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造血细胞移植后的呼吸道病毒感染

[Respiratory virus infections after hematopoietic cell transplantation].

作者信息

Seo Sachiko

机构信息

Dokkyo Medical University.

出版信息

Rinsho Ketsueki. 2021;62(8):1288-1295. doi: 10.11406/rinketsu.62.1288.

Abstract

Respiratory viral infection is a common disease even among immunocompetent individuals. Moreover, approximately 40% of the hematopoietic cell transplantation (HCT) recipients suffer from a respiratory infection within 100 days after HCT. New respiratory viruses have been continuously identified in the past 20 years, such as new strains of coronaviruses (CoV), human metapneumovirus (HMPV), and human bocavirus (BoV). In 2019, severe acute respiratory syndrome coronavirus (SARS-CoV)-2 that caused the coronavirus disease (COVID)-19 pandemic was identified. The 30-day overall survival after lower respiratory tract disease (LRTD) due to CoV, including SARS-CoV-2 or HMPV, was 60-70%, which is similar to that after LRTD due to influenza or respiratory syncytial virus. However, whether BoV is a pathogen of LRTD remains unclear. Moreover, corticosteroid has been reported as an efficient drug for LRTD due to SARS-CoV-2. Antiviral drug (remdesivir), anti-IL-6 receptor antibody (tocilizumab), and JAK inhibitor (ruxolitinib) are also expected to be efficient for the treatment of COVID-19. Thus, managing respiratory viruses in HCT recipients needs to be learned based on experiences from the COVID-19 pandemic.

摘要

呼吸道病毒感染即使在免疫功能正常的个体中也是一种常见疾病。此外,约40%的造血细胞移植(HCT)受者在HCT后100天内会发生呼吸道感染。在过去20年中,不断发现新的呼吸道病毒,如新型冠状病毒(CoV)、人偏肺病毒(HMPV)和人博卡病毒(BoV)。2019年,导致冠状病毒病(COVID)-19大流行的严重急性呼吸综合征冠状病毒(SARS-CoV)-2被发现。由包括SARS-CoV-2或HMPV在内的CoV引起的下呼吸道疾病(LRTD)后的30天总生存率为60%-70%,这与流感或呼吸道合胞病毒引起的LRTD后的生存率相似。然而,BoV是否为LRTD的病原体仍不清楚。此外,皮质类固醇已被报道为治疗由SARS-CoV-2引起的LRTD的有效药物。抗病毒药物(瑞德西韦)、抗IL-6受体抗体(托珠单抗)和JAK抑制剂(芦可替尼)也有望有效治疗COVID-19。因此,需要根据COVID-19大流行的经验来了解如何管理HCT受者中的呼吸道病毒。

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