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新型冠状病毒肺炎对儿童和成人实体器官移植受者的影响以及远程医疗的出现。

The effects of COVID-19 on pediatric and adult solid organ transplant recipients and the emergence of telehealth.

作者信息

Raina Rupesh, Shah Raghav, Marks Stephen D, Johnson Jonathan N, Nied Matthew, Bhatt Girish C, Bonham Clark A, Datla Nithin, Sethi Sidharth Kumar, Bartosh Sharon M

机构信息

Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, Ohio, USA.

Department of Nephrology, Akron Children's Hospital, Akron, Ohio, USA.

出版信息

Pediatr Transplant. 2023 Jun;27(4):e14490. doi: 10.1111/petr.14490. Epub 2023 Mar 6.

Abstract

BACKGROUND

The SARS-CoV-2 pandemic and corresponding acute respiratory syndrome have affected all populations and led to millions of deaths worldwide. The pandemic disproportionately affected immunocompromised and immunosuppressed adult patients who had received solid organ transplants (SOTs). With the onset of the pandemic, transplant societies across the world recommended reducing SOT activities to avoid exposing immunosuppressed recipients. Due to the risk of COVID-19-related outcomes, SOT providers adapted the way they deliver care to their patients, leading to a reliance on telehealth. Telehealth has helped organ transplant programs continue treatment regimens while protecting patients and physicians from COVID-19 transmission. This review highlights the adverse effects of COVID-19 on transplant activities and summarizes the increased role of telehealth in the management of solid organ transplant recipients (SOTRs) in both pediatric and adult populations.

METHODS

A comprehensive systematic review and meta-analysis were conducted to accentuate the outcomes of COVID-19 and analyze the efficacy of telehealth on transplant activities. This in-depth examination summarizes extensive data on the clinical detriments of COVID-19 in transplant recipients, advantages, disadvantages, patient/physician perspectives, and effectiveness in transplant treatment plans via telehealth.

RESULTS

COVID-19 has caused an increase in mortality, morbidity, hospitalization, and ICU admission in SOTRs. Telehealth efficacy and benefits to both patients and physicians have increasingly been reported.

CONCLUSIONS

Developing effective systems of telehealth delivery has become a top priority for healthcare providers during the COVID-19 pandemic. Further research is necessary to validate the effectiveness of telehealth in other settings.

摘要

背景

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)大流行及相应的急性呼吸综合征影响了所有人群,并在全球导致数百万例死亡。这场大流行对接受实体器官移植(SOT)的免疫功能低下和免疫抑制的成年患者影响尤为严重。随着大流行的爆发,世界各地的移植协会建议减少 SOT 活动,以避免使免疫抑制的受者暴露于病毒之下。由于存在与 2019 冠状病毒病(COVID-19)相关后果的风险,SOT 提供者调整了为患者提供护理的方式,从而导致对远程医疗的依赖。远程医疗有助于器官移植项目继续治疗方案,同时保护患者和医生免受 COVID-19 的传播。本综述强调了 COVID-19 对移植活动的不利影响,并总结了远程医疗在儿科和成人实体器官移植受者(SOTR)管理中日益增加的作用。

方法

进行了一项全面的系统综述和荟萃分析,以强调 COVID-19 的结果,并分析远程医疗对移植活动的疗效。这项深入研究总结了关于 COVID-19 在移植受者中的临床损害及远程医疗在移植治疗计划中的优势、劣势、患者/医生观点和有效性的大量数据。

结果

COVID-19 导致 SOTR 的死亡率、发病率、住院率和重症监护病房(ICU)入住率上升。越来越多的报告表明远程医疗对患者和医生都有效且有益。

结论

在 COVID-19 大流行期间,开发有效的远程医疗服务系统已成为医疗保健提供者的首要任务。有必要进行进一步研究以验证远程医疗在其他环境中的有效性。

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