Arentoft Nicoline Stender, Møller Dina Leth, Knudsen Andreas Delhbæk, Abdulovski Ranya, Kirkby Nikolai, Sørensen Søren Schwartz, Rasmussen Allan, Nielsen Susanne Dam
Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Microbiol Spectr. 2023 Mar 28;11(2):e0322622. doi: 10.1128/spectrum.03226-22.
Influenza is a common respiratory tract infection in solid organ transplant (SOT) recipients. We aimed to investigate the incidence, risk factors, and complications of influenza in a large cohort of kidney and liver transplant recipients over 10 consecutive seasons. We conducted a retrospective study, including 378 liver and 683 kidney transplant recipients who were transplanted from January 1, 2010, to October 1, 2019. The data on influenza were retrieved from MiBa, which is a nationwide database that contains all of the microbiology results in Denmark. Clinical data were retrieved from patient records. Incidence rates and cumulative incidences were calculated, and risk factors were investigated using time-updated Cox proportional hazards models. The cumulative incidence of influenza in the first 5 years posttransplantation was 6.3% (95% CI: 4.7 to 7.9%). Of the 84 influenza positive recipients, 63.1% had influenza A, 65.5% were treated with oseltamivir, 65.5% were hospitalized, and 16.7% developed pneumonia. There were no significant differences in outcomes when comparing patients with influenza A and B. We found no significant effect of same-season influenza vaccination, sex, age, or comorbidities on the risk of acquiring influenza. The incidence of influenza in kidney and liver recipients is high, and 65.5% of infected transplant recipients required hospitalization. We were not able to confirm a reduction in influenza incidence or in the risk of complications associated with vaccination. Influenza is a common respiratory virus in solid organ transplant recipients that may have severe complications, including pneumonia and hospitalization. This study investigates the incidence, risk factors, and complications of influenza in a Danish cohort of kidney and liver transplant recipients over 10 consecutive influenza seasons. The study shows a high incidence of influenza and a high frequency of both pneumonia and hospitalization. This emphasizes the importance of continuous focus on influenza in this vulnerable group. During the COVID-19 pandemic, the incidence of influenza has been low due to COVID-related restrictions, and immunity may have waned. However, as most countries have now opened up, the incidence of influenza is expected to be high this season.
流感是实体器官移植（SOT）受者常见的呼吸道感染。我们旨在调查连续10个季节中，一大群肾移植和肝移植受者的流感发病率、危险因素及并发症。我们进行了一项回顾性研究，纳入了2010年1月1日至2019年10月1日期间接受移植的378例肝移植受者和683例肾移植受者。流感数据来自MiBa，这是一个包含丹麦所有微生物学结果的全国性数据库。临床数据从患者记录中获取。计算发病率和累积发病率，并使用时间更新的Cox比例风险模型研究危险因素。移植后前5年流感的累积发病率为6.3%（95%CI：4.7%至7.9%）。在84例流感阳性受者中，63.1%感染甲型流感，65.5%接受奥司他韦治疗，65.5%住院，16.7%发生肺炎。比较甲型和乙型流感患者的结局，无显著差异。我们发现同季节流感疫苗接种、性别、年龄或合并症对感染流感的风险无显著影响。肾移植和肝移植受者的流感发病率很高，65.5%的感染移植受者需要住院治疗。我们无法证实流感发病率或与疫苗接种相关的并发症风险有所降低。流感是实体器官移植受者常见的呼吸道病毒，可能引发包括肺炎和住院在内的严重并发症。本研究调查了丹麦连续10个流感季节中肾移植和肝移植受者的流感发病率、危险因素及并发症。研究显示流感发病率高，肺炎和住院频率也高。这凸显了持续关注这一弱势群体流感问题的重要性。在新冠疫情期间，由于与新冠相关的限制措施，流感发病率一直较低，免疫力可能有所下降。然而，由于大多数国家现已开放，预计本季节流感发病率会很高。
