ABSTRACT
Background Kidney transplant (KT) recipients, who are chronically immunocompromised, face increased risks due to COVID-19 and lower vaccination rates. Limited knowledge exists regarding the clinical characteristics of unvaccinated KT patients with COVID-19. This study aimed to examine the clinical features and outcomes of unvaccinated KT patients infected with SARS-CoV-2 omicron subvariant BA.5.2. Methods The study enrolled 36 unvaccinated KT patients with COVID-19 and compared them to 20 infected control cases without underlying medical conditions. Clinical characteristics, laboratory tests, treatment regimens, and outcomes were analyzed. RT-PCR confirmed SARS-CoV-2 Omicron BA.5.2 subvariant infection. Results The KT patients experienced severe disease, with 66.7% classified as severe/critical illness. Dyspnea on admission, lower blood leukocyte and lymphocyte counts, hemoglobin levels, and serum albumin levels were more prevalent in the KT group compared to the control group. Severe/critical illness was associated with factors such as age, diabetes mellitus, lung infection CT score, and elevated levels of D-dimer, IL-6, CRP, Procalcitonin, and ferritin. Blood lymphocyte counts and serum albumin levels were significantly lower in the severe/critical illness group in KT patients. Treatment included discontinuation of anti-metabolic drugs, reduction, or discontinuation of calcineurin inhibitor drugs, antiviral therapy, and early patient-tailored nutritional support. Acute kidney injury was observed in 19.4% of cases, and four patients died during the observation period. Conclusions Early diagnosis, personalized treatment regimens, and diligent monitoring are crucial for unvaccinated KT patients with COVID-19. These findings contribute to understanding the clinical characteristics and management of COVID-19 in the KT population.
Subject(s)
Lung Diseases , Dyspnea , Critical Illness , Diabetes Mellitus , Kidney Diseases , COVID-19ABSTRACT
To analyze the clinical characteristics and outcomes of unvaccinated adult patients on maintenance hemodialysis infected with SARS-CoV-2 Omicron subvariant BA.5.2.The clinical data of 427 maintenance hemodialysis patients infected with SARS-CoV-2 Omicron subvariant BA.5.2 in our hospital were retrospectively collected. The patients were grouped according to the severity of the disease and compared. The clinical outcome and two-month follow-up were analyzed.These results suggest that CRP level, procalcitonin level, and bicarbonate concentration are related to the severity of disease caused by SARS-CoV-2 omicron BA.5.2 infection in unimmunized MHD patients. In addition, the co-bacterial infection may be an important cause of severe illness. Therefore, strengthen the treatment of critically ill patients, and actively and effectively control infection and secondary infection; Effective vaccination is the key to improving clinical outcomes to prevent the conversion of ordinary patients to severe and critical cases. Fever, age, ORF1ab gene value, and arterial oxygen partial pressure may be independent risk factors for disease severity in COVID-19 patients.
Subject(s)
Critical Illness , Bacterial Infections , Fever , COVID-19ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a major public health threat worldwide. Insight into protective and pathogenic aspects of SARS-CoV-2 immune responses is critical to work out effective therapeutics and develop vaccines for controlling the disease. Here, we review the present literature describing the innate and adaptive immune responses including innate immune cells, cytokine responses, antibody responses and T cell responses against SARS-CoV-2 in human infection, as well as in AEC2-humanized mouse infection. We also summarize the now known and unknown about the role of the SARS-CoV-2 immune responses. By better understanding the mechanisms that drive the immune responses, we can tailor treatment strategies at specific disease stages and improve our response to this worldwide public health threat.