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肺移植受者中新型冠状病毒肺炎感染的临床特征及预后

Clinical characteristics and prognosis of SARS-CoV-2 infection in lung transplant recipients.

作者信息

Zhang Wenping, Li Qiangming, Ma Zeheng, Han Zhijun, Hu Shuai, Xia Tian, Zhu Zibo, Wei Li

机构信息

Department of Thoracic Surgery/Lung Transplantation, Zhengzhou Key Laboratory for Surgical Treatment for End-Stage Lung Disease, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China.

出版信息

Front Surg. 2024 May 1;11:1354994. doi: 10.3389/fsurg.2024.1354994. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to investigate the clinical manifestations and prognosis of lung transplant (LTx) recipients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease (COVID-19) pandemic.

METHODS

The research participants were LTx recipients who underwent surgery and were regularly followed up at our center. From 1 December 2022 to 28 February 2023, during the COVID-19 pandemic in China, research participants were interviewed either online or in person. SARS-CoV-2 nucleic acid or self-tested antigens were detected according to accessibility. Diagnosis and treatment were performed according to the Diagnosis and Treatment Plan for COVID-19 (10th edition) issued by the National Health Commission of the People's Republic of China. Hospitalized patients underwent chest imaging examinations, routine blood tests, biomarkers for infection and inflammation, and biochemical tests, all of which were taken and recorded. Data were analyzed to describe the features of COVID-19 in LTx recipients.

RESULTS

In total, 52 patients were enrolled in this study, comprising 48 men and 4 women, with a mean age of 51.71 ± 11.67 years. By 1 December 2022, the mean survival period was 33.87 ± 25.97 months, of which 84.61% of the patients (44/52) had a survival period longer than 12 months. The SARS-CoV-2 infection rate in these LTx recipients was 82.69% (43/52), with 3.85% (2/52) of the infected recipients being asymptomatic, 50.00% (26/52) of the infected recipients experiencing mild COVID-19, 11.54% (6/52) having moderate COVID-19, and 17.31% (9/52) having severe or critical COVID-19. The mortality rate among severe and critical patients was 66.67% (6/9).

CONCLUSION

LTx recipients in this cohort exhibited a notable susceptibility to SARS-CoV-2, with 82.69% of individuals diagnosed with COVID-19. Moreover, the mortality rate among critically ill patients was high.

摘要

目的

本研究旨在调查在冠状病毒疾病(COVID-19)大流行期间感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的肺移植(LTx)受者的临床表现和预后。

方法

研究参与者为在本中心接受手术并定期随访的LTx受者。在2022年12月1日至2023年2月28日中国COVID-19大流行期间,通过线上或线下方式对研究参与者进行访谈。根据实际情况检测SARS-CoV-2核酸或自行检测抗原。根据中华人民共和国国家卫生健康委员会发布的《新型冠状病毒肺炎诊疗方案(第十版)》进行诊断和治疗。住院患者接受胸部影像学检查、血常规、感染及炎症生物标志物和生化检查,并全部采集记录。对数据进行分析以描述LTx受者中COVID-19的特征。

结果

本研究共纳入52例患者,其中男性48例,女性4例,平均年龄51.71±11.67岁。截至2022年12月1日,平均生存期为33.87±25.97个月,其中84.61%的患者(44/52)生存期超过12个月。这些LTx受者中SARS-CoV-2感染率为82.69%(43/52),其中3.85%(2/52)的感染受者无症状,50.00%(26/52)的感染受者为轻型COVID-19,11.54%(6/52)为中型COVID-19,17.31%(9/52)为重型或危重型COVID-19。重型和危重型患者的死亡率为66.67%(6/9)。

结论

该队列中的LTx受者对SARS-CoV-2表现出明显易感性,82.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21aa/11094252/8a60bf775130/fsurg-11-1354994-g001.jpg

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