Bakhsh Abeer, AlSaeed Mohammed, Ibrahim Mohammed Abdulrahman, AlHebaishi Yahya, AlBarrak Mohammed, AlAmro Sahar, Ezzeddien Ahmed, AlKhushail Abduallah, Amro Ahmed
Division of Heart Function and Transplant, Department of Cardiology, Prince Sultan Cardiac Centre.
Division of Infectious Disease, Department of Medicine, Prince Sultan Military Medical City.
Infect Dis Clin Pract (Baltim Md). 2021 Nov;29(6):e401-e403. doi: 10.1097/IPC.0000000000001004. Epub 2021 Mar 8.
Solid-organ transplant patients have a high risk of severe infection related to acute respiratory syndrome coronavirus-2 (SARS-Cov-2). This case represents a 54-year-old woman known as a diabetic, hypothyroidism, and a recent heart transplant recipient who presented with a 1-week history of cough and fatigue. She was hypoxic on presentation to the hospital and progressively declined and required invasive mechanical ventilation. She had respiratory distress and hypoxia and chest x-ray showed progressive bilateral chest infiltrates. She had leukopenia of 3.5 cells *10/L and lymphopenia of 0.2 cells *10/L. The inflammatory markers were increased: C-reactive protein, 25 mg/L; ferritin, 1106 ng/mL; lactate dehydrogenase, 632 U/L; and interleukin-6, 87 pg/mL. She was treated for severe coronavirus disease 2019 (COVID-19) pneumonia. Her treatment involved supportive care with mechanical ventilation, convalescent plasma transfusion, antiviral therapy with favipiravir, intravenous dexamethasone, and reduction of immune suppression medication. This case had a successful recovery through multidisciplinary team management. Solid-organ transplant recipients are a high-risk population who need an individualized care plan for the optimization of immunosuppressive medication and treatment of the COVID-19 infection.
实体器官移植患者因感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)而面临高风险。本病例为一名54岁女性,患有糖尿病、甲状腺功能减退症,近期接受了心脏移植,出现咳嗽和疲劳症状1周。入院时她存在低氧血症,病情逐渐恶化,需要有创机械通气。她有呼吸窘迫和低氧血症,胸部X线显示双侧肺部浸润逐渐加重。她的白细胞计数为3.5×10⁹/L,淋巴细胞计数为0.2×10⁹/L。炎症指标升高:C反应蛋白25mg/L;铁蛋白1106ng/mL;乳酸脱氢酶632U/L;白细胞介素-6 87pg/mL。她接受了重症2019冠状病毒病(COVID-19)肺炎的治疗。她的治疗包括机械通气支持治疗、恢复期血浆输注、法匹拉韦抗病毒治疗、静脉注射地塞米松以及减少免疫抑制药物剂量。通过多学科团队管理,该病例成功康复。实体器官移植受者是高危人群,需要个体化的护理计划,以优化免疫抑制药物治疗和COVID-19感染的治疗。