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肝移植项目患者中新型冠状病毒肺炎的发病率、特征及结局:伊朗北部的一项回顾性研究

Incidence, characteristics, and outcome of COVID-19 in patients on liver transplant program: a retrospective study in the north of Iran.

作者信息

Samidoust P, Esmaeili Delshad M S, Navid Talemi R, Mojtahedi K, Samidoust A, Jahangiri S, Ashoobi M T

机构信息

Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Gastrointestinal and Liver Diseases Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

New Microbes New Infect. 2021 Nov;44:100935. doi: 10.1016/j.nmni.2021.100935. Epub 2021 Sep 3.

Abstract

The risk of severe coronavirus disease-2019 (COVID-19) disease seems to be higher in individuals with solid organ transplantation. Therefore, the purpose of the present research is to investigate the incidence of COVID-19 and laboratory data and epidemiologic factors in liver transplant recipients and the patients on the waiting list for liver transplantation. In this study, we evaluated the records of patients on the waiting list for liver transplantation and of recipients of a liver transplant. Demographic data, underlying disease, history of drug use and participants' outcomes were collected. The diagnosis of SARS-CoV-2 infection for all patients was confirmed using a nasopharyngeal swab specimen with real-time RT-PCR. During the study period, 172 patients were enrolled, among whom 85 patients (49.4%) were on the waiting list for liver transplantation, and 87 patients (50.6%) were recipients of a liver transplant. Out of them, 10 (5.8%) had a positive result for SARS-CoV-2. Of these patients, 7.05% (6/85) and 4.6% (4/87) of patients on the waiting list and recipients of liver transplants were positive for SARS-CoV-2, respectively. Patients on the waiting list with COVID-19 infection had a higher median of albumin, ALT, AST, TBIL, DBIL, HDL and LDL value. In summary, the incidence of COVID-19 in liver transplant patients was slightly higher. The existence of underlying liver diseases should be well known as one of the poor predictive factors for worse outcomes in patients with COVID-19. So, comparative studies are recommended to identify risk factors for COVID-19 in patients with liver injury.

摘要

实体器官移植个体发生重症冠状病毒病2019(COVID-19)的风险似乎更高。因此,本研究的目的是调查肝移植受者以及肝移植等待名单上的患者中COVID-19的发病率、实验室数据和流行病学因素。在本研究中,我们评估了肝移植等待名单上患者和肝移植受者的记录。收集了人口统计学数据、基础疾病、用药史和参与者的结局。所有患者的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染诊断均通过鼻咽拭子标本的实时逆转录聚合酶链反应(RT-PCR)得以确诊。在研究期间,共纳入172例患者,其中85例(49.4%)在肝移植等待名单上,87例(50.6%)为肝移植受者。其中,10例(5.8%)SARS-CoV-2检测呈阳性。在这些患者中,肝移植等待名单上的患者和肝移植受者中SARS-CoV-2检测呈阳性的分别占7.05%(6/85)和4.6%(4/87)。感染COVID-19的肝移植等待名单上的患者白蛋白、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)值的中位数更高。总之,肝移植患者中COVID-19的发病率略高。基础肝脏疾病的存在应作为COVID-19患者预后较差的不良预测因素之一而广为人知。因此,建议进行比较研究以确定肝损伤患者中COVID-19的危险因素。

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