RESUMEN
The coronavirus disease 2019 (COVID-19) pandemic can lead to a severe course of disease in immunosuppressed patients requiring intensive care unit treatment even though a number of new vaccines and new antiviral drugs exist. One of the main reasons for this is the generally poorer immune response under immunosuppression. Therefore, it is all the more important to know the stages of the disease and to select the currently available therapeutic options accordingly.Copyright © 2023, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
RESUMEN
The coronavirus disease 2019 (COVID-19) pandemic can lead to a severe course of disease in immunosuppressed patients requiring intensive care unit treatment even though a number of new vaccines and new antiviral drugs exist. One of the main reasons for this is the generally poorer immune response under immunosuppression. Therefore, it is all the more important to know the stages of the disease and to select the currently available therapeutic options accordingly.
RESUMEN
Solid organ transplant recipients have an increased morbidity and mortality after SARS-CoV-2 infection. Immune responses after the third/fourth vaccination against SARS-CoV-2 are insufficiently studied in patients after kidney transplantation (KTX). We analyzed immune responses at a median of 4 months after the third/fourth vaccination in KTX patients and compared them to healthy controls. Cellular immunity was assessed using interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) ELISpot assays. Neutralizing antibody titers were assessed against SARS-CoV-2 D614G (wild type) and the variants alpha, delta and omicron by a cell culture-based neutralization assay. Humoral immunity was also determined by a competitive fluorescence assay, using 11 different variants of SARS-CoV-2. Antibody ratios were measured by ELISA. KTX patients showed significantly lower SARSCoV- 2-specific IFN-gamma responses after booster vaccination than healthy controls. However, the SARS-CoV-2 specific IL-2 responses were comparable to the T cell responses of healthy controls. Cell culture-based neutralizing antibody titers were 1.3-fold higher in healthy controls for D614G, alpha and delta and 7.8-fold higher for omicron (p < 0.01). Healthy controls had approximately 2-fold higher concentrations of potential neutralizing antibodies against all 11 variants than KTX patients. However, more than 60% of the KTX patients exhibited antibodies to variants of SARS-CoV-2. In conclusion, KTX patients should be partly protected against SARSCoV- 2, either by cross-reactive T cells, especially those producing IL-2, or by neutralizing antibodies to SARSCoV- 2 variants.
RESUMEN
Acute kidney injury (AKI) is a frequent complication in coronavirus disease 2019 (COVID-19). It is often linked to progressive respiratory failure and is associated with increased morbidity and mortality. The AKI is presumably of multifactorial origin, whereby direct viral infestation of the kidneys also seems to be involved. Specific treatment procedures for AKI associated with COVID-19 are currently missing. In addition, the role of extracorporeal procedures in the treatment of COVID-19 could so far not be clarified. Latest data indicate persistent loss of renal function following COVID-19-associated AKI. Therefore, a re-evaluation of renal function following recovery from COVID-19 should be recommended.
RESUMEN
The PCR-test for SARS-CoV-2 represents the state of the art in diagnosing COVID-19 disease as at November 2020. However, above all this is time-consuming. In future, so-called antigen tests could be carried out quickly and as a point-of-care method to facilitate the diagnosis of COVID-19. Changes in serological biomarkers (such as D-dimers, troponin T, CRP) can help to identify patients at risk for a severe COVID-19 course. A routine screening CT thorax to identify COVID-19 pneumonia is currently not recommended by most radiological societies. However, the number of CT examinations is increasing steadily and radiological diagnosis in COVID-19 patients with pulmonary symptoms is becomingmore and more important.
RESUMEN
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has become one of the greatest global challenges of our time. It quickly became clear that coronavirus disease 2019 (COVID-19) affects not only the lungs but also other organs to varying degrees. The kidneys are particularly frequently affected. Many patients without underlying kidney diseases already show urinary abnormalities at the onset of COVID-19 and often run the risk of developing acute kidney injury.
RESUMEN
The drastic consequences that emerging infectious diseases can have for people and society are currently being demonstrated by coronavirus disease 2019 (COVID-19). Since its initial description in December 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has dominated current scientific and public interest.