自2019年12月以来,一种引发病毒性肺炎的新型冠状病毒爆发并成为全球大流行疾病。2019冠状病毒病(COVID-19)由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒引起。关于实体器官移植(SOT)受者临床表现的报道很少。我们报告了一名感染COVID-19的中国肾移植受者的临床特征及治疗情况。一名46岁的中国女性,因慢性肾小球肾炎于2006年接受肾移植,因发热、咳嗽、咳痰10余天,腹泻3天入住武汉大学人民医院。入院时,她的体温为38.2℃,吸氧下脉搏血氧饱和度为96%。双侧呼吸音减弱。实验室检查数据显示白细胞计数正常、中性粒细胞百分比正常、淋巴细胞百分比正常、淋巴细胞计数减少、降钙素原和C反应蛋白(CRP)升高,尿素、肌酐水平升高,估计肾小球滤过率增加。通过实时逆转录聚合酶链反应(RT-PCR)检测,鼻咽拭子和痰液中SARS-CoV-2呈阳性,确诊为COVID-19。胸部CT显示双侧肺野多发斑片状及片状磨玻璃影,双侧下叶有条状影。治疗包括抗病毒(乌米芬诺、羟氯喹)、抗菌(莫西沙星)及其他支持治疗。她的症状、实验室检查数据及胸部CT显示逐渐改善的趋势,而鼻咽拭子SARS-CoV-2始终呈阳性。住院第70天,当连续两次鼻咽拭子SARS-CoV-2检测为阴性时,她最终出院。这是一份关于肾移植受者感染COVID-19的罕见报告,有助于提高对肾移植受者感染COVID-19的认识及治疗水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a76/8185678/ac3ca428082e/tau-10-05-2140-f1.jpg

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