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实体器官移植中的呼吸道病毒感染,包括 COVID-19。

Respiratory viral infections including COVID-19 in solid organ transplantation.

机构信息

Transplant Infectious Diseases, Ajmera Transplant Centre, University Health Network, University of Toronto, Toronto, ON, Canada.

出版信息

Curr Opin Organ Transplant. 2023 Dec 1;28(6):471-482. doi: 10.1097/MOT.0000000000001106. Epub 2023 Sep 26.

Abstract

PURPOSE OF REVIEW

Respiratory viral infections are prevalent and contribute to significant morbidity and mortality among solid organ transplant (SOT) recipients. We review updates from literature on respiratory viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the SOT recipient.

RECENT FINDINGS

With the wider availability and use of molecular diagnostic tests, our understanding of the epidemiology and impact of respiratory viruses in the SOT population continues to expand. While considerable attention has been given to the coronavirus disease 2019 (COVID-19) pandemic, the advances in prevention and treatment strategies of SARS-CoV-2 offered valuable insights into the development of new therapeutic options for managing other respiratory viruses in both the general and SOT population.

SUMMARY

Respiratory viruses can present with a diverse range of symptoms in SOT recipients, with potentially associated acute rejection and chronic lung allograft dysfunction in lung transplant recipients. The epidemiology, clinical presentations, diagnostic approaches, and treatment and preventive strategies for clinically significant RNA and DNA respiratory viruses in SOT recipients are reviewed. This review also covers novel antivirals, immunologic therapies, and vaccines in development for various community-acquired respiratory viruses.

摘要

目的综述

呼吸道病毒感染普遍存在,并导致实体器官移植(SOT)受者发病率和死亡率显著升高。我们回顾了有关呼吸道病毒的文献更新,包括严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)在 SOT 受者中的情况。

最新发现

随着分子诊断检测的广泛应用,我们对呼吸道病毒在 SOT 人群中的流行病学和影响的认识不断扩大。虽然人们对 2019 年冠状病毒病(COVID-19)大流行给予了极大关注,但 SARS-CoV-2 的预防和治疗策略的进展为管理一般人群和 SOT 人群中其他呼吸道病毒的新治疗选择的发展提供了宝贵的见解。

总结

呼吸道病毒可导致 SOT 受者出现多种症状,肺移植受者可能伴有相关的急性排斥和慢性肺移植物功能障碍。本文综述了 SOT 受者中具有临床意义的 RNA 和 DNA 呼吸道病毒的流行病学、临床表现、诊断方法以及治疗和预防策略。本文还介绍了正在开发用于各种社区获得性呼吸道病毒的新型抗病毒药物、免疫疗法和疫苗。

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