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Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases最新文献

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"Stuck in pandemic uncertainty: A review of the persistent Effects of COVID-19 infection in immune deficient people". "陷入大流行的不确定性:回顾 COVID-19 在免疫缺陷人群中的持续感染效应"。
Bevin Manuelpillai, Mackenzie Zendt, Emma Chang-Rabley, Emily Ricotta
BACKGROUNDImmune-deficient/disordered people (IDP) are underrepresented in COVID-19 studies. Specifically, there is limited research on post-SARS-CoV-2 infection outcomes, including viral persistence and long-term sequelae in these populations.OBJECTIVESThis review aimed to examine the published literature on the occurrence of persistent SARS-CoV-2 positivity, relapse, reinfections, variant coinfection, and post-acute sequelae of COVID-19 in IDP. While the available literature largely centered on those with secondary immunodeficiencies, studies on people with inborn errors of immunity are also included.SOURCESPubMed was searched using Medical Subject Headings (MeSH) terms to identify relevant articles from the last four years. Articles on primary and secondary immunodeficiencies were chosen and a special emphasis was placed on including articles that studied people with inborn errors of immunity. The absence of extensive cohort studies including these individuals has limited most articles in this review to case reports, whereas the articles focusing on secondary immunodeficiencies include larger cohort, case-control, and cross-sectional studies. Articles focusing solely on HIV/AIDS were excluded.CONTENTScientific literature suggests that IDP of any age are more likely to experience persistent SARS-CoV-2 infections. While adult IDP exhibit a higher rate of post-acute sequelae of COVID-19 (PASC), milder COVID-19 infections in children may reduce their risk of experiencing PASC. Reinfections and coinfections may occur at a slightly higher rate in IDP than the general population.IMPLICATIONSWhile IDP experience increased viral persistence and inter-host evolution, it is unlikely that enough evidence can be generated at the population-level to support or refute the hypothesis that infections in IDP are significantly more likely to result in variants of concern than infections in the general population. Additional research on the relationship between viral persistence and the rate of long-term sequelae in IDP could inform the understanding of the immune response to SARS-CoV-2 in IDP and the general population.
背景免疫缺陷者/障碍者(IDP)在 COVID-19 研究中的代表性不足。本综述旨在研究已发表的有关 IDP 中 SARS-CoV-2 持续阳性、复发、再感染、变异型合并感染以及 COVID-19 急性后遗症的文献。虽然现有文献主要以继发性免疫缺陷患者为研究对象,但也包括对先天性免疫错误患者的研究。我们选择了有关原发性和继发性免疫缺陷的文章,并特别强调要收录研究先天性免疫错误患者的文章。由于缺乏包括这些人在内的大量队列研究,本综述中的大多数文章仅限于病例报告,而关注继发性免疫缺陷的文章则包括规模较大的队列、病例对照和横断面研究。科学文献表明,任何年龄段的国内流离失所者都更有可能持续感染 SARS-CoV-2。虽然成年 IDP 表现出较高的 COVID-19 急性后遗症(PASC)发病率,但儿童感染较轻的 COVID-19 可能会降低他们出现 PASC 的风险。虽然国内流离失所者的病毒持久性和宿主间的进化程度都有所提高,但不太可能在人群层面获得足够的证据来支持或反驳国内流离失所者感染比普通人群感染更有可能导致令人担忧的变异病毒的假设。对 IDP 中病毒持续存在与长期后遗症发生率之间的关系进行更多研究,可以帮助了解 IDP 和普通人群对 SARS-CoV-2 的免疫反应。
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Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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