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肾移植受者中的2019冠状病毒病：一项系统综述和荟萃分析。

Coronavirus disease 2019 in kidney transplant recipients: a systematic review and meta-analysis.

作者信息

Ho Quan Yao, Sultana Rehena, Lee Tung Lin, Thangaraju Sobhana, Kee Terence, Htay Htay

机构信息

Department of Renal Medicine, Singapore General Hospital; SingHealth Duke-NUS Transplant Centre, Singapore.

Duke-NUS Medical School, Singapore.

出版信息

Singapore Med J. 2023 Oct;64(10):593-602. doi: 10.11622/smedj.2021171.

DOI:10.11622/smedj.2021171
PMID:34688231
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10645004/
Abstract

INTRODUCTION

The clinical presentation and outcomes of coronavirus disease 2019 (COVID-19) in kidney transplant recipients (KTRs) have not been well studied.

METHODS

We performed a meta-analysis to examine the presenting features, outcomes and the effect of treatment on outcomes of KTRs with COVID-19. Database search was performed up to 5 September 2020 through PubMed, Embase, Web of Science, Scopus and CENTRAL.

RESULTS

Overall, 23 studies (1,373 patients) were included in the review and meta-analysis. The most common presenting symptoms included fever (74.0%, 95% confidence interval [CI] 65.3-81.1), cough (63.3%, 95% CI 56.5-69.6) and dyspnoea (47.5%, 95% CI 39.6-55.6). Pooled rates of mortality and critical illness were 21.1% (95% CI 15.3-28.4) and 27.7% (95% CI 21.5-34.8), respectively. Acute kidney injury occurred in 38.9% (95% CI 30.6-48.1) and dialysis was required in 12.4% (95% CI 8.3-18.0) of the cases.

CONCLUSION

Kidney transplant recipients with COVID-19 have a similar clinical presentation as the general population, but they have higher morbidity and mortality. It is uncertain whether high-dose corticosteroid or hydroxychloroquine reduces the risks of mortality in KTRs with COVID-19.

摘要

引言

2019冠状病毒病（COVID-19）在肾移植受者（KTRs）中的临床表现和预后尚未得到充分研究。

方法

我们进行了一项荟萃分析，以研究感染COVID-19的KTRs的表现特征、预后以及治疗对预后的影响。截至2020年9月5日，通过PubMed、Embase、Web of Science、Scopus和CENTRAL进行数据库检索。

结果

总体而言，23项研究（1373例患者）纳入了本综述和荟萃分析。最常见的表现症状包括发热（74.0%，95%置信区间[CI]65.3-81.1）、咳嗽（63.3%，95%CI 56.5-69.6）和呼吸困难（47.5%，95%CI 39.6-55.6）。汇总的死亡率和危重病发生率分别为21.1%（95%CI 15.3-28.4）和27.7%（95%CI 21.5-34.8）。38.9%（95%CI 30.6-48.1）的病例发生急性肾损伤，12.4%（95%CI 8.3-18.0）的病例需要透析。

结论

感染COVID-19的肾移植受者的临床表现与普通人群相似，但他们的发病率和死亡率更高。大剂量皮质类固醇或羟氯喹是否能降低感染COVID-19的KTRs的死亡风险尚不确定。

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