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接受免疫抑制治疗的再生障碍性贫血患者中新型冠状病毒肺炎临床表现的评估:一项前瞻性队列研究(NICHE)

[Evaluation of the clinical manifestations of COVID-19 in patients with aplastic anemia undergoing immunosuppressive therapy: a prospective cohort study (NICHE)].

作者信息

Zhao J Y, Zhang L L, Kuang Z X, Xu J, Wang W W, Pan H, Gao Z, Li W W, Fang L W, Song Z, Shi J

机构信息

State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2023 Nov 14;44(11):900-905. doi: 10.3760/cma.j.issn.0253-2727.2023.11.003.

Abstract

To investigate the clinical features of coronavirus disease 2019 (COVID-19) in patients with aplastic anemia (AA) undergoing immunosuppressive therapy (IST) . In this prospective cohort study, we collected the demographic and clinical data of patients with AA and COVID-19 from December 1, 2022, to January 31, 2023. We described the clinical features of COVID-19 among patients with AA and evaluated the effects of IST on the signs and severity of COVID-19. A total of 170 patients with AA and COVID-19 were included. The common early symptoms, including fever, dizziness or headache, muscle or body aches, and sore throat, disappeared within 1-2 weeks. Approximately 25% of the patients had persistent fatigue within 2 weeks. Many patients experienced cough after an initial 1-3 days of infection, which lasted for more than 2 weeks. There were no differences in the duration of total fever episodes and maximum body temperature when patients were stratified according to whether or not they underwent IST, by IST duration, or by use of anti-lymphocyte globulin (ALG) (>0.05). No differences were observed in the occurrence of symptoms in either the early or recovery stages when patients with AA were stratified according to whether or not they underwent IST, or by IST duration (>0.05). However, patients who received ALG had fewer fever episodes within 1 week after infection (=0.035) and more sore throat episodes within 2 weeks after infection (=0.015). There were no other significant differences in clinical symptoms between patients who did and patients who did not receive ALG (>0.05) . The majority of patients with AA and COVID-19 recovered within 2 weeks of noticing symptoms when treated with IST.

摘要

探讨接受免疫抑制治疗(IST)的再生障碍性贫血(AA)患者感染新型冠状病毒肺炎(COVID-19)的临床特征。在这项前瞻性队列研究中,我们收集了2022年12月1日至2023年1月31日期间AA合并COVID-19患者的人口统计学和临床数据。我们描述了AA患者中COVID-19的临床特征,并评估了IST对COVID-19体征和严重程度的影响。共纳入170例AA合并COVID-19患者。常见的早期症状,包括发热、头晕或头痛、肌肉或全身疼痛以及咽痛,在1-2周内消失。约25%的患者在2周内持续疲劳。许多患者在感染最初1-3天后出现咳嗽,持续超过2周。根据患者是否接受IST、IST持续时间或是否使用抗淋巴细胞球蛋白(ALG)进行分层时,总发热发作持续时间和最高体温无差异(>0.05)。根据是否接受IST或IST持续时间对AA患者进行分层时,在早期或恢复阶段症状的发生情况无差异(>0.05)。然而,接受ALG的患者在感染后1周内发热发作较少(=0.035),在感染后2周内咽痛发作较多(=0.015)。接受ALG和未接受ALG的患者在临床症状方面无其他显著差异(>0.05)。大多数AA合并COVID-19患者在接受IST治疗后,在出现症状的2周内康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec6/10753251/94729ed1500e/cjh-44-11-900-g001.jpg

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