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肾移植受者和普通人群中的 COVID-19:临床、实验室和影像学特征、严重程度和结局的比较研究。

COVID-19 in renal transplant recipients and general population: a comparative study of clinical, laboratory, and radiological features, severity, and outcome.

机构信息

Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Virol J. 2021 Dec 7;18(1):243. doi: 10.1186/s12985-021-01713-x.

Abstract

INTRODUCTION

Coronavirus disease 2019 (COVID-19), a novel disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to millions of deaths worldwide. Kidney transplant recipients (KTRs) are a fragile population due to their immunosuppressed status. However, there are limited studies available comparing this population with the general population regarding clinical symptoms, and laboratory and imaging features as well as disease severity and clinical outcomes.

METHODS

A total of 24 KTRs and 40 patients from the general population (control group) were enrolled after applying exclusion criteria. Clinical symptoms, laboratory values, and lung involvement patterns in high-resolution computed tomography (HRCT) were compared between KTRs with COVID-19 and their counterparts from the general population. Moreover, the category of disease severity and adverse outcomes such as intensive care unit (ICU) admission, mechanical ventilation (MV), and mortality rate were also compared between these two groups.

RESULTS

Hypertension was significantly higher among KTRs. Dyspnea was significantly more among the control group (P = 0.045). There was no significant difference in the rest of clinical symptoms (P > 0.05). There was no significant difference in CT features as well, except pleural effusion, which was more prevalent in the control group. A lower absolute lymphocytic count (ALC) and platelet count were observed in KTRs. Renal transplant recipients (RTRs) had a higher elevation in creatinine level than their counterparts. The ICU admission, MV, duration of hospital stay, and mortality as adverse outcomes were not significantly different between the KTR and control groups.

CONCLUSION

In conclusion, there was no significant difference in the severity and risk of adverse outcomes, including MV, ICU admission, and mortality between KTRs under chronic immunosuppression and the control group.

摘要

引言

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)已导致全球数百万人死亡。由于免疫抑制状态,肾移植受者(KTR)是一个脆弱的群体。然而,与普通人群相比,关于临床症状、实验室和影像学特征以及疾病严重程度和临床结局,可供比较的研究有限。

方法

在应用排除标准后,共纳入 24 名 KTR 和 40 名来自普通人群(对照组)的患者。比较 COVID-19 肾移植受者与普通人群中 COVID-19 患者的临床症状、实验室值和高分辨率计算机断层扫描(HRCT)中的肺部受累模式。此外,还比较了两组之间疾病严重程度和不良结局(如入住重症监护病房(ICU)、机械通气(MV)和死亡率)的类别。

结果

高血压在 KTR 中明显更高。对照组呼吸困难明显更多(P=0.045)。其余临床症状无显著差异(P>0.05)。CT 特征也无明显差异,除胸腔积液外,对照组更为常见。KTR 的绝对淋巴细胞计数(ALC)和血小板计数较低。肾移植受者的肌酐水平升高幅度高于对照组。作为不良结局的 ICU 入住、MV、住院时间和死亡率在 KTR 和对照组之间无显著差异。

结论

总之,慢性免疫抑制的 KTR 与对照组之间,在 MV、ICU 入住、死亡率等不良结局的严重程度和风险方面无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8fd/8650236/ed7e2e5be1c9/12985_2021_1713_Fig1_HTML.jpg

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