EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT
Identifieur interne : 001147 ( Pmc/Corpus ); précédent : 001146; suivant : 001148EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT
Auteurs : Zong-Li Ren ; Rui Hu ; Zhi-Wei Wang ; Min Zhang ; Yong-Le Ruan ; Zhi-Yong Wu ; Hong-Bing Wu ; Xiao-Ping Hu ; Zhi-Peng Hu ; Wei Ren ; Luo-Cheng Li ; Fei-Feng Dai ; Huan Liu ; Xin CaiSource :
- The Journal of Heart and Lung Transplantation [ 1053-2498 ] ; 2020.
Abstract
The epidemiological and clinical characteristics of heart transplant (HTx) recipients during the SARS-CoV-2 epidemic remains unclear. We studied the characteristics of HTx recipients during Dec 20, 2019 and Feb 25, 2020 in an effort to understand their risk and outcomes.
All accessible HTx recipients were included in this single-center, retrospective study. We collected information on the recipients using a web-based questionnaire as well as the hospital database.
We followed 87 HTx recipients (72.4% were men and average age was 51 years). 79 recipients resided in Hubei, and 57 recipients had a Wuhan related history of travel or contact. The majority took precautionary measures while in contact with suspicious crowds. 96.6% of the families and communities undertook prevention and quarantine procedures. 4 upper airway infection were reported, and 3 of them tested negative for SARS-CoV-2 (the 4th recovered and was not tested). All cases were mild and successfully recovered after proper treatment. Laboratory results of 47 HTx cases within the last 2 months were extracted. 21.3% recipients had pre-existing lymphopenia and 87.2% of recipients had therapeutic tacrolimus concentration (5-12ng/ml). 5 and 6 recipients had liver and kidney insufficiency respectively.
HTx recipients that practiced appropriate prevention measures had a low rate of infection with SARS-CoV-2 and transition to COVID-19. These early data will require confirmation as the pandemic establishes around the world.
Url:
DOI: 10.1016/j.healun.2020.03.008
PubMed: 32115364
PubMed Central: 7102567
Links to Exploration step
PMC:7102567Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT</title><author><name sortKey="Ren, Zong Li" sort="Ren, Zong Li" uniqKey="Ren Z" first="Zong-Li" last="Ren">Zong-Li Ren</name></author><author><name sortKey="Hu, Rui" sort="Hu, Rui" uniqKey="Hu R" first="Rui" last="Hu">Rui Hu</name></author><author><name sortKey="Wang, Zhi Wei" sort="Wang, Zhi Wei" uniqKey="Wang Z" first="Zhi-Wei" last="Wang">Zhi-Wei Wang</name></author><author><name sortKey="Zhang, Min" sort="Zhang, Min" uniqKey="Zhang M" first="Min" last="Zhang">Min Zhang</name></author><author><name sortKey="Ruan, Yong Le" sort="Ruan, Yong Le" uniqKey="Ruan Y" first="Yong-Le" last="Ruan">Yong-Le Ruan</name></author><author><name sortKey="Wu, Zhi Yong" sort="Wu, Zhi Yong" uniqKey="Wu Z" first="Zhi-Yong" last="Wu">Zhi-Yong Wu</name></author><author><name sortKey="Wu, Hong Bing" sort="Wu, Hong Bing" uniqKey="Wu H" first="Hong-Bing" last="Wu">Hong-Bing Wu</name></author><author><name sortKey="Hu, Xiao Ping" sort="Hu, Xiao Ping" uniqKey="Hu X" first="Xiao-Ping" last="Hu">Xiao-Ping Hu</name></author><author><name sortKey="Hu, Zhi Peng" sort="Hu, Zhi Peng" uniqKey="Hu Z" first="Zhi-Peng" last="Hu">Zhi-Peng Hu</name></author><author><name sortKey="Ren, Wei" sort="Ren, Wei" uniqKey="Ren W" first="Wei" last="Ren">Wei Ren</name></author><author><name sortKey="Li, Luo Cheng" sort="Li, Luo Cheng" uniqKey="Li L" first="Luo-Cheng" last="Li">Luo-Cheng Li</name></author><author><name sortKey="Dai, Fei Feng" sort="Dai, Fei Feng" uniqKey="Dai F" first="Fei-Feng" last="Dai">Fei-Feng Dai</name></author><author><name sortKey="Liu, Huan" sort="Liu, Huan" uniqKey="Liu H" first="Huan" last="Liu">Huan Liu</name></author><author><name sortKey="Cai, Xin" sort="Cai, Xin" uniqKey="Cai X" first="Xin" last="Cai">Xin Cai</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32115364</idno><idno type="pmc">7102567</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102567</idno><idno type="RBID">PMC:7102567</idno><idno type="doi">10.1016/j.healun.2020.03.008</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">001147</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001147</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT</title><author><name sortKey="Ren, Zong Li" sort="Ren, Zong Li" uniqKey="Ren Z" first="Zong-Li" last="Ren">Zong-Li Ren</name></author><author><name sortKey="Hu, Rui" sort="Hu, Rui" uniqKey="Hu R" first="Rui" last="Hu">Rui Hu</name></author><author><name sortKey="Wang, Zhi Wei" sort="Wang, Zhi Wei" uniqKey="Wang Z" first="Zhi-Wei" last="Wang">Zhi-Wei Wang</name></author><author><name sortKey="Zhang, Min" sort="Zhang, Min" uniqKey="Zhang M" first="Min" last="Zhang">Min Zhang</name></author><author><name sortKey="Ruan, Yong Le" sort="Ruan, Yong Le" uniqKey="Ruan Y" first="Yong-Le" last="Ruan">Yong-Le Ruan</name></author><author><name sortKey="Wu, Zhi Yong" sort="Wu, Zhi Yong" uniqKey="Wu Z" first="Zhi-Yong" last="Wu">Zhi-Yong Wu</name></author><author><name sortKey="Wu, Hong Bing" sort="Wu, Hong Bing" uniqKey="Wu H" first="Hong-Bing" last="Wu">Hong-Bing Wu</name></author><author><name sortKey="Hu, Xiao Ping" sort="Hu, Xiao Ping" uniqKey="Hu X" first="Xiao-Ping" last="Hu">Xiao-Ping Hu</name></author><author><name sortKey="Hu, Zhi Peng" sort="Hu, Zhi Peng" uniqKey="Hu Z" first="Zhi-Peng" last="Hu">Zhi-Peng Hu</name></author><author><name sortKey="Ren, Wei" sort="Ren, Wei" uniqKey="Ren W" first="Wei" last="Ren">Wei Ren</name></author><author><name sortKey="Li, Luo Cheng" sort="Li, Luo Cheng" uniqKey="Li L" first="Luo-Cheng" last="Li">Luo-Cheng Li</name></author><author><name sortKey="Dai, Fei Feng" sort="Dai, Fei Feng" uniqKey="Dai F" first="Fei-Feng" last="Dai">Fei-Feng Dai</name></author><author><name sortKey="Liu, Huan" sort="Liu, Huan" uniqKey="Liu H" first="Huan" last="Liu">Huan Liu</name></author><author><name sortKey="Cai, Xin" sort="Cai, Xin" uniqKey="Cai X" first="Xin" last="Cai">Xin Cai</name></author></analytic><series><title level="j">The Journal of Heart and Lung Transplantation</title><idno type="ISSN">1053-2498</idno><idno type="eISSN">1557-3117</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>BACKGROUND</title><p>The epidemiological and clinical characteristics of heart transplant (HTx) recipients during the SARS-CoV-2 epidemic remains unclear. We studied the characteristics of HTx recipients during Dec 20, 2019 and Feb 25, 2020 in an effort to understand their risk and outcomes.</p></sec><sec><title>METHODS</title><p>All accessible HTx recipients were included in this single-center, retrospective study. We collected information on the recipients using a web-based questionnaire as well as the hospital database.</p></sec><sec><title>RESULTS</title><p>We followed 87 HTx recipients (72.4% were men and average age was 51 years). 79 recipients resided in Hubei, and 57 recipients had a Wuhan related history of travel or contact. The majority took precautionary measures while in contact with suspicious crowds. 96.6% of the families and communities undertook prevention and quarantine procedures. 4 upper airway infection were reported, and 3 of them tested negative for SARS-CoV-2 (the 4<sup>th</sup> recovered and was not tested). All cases were mild and successfully recovered after proper treatment. Laboratory results of 47 HTx cases within the last 2 months were extracted. 21.3% recipients had pre-existing lymphopenia and 87.2% of recipients had therapeutic tacrolimus concentration (5-12ng/ml). 5 and 6 recipients had liver and kidney insufficiency respectively.</p></sec><sec><title>CONCLUSION</title><p>HTx recipients that practiced appropriate prevention measures had a low rate of infection with SARS-CoV-2 and transition to COVID-19. These early data will require confirmation as the pandemic establishes around the world.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zhu, N" uniqKey="Zhu N">N Zhu</name></author><author><name sortKey="Zhang, D" uniqKey="Zhang D">D Zhang</name></author><author><name sortKey="Wang, W" uniqKey="Wang W">W Wang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Huang, C" uniqKey="Huang C">C Huang</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, N" uniqKey="Chen N">N Chen</name></author><author><name sortKey="Zhou, M" uniqKey="Zhou M">M Zhou</name></author><author><name sortKey="Dong, X" uniqKey="Dong X">X Dong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zhou, P" uniqKey="Zhou P">P Zhou</name></author><author><name sortKey="Yang, X" uniqKey="Yang X">X Yang</name></author><author><name sortKey="Wang, X" uniqKey="Wang X">X Wang</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Wang, D" uniqKey="Wang D">D Wang</name></author><author><name sortKey="Hu, B" uniqKey="Hu B">B Hu</name></author><author><name sortKey="Hu, C" uniqKey="Hu C">C Hu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shi, B" uniqKey="Shi B">B Shi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Huang, J" uniqKey="Huang J">J. Huang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peiris, Js" uniqKey="Peiris J">JS Peiris</name></author><author><name sortKey="Lai, St" uniqKey="Lai S">ST Lai</name></author><author><name sortKey="Poon, Ll" uniqKey="Poon L">LL Poon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yeung, Ml" uniqKey="Yeung M">ML Yeung</name></author><author><name sortKey="Yao, Y" uniqKey="Yao Y">Y Yao</name></author><author><name sortKey="Jia, L" uniqKey="Jia L">L Jia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hung, If" uniqKey="Hung I">IF Hung</name></author><author><name sortKey="Cheng, Vc" uniqKey="Cheng V">VC Cheng</name></author><author><name sortKey="Wu, Ak" uniqKey="Wu A">AK Wu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Assiri, A" uniqKey="Assiri A">A Assiri</name></author><author><name sortKey="Al Tawfiq, Ja" uniqKey="Al Tawfiq J">JA Al-Tawfiq</name></author><author><name sortKey="Al Rabeeah, Aa" uniqKey="Al Rabeeah A">AA Al-Rabeeah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rahman, A" uniqKey="Rahman A">A Rahman</name></author><author><name sortKey="Sarkar, A" uniqKey="Sarkar A">A. Sarkar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tu, Y" uniqKey="Tu Y">Y Tu</name></author><author><name sortKey="Wu, X" uniqKey="Wu X">X Wu</name></author><author><name sortKey="Liu, F" uniqKey="Liu F">F Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ju, C" uniqKey="Ju C">C Ju</name></author><author><name sortKey="Li, L" uniqKey="Li L">L Li</name></author><author><name sortKey="Qiu, T" uniqKey="Qiu T">T Qiu</name></author><author><name sortKey="Xue, W" uniqKey="Xue W">W Xue</name></author><author><name sortKey="Shi, B" uniqKey="Shi B">B Shi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gonzalez, Jm" uniqKey="Gonzalez J">JM Gonzalez</name></author><author><name sortKey="Gomez Puertas, P" uniqKey="Gomez Puertas P">P Gomez-Puertas</name></author><author><name sortKey="Cavanagh, D" uniqKey="Cavanagh D">D Cavanagh</name></author><author><name sortKey="Gorbalenya, Ae" uniqKey="Gorbalenya A">AE Gorbalenya</name></author><author><name sortKey="Enjuanes, L" uniqKey="Enjuanes L">L Enjuanes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Weiss, S R" uniqKey="Weiss S">S R Weiss</name></author><author><name sortKey="Navas Martin, S" uniqKey="Navas Martin S">S Navas-Martin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wevers, B A" uniqKey="Wevers B">B A Wevers</name></author><author><name sortKey="Hoek, L V D" uniqKey="Hoek L">L V D Hoek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kuba, K" uniqKey="Kuba K">K Kuba</name></author><author><name sortKey="Imai, Y" uniqKey="Imai Y">Y Imai</name></author><author><name sortKey="Rao, S" uniqKey="Rao S">S Rao</name></author><author><name sortKey="Gao, H" uniqKey="Gao H">H Gao</name></author><author><name sortKey="Guo, F" uniqKey="Guo F">F Guo</name></author><author><name sortKey="Guan, B" uniqKey="Guan B">B Guan</name></author><author><name sortKey="Huan, Y" uniqKey="Huan Y">Y Huan</name></author><author><name sortKey="Yang, P" uniqKey="Yang P">P Yang</name></author><author><name sortKey="Zhang, Y" uniqKey="Zhang Y">Y Zhang</name></author><author><name sortKey="Deng, W" uniqKey="Deng W">W Deng</name></author><author><name sortKey="Bao, L" uniqKey="Bao L">L Bao</name></author><author><name sortKey="Zhang, B" uniqKey="Zhang B">B Zhang</name></author><author><name sortKey="Liu, G" uniqKey="Liu G">G Liu</name></author><author><name sortKey="Wang, Z" uniqKey="Wang Z">Z Wang</name></author><author><name sortKey="Chappell, M" uniqKey="Chappell M">M Chappell</name></author><author><name sortKey="Liu, Y" uniqKey="Liu Y">Y Liu</name></author><author><name sortKey="Zheng, D" uniqKey="Zheng D">D Zheng</name></author><author><name sortKey="Leibbrandt, A" uniqKey="Leibbrandt A">A Leibbrandt</name></author><author><name sortKey="Wada, T" uniqKey="Wada T">T Wada</name></author><author><name sortKey="Slutsky, As" uniqKey="Slutsky A">AS Slutsky</name></author><author><name sortKey="Liu, D" uniqKey="Liu D">D Liu</name></author><author><name sortKey="Qin, C" uniqKey="Qin C">C Qin</name></author><author><name sortKey="Jiang, C" uniqKey="Jiang C">C Jiang</name></author><author><name sortKey="Penninger, Jm" uniqKey="Penninger J">JM Penninger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Li, W" uniqKey="Li W">W Li</name></author><author><name sortKey="Moore, Mj" uniqKey="Moore M">MJ Moore</name></author><author><name sortKey="Vasilieva, N" uniqKey="Vasilieva N">N Vasilieva</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Xu, X" uniqKey="Xu X">X Xu</name></author><author><name sortKey="Chen, P" uniqKey="Chen P">P Chen</name></author><author><name sortKey="Wang, J" uniqKey="Wang J">J Wang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hao, X" uniqKey="Hao X">X Hao</name></author><author><name sortKey="Liang, Z" uniqKey="Liang Z">Z Liang</name></author><author><name sortKey="Jiaxin, D" uniqKey="Jiaxin D">D Jiaxin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kurdi, M" uniqKey="Kurdi M">M Kurdi</name></author><author><name sortKey="De Mello, W C" uniqKey="De Mello W">W C De Mello</name></author><author><name sortKey="Booz, G W" uniqKey="Booz G">G W Booz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gallagher, Pe" uniqKey="Gallagher P">PE Gallagher</name></author><author><name sortKey="Chappell, Mc" uniqKey="Chappell M">MC Chappell</name></author><author><name sortKey="Ferrario, Cm" uniqKey="Ferrario C">CM Ferrario</name></author><author><name sortKey="Tallant, Ea" uniqKey="Tallant E">EA Tallant</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Letizia, C" uniqKey="Letizia C">C Letizia</name></author><author><name sortKey="D Ambrosio, C" uniqKey="D Ambrosio C">C D'Ambrosio</name></author><author><name sortKey="De Ciocchis, A" uniqKey="De Ciocchis A">A De Ciocchis</name></author><author><name sortKey="Scavo, D" uniqKey="Scavo D">D Scavo</name></author><author><name sortKey="Pozzilli, P" uniqKey="Pozzilli P">P Pozzilli</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hoskova, L" uniqKey="Hoskova L">L Hoskova</name></author><author><name sortKey="Malek, I" uniqKey="Malek I">I Malek</name></author><author><name sortKey="Kautzner, J" uniqKey="Kautzner J">J Kautzner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kupferman, Jc" uniqKey="Kupferman J">JC Kupferman</name></author><author><name sortKey="Beaudoin, R" uniqKey="Beaudoin R">R Beaudoin</name></author><author><name sortKey="Carr, R" uniqKey="Carr R">R Carr</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Julien, J" uniqKey="Julien J">J Julien</name></author><author><name sortKey="Farge, D" uniqKey="Farge D">D Farge</name></author><author><name sortKey="Kreft Jais, C" uniqKey="Kreft Jais C">C Kreft-Jais</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schreiber, S L" uniqKey="Schreiber S">S L Schreiber</name></author><author><name sortKey="Crabtree, G R" uniqKey="Crabtree G">G R Crabtree</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ferrario, Cm" uniqKey="Ferrario C">CM Ferrario</name></author><author><name sortKey="Jessup, J" uniqKey="Jessup J">J Jessup</name></author><author><name sortKey="Chappell, Mc" uniqKey="Chappell M">MC Chappell</name></author><author><name sortKey="Averill, Db" uniqKey="Averill D">DB Averill</name></author><author><name sortKey="Brosnihan, Kb" uniqKey="Brosnihan K">KB Brosnihan</name></author><author><name sortKey="Tallant, Ea" uniqKey="Tallant E">EA Tallant</name></author><author><name sortKey="Diz, Di" uniqKey="Diz D">DI Diz</name></author><author><name sortKey="Gallagher, Pe" uniqKey="Gallagher P">PE Gallagher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zumla, A" uniqKey="Zumla A">A Zumla</name></author><author><name sortKey="Hui, Ds" uniqKey="Hui D">DS Hui</name></author><author><name sortKey="Azhar, Ei" uniqKey="Azhar E">EI Azhar</name></author><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author><author><name sortKey="Maeurer, M" uniqKey="Maeurer M">M Maeurer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Xu, Z" uniqKey="Xu Z">Z Xu</name></author><author><name sortKey="Shi, L" uniqKey="Shi L">L Shi</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nicholls, Jm" uniqKey="Nicholls J">JM Nicholls</name></author><author><name sortKey="Poon, Ll" uniqKey="Poon L">LL Poon</name></author><author><name sortKey="Lee, Kc" uniqKey="Lee K">KC Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fu, R" uniqKey="Fu R">R Fu</name></author><author><name sortKey="Tajima, S" uniqKey="Tajima S">S Tajima</name></author><author><name sortKey="Suetsugu, K" uniqKey="Suetsugu K">K Suetsugu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, J" uniqKey="Liu J">J Liu</name></author><author><name sortKey="Farmer, Jj" uniqKey="Farmer J">JJ Farmer</name></author><author><name sortKey="Lane, Ws" uniqKey="Lane W">WS Lane</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, J" uniqKey="Liu J">J Liu</name></author><author><name sortKey="Albers, Mw" uniqKey="Albers M">MW Albers</name></author><author><name sortKey="Wandless, Tj" uniqKey="Wandless T">TJ Wandless</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eugui, Em" uniqKey="Eugui E">EM Eugui</name></author><author><name sortKey="Almquist, Sj" uniqKey="Almquist S">SJ Almquist</name></author><author><name sortKey="Muller, Cd" uniqKey="Muller C">CD Muller</name></author><author><name sortKey="Allison, Ac" uniqKey="Allison A">AC Allison</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blaheta, Ra" uniqKey="Blaheta R">RA Blaheta</name></author><author><name sortKey="Leckel, K" uniqKey="Leckel K">K Leckel</name></author><author><name sortKey="Wittig, B" uniqKey="Wittig B">B Wittig</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Takahira, R" uniqKey="Takahira R">R Takahira</name></author><author><name sortKey="Yonemura, K" uniqKey="Yonemura K">K Yonemura</name></author><author><name sortKey="Fujise, Y" uniqKey="Fujise Y">Y Fujise</name></author><author><name sortKey="Hishida, A" uniqKey="Hishida A">A Hishida</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abe, M" uniqKey="Abe M">M Abe</name></author><author><name sortKey="Thomson, A W" uniqKey="Thomson A">A W Thomson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ehrchen, J" uniqKey="Ehrchen J">J Ehrchen</name></author><author><name sortKey="Steinmuller, L" uniqKey="Steinmuller L">L Steinmuller</name></author><author><name sortKey="Barczyk, K" uniqKey="Barczyk K">K Barczyk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suda, T" uniqKey="Suda T">T Suda</name></author><author><name sortKey="Chida, K" uniqKey="Chida K">K Chida</name></author><author><name sortKey="Matsuda, H" uniqKey="Matsuda H">H Matsuda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cupic, B" uniqKey="Cupic B">B Cupic</name></author><author><name sortKey="Breljak, D" uniqKey="Breljak D">D Breljak</name></author><author><name sortKey="Gabrilovac, J" uniqKey="Gabrilovac J">J Gabrilovac</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Youinou, P" uniqKey="Youinou P">P Youinou</name></author><author><name sortKey="Pers, J O" uniqKey="Pers J">J O Pers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harr, Mw" uniqKey="Harr M">MW Harr</name></author><author><name sortKey="Rong, Y" uniqKey="Rong Y">Y Rong</name></author><author><name sortKey="Bootman, Md" uniqKey="Bootman M">MD Bootman</name></author><author><name sortKey="Roderick, Hl" uniqKey="Roderick H">HL Roderick</name></author><author><name sortKey="Distelhorst, Cw" uniqKey="Distelhorst C">CW Distelhorst</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Heart Lung Transplant</journal-id><journal-id journal-id-type="iso-abbrev">J. Heart Lung Transplant</journal-id><journal-title-group><journal-title>The Journal of Heart and Lung Transplantation</journal-title></journal-title-group><issn pub-type="ppub">1053-2498</issn><issn pub-type="epub">1557-3117</issn><publisher><publisher-name>Elsevier</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32115364</article-id><article-id pub-id-type="pmc">7102567</article-id><article-id pub-id-type="publisher-id">S1053-2498(20)31469-8</article-id><article-id pub-id-type="doi">10.1016/j.healun.2020.03.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT</article-title></title-group><contrib-group><contrib contrib-type="author" id="au0001"><name><surname>Ren</surname><given-names>Zong-Li</given-names></name><xref rid="fn1" ref-type="fn">1</xref></contrib><contrib contrib-type="author" id="au0002"><name><surname>Hu</surname><given-names>Rui</given-names></name><xref rid="fn1" ref-type="fn">1</xref></contrib><contrib contrib-type="author" id="au0003"><name><surname>Wang</surname><given-names>Zhi-Wei</given-names></name><email>wangzhiwei@whu.edu.cn</email><xref rid="cor0001" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="au0004"><name><surname>Zhang</surname><given-names>Min</given-names></name><email>zhangmwhurm@whu.edu.cn</email><xref rid="cor0001" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="au0005"><name><surname>Ruan</surname><given-names>Yong-Le</given-names></name></contrib><contrib contrib-type="author" id="au0006"><name><surname>Wu</surname><given-names>Zhi-Yong</given-names></name></contrib><contrib contrib-type="author" id="au0007"><name><surname>Wu</surname><given-names>Hong-Bing</given-names></name></contrib><contrib contrib-type="author" id="au0008"><name><surname>Hu</surname><given-names>Xiao-Ping</given-names></name></contrib><contrib contrib-type="author" id="au0009"><name><surname>Hu</surname><given-names>Zhi-Peng</given-names></name></contrib><contrib contrib-type="author" id="au0010"><name><surname>Ren</surname><given-names>Wei</given-names></name></contrib><contrib contrib-type="author" id="au0011"><name><surname>Li</surname><given-names>Luo-Cheng</given-names></name></contrib><contrib contrib-type="author" id="au0012"><name><surname>Dai</surname><given-names>Fei-Feng</given-names></name></contrib><contrib contrib-type="author" id="au0013"><name><surname>Liu</surname><given-names>Huan</given-names></name></contrib><contrib contrib-type="author" id="au0014"><name><surname>Cai</surname><given-names>Xin</given-names></name></contrib></contrib-group><aff id="aff0001"><label>a</label>Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuhan, 430060, Hubei, China.</aff><author-notes><corresp id="cor0001"><label>⁎</label>Zhi-Wei Wang and Min Zhang are joint corresponding authors; Correspondence to: Zhi-Wei Wang, Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuhan, 430060, Hubei, China. Tel: +86-13995628899 <email>wangzhiwei@whu.edu.cn</email><email>zhangmwhurm@whu.edu.cn</email></corresp><fn id="fn1"><label>1</label><p id="notep0001">Zong-Li Ren and Rui Hu contributed equally to this work;</p></fn></author-notes><pub-date pub-type="pmc-release"><day>25</day><month>3</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>25</day><month>3</month><year>2020</year></pub-date><elocation-id></elocation-id><permissions><copyright-statement>© Published by Elsevier Inc. on behalf of International Society for Heart and Lung Transplantation.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="abs0001"><sec><title>BACKGROUND</title><p>The epidemiological and clinical characteristics of heart transplant (HTx) recipients during the SARS-CoV-2 epidemic remains unclear. We studied the characteristics of HTx recipients during Dec 20, 2019 and Feb 25, 2020 in an effort to understand their risk and outcomes.</p></sec><sec><title>METHODS</title><p>All accessible HTx recipients were included in this single-center, retrospective study. We collected information on the recipients using a web-based questionnaire as well as the hospital database.</p></sec><sec><title>RESULTS</title><p>We followed 87 HTx recipients (72.4% were men and average age was 51 years). 79 recipients resided in Hubei, and 57 recipients had a Wuhan related history of travel or contact. The majority took precautionary measures while in contact with suspicious crowds. 96.6% of the families and communities undertook prevention and quarantine procedures. 4 upper airway infection were reported, and 3 of them tested negative for SARS-CoV-2 (the 4<sup>th</sup> recovered and was not tested). All cases were mild and successfully recovered after proper treatment. Laboratory results of 47 HTx cases within the last 2 months were extracted. 21.3% recipients had pre-existing lymphopenia and 87.2% of recipients had therapeutic tacrolimus concentration (5-12ng/ml). 5 and 6 recipients had liver and kidney insufficiency respectively.</p></sec><sec><title>CONCLUSION</title><p>HTx recipients that practiced appropriate prevention measures had a low rate of infection with SARS-CoV-2 and transition to COVID-19. These early data will require confirmation as the pandemic establishes around the world.</p></sec></abstract><kwd-group id="keys0001"><title>KEY WORDS</title><kwd>heart transplantation</kwd><kwd>COVID-19</kwd><kwd>SARS-CoV-2</kwd><kwd>angiotensin converting enzyme 2</kwd><kwd>immunosuppressive therapy</kwd></kwd-group></article-meta></front><body><sec id="sec0001"><title>INTRODUCTION</title><p id="para0007">Since December, 2019, a kind of novel coronavirus infection later named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by International Committee on Taxonomy of Viruses (ICTV) broke out in Wuhan, Hubei, PRC.<xref rid="bib0001" ref-type="bibr">1</xref>, <xref rid="bib0002" ref-type="bibr">2</xref>, <xref rid="bib0003" ref-type="bibr">3</xref> The virus targets airway epithelium using angiotensin converting enzyme 2 (ACE2) as a receptor and causes a novel coronavirus related pneumonia (NCP). Some severe cases develop into acute respiratory distress syndrome (ARDS), which can be fatal.<xref rid="bib0004" ref-type="bibr"><sup>4</sup></xref> The infection spread throughout China and all over the world within 2 months. As of Feb 25<sup>th</sup>, 2020, report from world health organization (WHO) indicated a total of 81,109 lab confirmed cases, from 38 countries and regions. Of them China had more than 78000 cases, and deaths had exceeded 2700.<xref rid="bib0005" ref-type="bibr"><sup>5</sup></xref></p><p id="para0008">Current epidemic evidence suggested the SARS-CoV-2 was highly contagious and humans were generally susceptible.<xref rid="bib0006" ref-type="bibr"><sup>6</sup></xref> While most of the cases were mild or moderate and recovered after proper treatment, patients with underlying morbidities carried a substantial higher mortality than those without, especially those with cardiovascular disease. Also, severe cases can develop complications other than respiratory syndromes, and reports suggest 7-12% of the patients experience acute cardiac damage.<xref rid="bib0002" ref-type="bibr"><sup>2</sup></xref><sup>,</sup><xref rid="bib0007" ref-type="bibr"><sup>7</sup></xref></p><p id="para0009">Solid organ transplantation (SOT) recipients including heart transplant (HTx) recipients have a higher infection risk compared to the normal population due to immunosuppression by anti-rejection therapy.<xref rid="bib0008" ref-type="bibr"><sup>8</sup></xref><sup>.</sup><xref rid="bib0009" ref-type="bibr"><sup>9</sup></xref> However, epidemiological and clinical characteristics of HTx recipients during the SARS-CoV-2 epidemics is largely unknown so far. We designed a comprehensive questionnaire to collect exposure history, clinical manifestations and treatments of HTx recipients in our hospital.</p></sec><sec id="sec0002"><title>METHODS</title><p id="para0010">All patients receiving an allograft heart transplantation and discharged between July, 2015 to Jan, 2020 in our hospital were included in this retrospective, single-center study and numbered as No.1 to No.87 by date of transplantation. We obtained personal information, transplantation related history, epidemiological history, clinical manifestations and treatments through a web-based comprehensive questionnaire designed by clinical physicians and public health experts. The missing or unclear data collected from the questionnaire were reconciled by direct communication with the patients or their close relatives. Latest laboratory data of the recipients within the last 2 months were extracted from the hospital database. All data were finally checked and confirmed by two independent investigators. This study was approved by Renmin Hospital of Wuhan University Ethics Committee. Our study complies with the International Society for Heart and Lung Transplantation (ISHLT) ethics statement.</p><p id="para0011">Continuous variables were expressed as mean (SD) if they were normally distributed or median (IQR) if they were not. Categorical variables were expressed as count and frequency. All statistical analyses were performed using the SPSS software, version 26.0.</p></sec><sec id="sec0003"><title>RESULTS</title><p id="para0012"><bold>Demographic data:</bold> A total of 87 recipients were included in the study and carefully followed-up (<xref rid="tbl0001" ref-type="table">Table 1</xref>). There are 63 men and 24 women, average age is 51±12 years, 80 (92.0%) of them lived together with relatives, the number of relatives ranged from 1 to 8. 83 (95.4%) recipients followed the predefined anti-rejection therapy, and there was no rejection episode in the recent 2 months, while 2 cases was admitted to hospital due to bacterial infection and subsequently discharged after proper antibiotic treatment. The accompanying comorbidities in this group include: hypertension 28 cases (32.2%), hyperlipidemia 15 cases (17.2%), diabetes 20 cases (23.0%), new onset coronary heart disease 1 case (1.1%), chronic obstructive pulmonary disease 1 case (1.1%), cerebral vascular disease 6 cases (6.9%), chronic renal dysfunction 8 cases (12.6%), gout 6 cases (6.9%), hypothyroidism 1 case (1.1%), all the recipients with comorbidities were prescribed with corresponding drugs by specifically trained physicians.<table-wrap position="float" id="tbl0001"><label>Table 1</label><caption><p>Demographic description of the heart transplant recipients</p></caption><alt-text id="alt0001">Table 1</alt-text><table frame="hsides" rules="groups"><thead><tr><th valign="top"></th><th valign="top">Recipients (N=87)</th></tr></thead><tbody><tr><td valign="top">Age, years</td><td valign="top"></td></tr><tr><td valign="top"> Mean±SD</td><td valign="top">51±12</td></tr><tr><td valign="top"> Range</td><td valign="top">14-73</td></tr><tr><td valign="top">Sex</td><td valign="top"></td></tr><tr><td valign="top"> Male</td><td valign="top">63 (72.4%)</td></tr><tr><td valign="top"> Female</td><td valign="top">24 (27.6%)</td></tr><tr><td valign="top">Living together with relatives</td><td valign="top">80 (92.0%)</td></tr><tr><td valign="top">Anti-rejection therapy compliance</td><td valign="top">83 (95.4%)</td></tr><tr><td valign="top">Comorbidity</td><td valign="top"></td></tr><tr><td valign="top"> Hypertension</td><td valign="top">28 (32.2%)</td></tr><tr><td valign="top"> Hyperlipidemia</td><td valign="top">15 (17.2%)</td></tr><tr><td valign="top"> Diabetes</td><td valign="top">20 (23.0%)</td></tr><tr><td valign="top"> New onset CHD</td><td valign="top">1 (1.1%)</td></tr><tr><td valign="top"> COPD</td><td valign="top">1 (1.1%)</td></tr><tr><td valign="top"> Cerebrovascular disease</td><td valign="top">6 (6.9%)</td></tr><tr><td valign="top"> Renal dysfunction</td><td valign="top">11 (12.6%)</td></tr><tr><td valign="top"> Gout</td><td valign="top">6 (6.9%)</td></tr><tr><td valign="top"> Hypothyroidism</td><td valign="top">1 (1.1%)</td></tr></tbody></table><table-wrap-foot><fn><p>Data are mean±SD and n (%). CHD=coronary heart disease, COPD=chronic obstructive pulmonary disease.</p></fn></table-wrap-foot></table-wrap></p><p id="para0013"><bold>Epidemiological and exposure history</bold>: 79 recipients lived in Hubei province, while 57 recipients had a Wuhan contact related history. The whole group reported no obvious contact with confirmed or suspected Coronavirus Disease 2019 (COVID-19) patients. 11(68.8%) of 16 recipients who were in contact with asymptomatic individuals who travelled to or came back from Wuhan, had protective procedures initiated. After Jan 23 2020, 84 (96.6%) of 87 recipients undertook precautionary procedure in their community. 56 (64.4%) of 87 recipients self-quarantined at home by more than 1 week. The other major exposure history is presented in <xref rid="tbl0002" ref-type="table">Table 2</xref>.<table-wrap position="float" id="tbl0002"><label>Table 2</label><caption><p>Exposure history of the recipients</p></caption><alt-text id="alt0002">Table 2</alt-text><table frame="hsides" rules="groups"><thead><tr><th valign="top"></th><th valign="top">Recipients (N=87)</th></tr></thead><tbody><tr><td valign="top">Have been to Wuhan</td><td valign="top">57 (65.5%)</td></tr><tr><td valign="top">Contact with 2019-nCoV patients</td><td valign="top">0 (0.0%)</td></tr><tr><td valign="top">Contact with asymptomatic individual with epidemic history</td><td valign="top">16 (18.4%)</td></tr><tr><td valign="top"> Precautionary procedure</td><td valign="top">11/16 (68.8%)</td></tr><tr><td valign="top">Take public transport</td><td valign="top">25 (28.7%)</td></tr><tr><td valign="top"> Precautionary procedure</td><td valign="top">24/25 (96.0%)</td></tr><tr><td valign="top">Have been to crowded place</td><td valign="top">19 (21.8%)</td></tr><tr><td valign="top"> Precautionary procedure</td><td valign="top">18/19 (94.7%)</td></tr><tr><td valign="top">Attend group events</td><td valign="top">5 (5.7%)</td></tr><tr><td valign="top"> Precautionary procedure</td><td valign="top">3/5 (60.0%)</td></tr><tr><td valign="top">Animal or poultry touch</td><td valign="top">16 (18.4%)</td></tr><tr><td valign="top"> Animal death</td><td valign="top">0/16 (0.0%)</td></tr><tr><td valign="top">Precautionary procedure in the family</td><td valign="top">84 (96.6%)</td></tr><tr><td valign="top"> Mask</td><td valign="top">71/84 (84.5%)</td></tr><tr><td valign="top"> Hand wash</td><td valign="top">75/84 (89.3%)</td></tr><tr><td valign="top"> Sanitization</td><td valign="top">52/84 (61.9%)</td></tr><tr><td valign="top">Precautionary procedure in the community</td><td valign="top">84 (96.6%)</td></tr><tr><td valign="top"> Daily body temperature and symptoms monitoring</td><td valign="top">63/84 (75.0%)</td></tr><tr><td valign="top"> Unified living supplies purchasing and distribution</td><td valign="top">59/84 (70.2%)</td></tr><tr><td valign="top"> Community shutting down and no passing</td><td valign="top">72/84 (85.7%)</td></tr><tr><td valign="top">Self-quarantine at home</td><td valign="top">56 (64.4%)</td></tr><tr><td valign="top"> 22-28 days</td><td valign="top">52/56 (92.9%)</td></tr><tr><td valign="top"> 15-21 days</td><td valign="top">3/56 (5.4%)</td></tr><tr><td valign="top"> 8-14 days</td><td valign="top">1/56 (1.8%)</td></tr></tbody></table><table-wrap-foot><fn><p>Data are n (%) and n/N (%).</p></fn></table-wrap-foot></table-wrap></p><p id="para0014"><bold>Laboratory results:</bold> Lab results of 47 recipients within the last 2 months were identified and extracted from the database, including blood routine, tacrolimus concentration, liver and kidney function examination (<xref rid="tbl0003" ref-type="table">Table 3</xref>). The average white blood cell (WBC) count was 7.2±2.2 × 10<sup>9</sup>/L, 6 (6/47, 12.8%) recipients had an abnormal WBC count including 5 which were elevated. The average neutrophil percentage was 60.4±12.1%, 5 recipients were abnormal. The average lymphocyte percentage was 27.7±9.9%, while 10 (10/47, 21.3%) recipients had lymphopenia and 31 (31/47, 66.0%) recipients had a lym% lower than 30%. The average tacrolimus concentration was 7.6±2.4ng/mL, which was therapeutic. Examination of liver and renal function was evaluated by ALT, AST, Urea and Creatinine assessments and the average results were grossly normal, while recipients 5 and 6 recipients had liver or kidney insufficiency respectively.<table-wrap position="float" id="tbl0003"><label>Table 3</label><caption><p>Laboratory results of the recipients</p></caption><alt-text id="alt0003">Table 3</alt-text><table frame="hsides" rules="groups"><thead><tr><th valign="top"></th><th valign="top">Recipients (N=47)</th></tr></thead><tbody><tr><td valign="top">Blood Routine</td><td valign="top"></td></tr><tr><td valign="top"> WBC count (× 10<sup>9</sup>/L)</td><td valign="top">7.2±2.2</td></tr><tr><td valign="top"> Abnormal WBC count</td><td valign="top">6 (12.8%)</td></tr><tr><td valign="top"> Neu%</td><td valign="top">60.4±12.1</td></tr><tr><td valign="top"> Abnormal Neu%</td><td valign="top">5 (10.6%)</td></tr><tr><td valign="top"> Lym%</td><td valign="top">27.7±9.9</td></tr><tr><td valign="top"> <20%</td><td valign="top">10 (21.3%)</td></tr><tr><td valign="top"> 20-30%</td><td valign="top">21 (44.7%)</td></tr><tr><td valign="top"> 30-40%</td><td valign="top">10 (21.3%)</td></tr><tr><td valign="top"> 40-50%</td><td valign="top">5 (10.6%)</td></tr><tr><td valign="top"> >50%</td><td valign="top">1 (2.1%)</td></tr><tr><td valign="top">FK506(ng/mL)</td><td valign="top">7.6±2.4</td></tr><tr><td valign="top"> <5.0</td><td valign="top">4 (8.5%)</td></tr><tr><td valign="top"> 5.0-7.9</td><td valign="top">25 (53.2%)</td></tr><tr><td valign="top"> 8.0-11.9</td><td valign="top">16 (34.0%)</td></tr><tr><td valign="top"> ≥12.0</td><td valign="top">2 (4.3%)</td></tr><tr><td valign="top">Biochemistry</td><td valign="top"></td></tr><tr><td valign="top"> ALT(U/L)</td><td valign="top">22.6±17.8</td></tr><tr><td valign="top"> AST(U/L)</td><td valign="top">25.5±18.7</td></tr><tr><td valign="top"> Abnormal ALT or AST</td><td valign="top">5 (10.6%)</td></tr><tr><td valign="top"> Urea(mmol/L)</td><td valign="top">8.6±3.0</td></tr><tr><td valign="top"> Cr(umol/L)</td><td valign="top">92.9±38.4</td></tr><tr><td valign="top"> Abnormal Urea or Cr</td><td valign="top">6 (12.8%)</td></tr></tbody></table><table-wrap-foot><fn><p>Data are mean±SD and n (%). WBC=white blood cell, Neu%= neutrophilic granulocyte percentage, Lym%= Lymphocyte percentage, ALT= alanine aminotransferase, AST= aspartate aminotransferase</p></fn></table-wrap-foot></table-wrap></p><p id="para0015"><bold>Clinical characteristics of recipients with airway infection</bold>: There were 4 upper airway infections reported during this time period (<xref rid="tbl0004" ref-type="table">Table 4</xref>). 3 of them have been tested for SARS-CoV-2 infection and were negative. The other recipient with upper airway infection recovered after 6 days and was not tested for SARS-CoV-2, because the specific test kit has not yet launched during the early stage of SARS-CoV-2 epidemic. All of them were tested for Flu A and B, and 1 upper airway infection recipient was confirmed with Flu A infection. All of the 4 recipients successfully recovered after proper therapies.<table-wrap position="float" id="tbl0004"><label>Table 4</label><caption><p>Clinical characteristics of the recipients with airway infection</p></caption><alt-text id="alt0004">Table 4</alt-text><table frame="hsides" rules="groups"><thead><tr><th valign="top">Patient No.</th><th align="center" valign="top">Date of onset</th><th align="center" valign="top">Symptom</th><th valign="top">Blood routine</th><th align="center" valign="top">Test for airway pathogen</th><th align="center" valign="top">Chest CT report</th><th align="center" valign="top">Diagnosis</th><th align="center" valign="top">Treatment</th><th align="center" valign="top">Outcome</th></tr></thead><tbody><tr><td valign="top">No.17</td><td valign="top">Dec.31,2019</td><td valign="top">Nasal obstruction</td><td valign="top">WBC 11.34 × 10<sup>9</sup><break></break>Neu% 71.6%<break></break>Lym% 18.7%</td><td valign="top">SARS-Cov-2(N/A), FluA(-),FluB(-)</td><td valign="top">Negative</td><td valign="top">Upper airway infection</td><td valign="top">Antibiotics</td><td valign="top">Recovered</td></tr><tr><td valign="top">No.44</td><td valign="top">Jan.28,2020</td><td valign="top">Fever, nasal obstruction</td><td valign="top">WBC 6.36 × 10<sup>9</sup><break></break>Neu% 76.4%<break></break>Lym% 13.9%</td><td valign="top">SARS-Cov-2(-), FluA(+),FluB(-)</td><td valign="top">Negative</td><td valign="top">Upper airway infection; Influenza A</td><td valign="top">Antibiotics, Anti-viral drugs</td><td valign="top">Recovered</td></tr><tr><td valign="top">No.58</td><td valign="top">Feb.2,2020</td><td valign="top">Dry cough</td><td valign="top">WBC 5.3 × 10<sup>9</sup><break></break>Neu% 89.5%<break></break>Lym% 5.7%</td><td valign="top">SARS-Cov-2(-), FluA(-),FluB(-), HPIV(-),RSV(-), Adv(-), Mpn(-), Cpn(-)</td><td valign="top">Viral pneumonia</td><td valign="top">Lower airway infection, viral pneumonia</td><td valign="top">Antibiotics, Anti-viral drugs</td><td valign="top">Recovered</td></tr><tr><td valign="top">No.70</td><td valign="top">Jan.19,2020</td><td valign="top">Fever</td><td valign="top">WBC 4.3 × 10<sup>9</sup><break></break>Neu% 74.7%<break></break>Lym% 12.3%</td><td valign="top">SARS-Cov-2(-), FluA(-),FluB(-), HPIV(-),RSV(-), Adv(-), Mpn(-), Cpn(-)</td><td valign="top">Pulmonary infection</td><td valign="top">Lower airway infection, pulmonary infection</td><td valign="top">Antibiotics</td><td valign="top">Recovered</td></tr></tbody></table><table-wrap-foot><fn><p>WBC=white blood cell, Neu%= neutrophilic granulocyte percentage, Lym%= Lymphocyte percentage, HPIV=parainfluenza virus, RSV=respiratory syncytial virus, Adv=adenovirus, Mpn=mycoplasma pneumo, Cpn=chlamydia pneumoniae, CT=computed tomography, (-)=negative, (+)=positive, N/A=not applied</p></fn></table-wrap-foot></table-wrap></p></sec><sec id="sec0004"><title>DISCUSSION</title><p id="para0016">This is the largest comprehensive report of HTx recipients during the SARS-CoV-2 epidemic and our findings indicated that this immunocompromised population received similar exposure, including contacting with individuals with travel from Wuhan, taking public transport, going to crowded places, however they exhibited less infection than expected.</p><p id="para0017">The origins of this virus have been traced back to the seafood wholesale market in Wuhan, China.<xref rid="bib0004" ref-type="bibr"><sup>4</sup></xref> In our epidemiologic investigation, 16 recipients experienced contact with animals or poultry, but there was no reported animal death. No recipients have ever been to the seafood wholesale market in Wuhan or were in contact with any potential supply chains of wild or game meat.</p><p id="para0018">SARS-CoV-2 mainly spreads through the respiratory tract, and survival time of SARS-CoV-2 in air may be somewhat limited. Any protective measures that block the transmission pathway can reduce the risk of infection. According to our investigation of epidemiologic history, it would be reasonable to infer that although HTx recipients have the similar epidemiologic history as normal population, they may have a better protection awareness and use of precautions as a usual practice, during SARS-CoV-2 epidemic.</p><p id="para0019">Studies have shown that people are generally susceptible to coronavirus. Coronaviruses (CoVs), such as SARS-CoV and MERS-CoV, also caused severe lower respiratory tract infection with acute respiratory distress syndrome (ARDS), extrapulmonary manifestations and multiorgan dysfunction syndrome (MODS), among both immunocompetent and immunocompromised hosts with mortality rates of 10% and 35%, respectively.<xref rid="bib0010" ref-type="bibr"><sup>10</sup></xref><sup>,</sup><xref rid="bib0011" ref-type="bibr"><sup>11</sup></xref> Early patient reports from SARS-CoV-2 find similar trends. Severe manifestations even death with SARS-CoV-2 has been associated in elderly patients with comorbidities, including hypertension, diabetes, heart and/or kidney disease.<xref rid="bib0003" ref-type="bibr"><sup>3</sup></xref> This finding is similar to increased severity and death in elderly patients following both SARS and MERS-CoV infection.<xref rid="bib0012" ref-type="bibr"><sup>12</sup></xref><sup>,</sup><xref rid="bib0013" ref-type="bibr"><sup>13</sup></xref> For the MERS-CoV outbreak, smoking, hypertension, diabetes, cardiovascular disease, and/or other chronic illnesses were present in the majority of deaths and correspond to findings in animal models.<xref rid="bib0014" ref-type="bibr"><sup>14</sup></xref> The accompanying comorbidities in this group of HTx recipients include: hypertension 28 cases (34.2%), hyperlipidemia 15 cases (17.2%), diabetes 20 cases (23.0%), new onset coronary heart disease 1 case (1.1%), chronic obstructive pulmonary disease 1 case (1.1%), cerebrovascular disease 6 cases (6.9%), chronic renal dysfunction 11 cases (12.6%), hyperuricemia 6 cases (6.9%), hypothyroidism 1 case (1.1%), and the average age is 50.5±11.7. Thus, it would indicate vigilance is necessary for these immunocompromised recipients following SARS-CoV-2 infection.</p><p id="para0020">Our results are unexpected since only 4 recipients got airway infection and 3 of them had a negative SARS-CoV-2 result. This is similar with the information from the Organ Transplant Center in our hospital, where only 2 cases were reported with SARS-CoV-2 infection in renal transplantation.<xref rid="bib0015" ref-type="bibr"><sup>15</sup></xref> Data from Ju Chunrong suggest that the number of SOT recipients in China suffering from SARS-CoV-2 infection are few, including only 9 confirmed cases altogether.<xref rid="bib0016" ref-type="bibr"><sup>16</sup></xref> With limited data, it is difficult to determine the populations that may be most susceptible to SARS-CoV-2. More data are needed to determine the susceptibility of the immunocompromised population.</p><p id="para0021">Coronavirus (CoVs) are positive-strand RNA viruses, which primarily target mucosal surfaces of respiratory and intestinal tracts to establish an infection.<xref rid="bib0017" ref-type="bibr"><sup>17</sup></xref><sup>,</sup><xref rid="bib0018" ref-type="bibr"><sup>18</sup></xref> Epithelial cell surface components are exploited as primary receptors to mediate viral entry and the establishment of a viral infection.<xref rid="bib0019" ref-type="bibr"><sup>19</sup></xref> One integral protease of the renin-angiotensin system (RAS), angiotensin converting enzyme 2 (ACE2), which is a major physiologic regulator of the cardiovascular system, facilitates cellular entry of human CoVs.<xref rid="bib0020" ref-type="bibr"><sup>20</sup></xref><sup>,</sup><xref rid="bib0021" ref-type="bibr"><sup>21</sup></xref> Most recently, the ACE2 had been identified as a receptor for SARS-CoV-2.<xref rid="bib0022" ref-type="bibr"><sup>22</sup></xref><sup>,</sup><xref rid="bib0023" ref-type="bibr"><sup>23</sup></xref> ACE2 is thought to be a key regulator in maintenance of RAS homeostasis.<xref rid="bib0024" ref-type="bibr"><sup>24</sup></xref><sup>,</sup><xref rid="bib0025" ref-type="bibr"><sup>25</sup></xref> Several studies illustrate the possible mechanism of immunosuppressants in activating RAS.<xref rid="bib0026" ref-type="bibr">26</xref>, <xref rid="bib0027" ref-type="bibr">27</xref>, <xref rid="bib0028" ref-type="bibr">28</xref>, <xref rid="bib0029" ref-type="bibr">29</xref>, <xref rid="bib0030" ref-type="bibr">30</xref> Ferrario et al. demonstrated that the treatment of cultured astrocytes with Ang-II caused a marked reduction in neural ACE2 mRNA and protein, mediated with either losartan or both losartan and lisinopril by the AT1 receptor.<xref rid="bib0031" ref-type="bibr"><sup>31</sup></xref> It is unclear what, if any, difference in the expression of pulmonary ACE2 exists in the presence of immunosuppression and Investigating the difference of ACE2 between the recipients and normal population would provide further evidence.</p><p id="para0022">Similar to SARS-CoV and MERS-CoV infection, patients with SARS-CoV-2 infections exhibit symptoms of viral pneumonia including fever, cough or dyspnea, and bilateral lung infiltration in severe cases. All these three CoVs induce excessive and aberrant non-effective host immune responses that are associated with severe lung pathology, leading to death.<xref rid="bib0032" ref-type="bibr"><sup>32</sup></xref> The autopsy results of dead patients indicate diffuse alveolar damage (DAD) with alveolar edema, focal hemorrhage and hyaline membrane formation,<xref rid="bib0033" ref-type="bibr"><sup>33</sup></xref> which are similar to the pathological manifestations of acute respiratory distress syndrome (ARDS).<xref rid="bib0034" ref-type="bibr"><sup>34</sup></xref> However, most SARS-CoV-2 were mild or moderate cases, meanwhile cases report showed that the clinical manifestations and progression of SARS-CoV-2 infection in renal transplant recipients were generally consistent with common SARS-CoV-2 infected patients.<xref rid="bib0015" ref-type="bibr"><sup>15</sup></xref> According to our investigation of epidemiologic history, we could not deny the possibility of contacting and getting infected with SARS-CoV-2 in HTx recipients. It is important to note that laboratory data may be misleading in HTx since several of our patients already exhibited lymphopenia which may be a result of use of immunosuppressants which prevent lymphocyte development and proinflammatory cytokines genes expression, such as interleukin (IL)-2, IL-3, IL-4, IFN-γ, and TNF-α.<xref rid="bib0036" ref-type="bibr">36</xref>, <xref rid="bib0037" ref-type="bibr">37</xref>, <xref rid="bib0038" ref-type="bibr">38</xref>, <xref rid="bib0039" ref-type="bibr">39</xref> Glucocorticoids inhibit immune responses by negative regulating immunocytes,<xref rid="bib0040" ref-type="bibr">40</xref>, <xref rid="bib0041" ref-type="bibr">41</xref>, <xref rid="bib0042" ref-type="bibr">42</xref>, <xref rid="bib0043" ref-type="bibr">43</xref>, <xref rid="bib0044" ref-type="bibr">44</xref>, <xref rid="bib0045" ref-type="bibr">45</xref> and especially weaken the strength of the T-cell receptor (TCR) signal, which is important in T cells activation and differentiation<xref rid="bib0046" ref-type="bibr"><sup>46</sup></xref>. Thus, we imply that if HTx recipients were infected with SARS-CoV-2, they may not exhibit typical manifestations in the early stage due to the presence of immunosuppression. Our data suggest that maintaining the blood trough concentration of FK506 at (7.9±2.9) ng/mL is appropriate. Yet the appropriate degree of immunosuppression needs further verification.</p><p id="para0023">There are several limitations in current study. First, the detailed clinical data for the recipients with airway symptoms were not fully extracted due to the variation of the database in different hospitals. Second, it's reported SARS-CoV-2 may have an extremely long incubation time, so longer observation and following-up are warranted. Furthermore, larger sample size will contribute to more reliability of the data. Furthermore, recall bias, which would be hard to avoid in a survey based investigation, should also be noted as a limitation.</p><p id="para0024">In conclusion, according to our investigation we suggest that HTx recipients who used enhanced protection measures during the SARS-CoV-2 outbreak did not have a substantially higher rate of infection among the population. It is also important to note that immunosuppressed patients may not exhibit typical manifestations and might present confusing laboratory data thus obfuscating diagnosis in some cases. These early data will require confirmation as the pandemic establishes around the world.</p></sec><sec id="sec0005"><title>Uncited References:</title><p id="para0025"><xref rid="bib0035" ref-type="bibr">[35]</xref></p></sec></body><back><ref-list id="cebibl1"><title>Reference</title><ref id="bib0001"><label>1</label><element-citation publication-type="journal" id="sbref0001"><person-group person-group-type="author"><name><surname>Zhu</surname><given-names>N</given-names></name><name><surname>Zhang</surname><given-names>D</given-names></name><name><surname>Wang</surname><given-names>W</given-names></name></person-group><article-title>A Novel Coronavirus from Patients with Pneumonia in China, 2019</article-title><source>N Engl J Med</source><volume>382</volume><issue>8</issue><year>2020</year><fpage>727</fpage><lpage>733</lpage><pub-id pub-id-type="pmid">31978945</pub-id></element-citation></ref><ref id="bib0002"><label>2</label><element-citation publication-type="journal" id="sbref0002"><person-group person-group-type="author"><name><surname>Huang</surname><given-names>C</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>X</given-names></name></person-group><article-title>Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China</article-title><source>The Lancet</source><volume>395</volume><issue>10223</issue><year>2020</year><fpage>497</fpage><lpage>506</lpage></element-citation></ref><ref id="bib0003"><label>3</label><element-citation publication-type="journal" id="sbref0003"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>N</given-names></name><name><surname>Zhou</surname><given-names>M</given-names></name><name><surname>Dong</surname><given-names>X</given-names></name></person-group><article-title>Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study</article-title><source>The Lancet</source><volume>395</volume><issue>10223</issue><year>2020</year><fpage>507</fpage><lpage>513</lpage></element-citation></ref><ref id="bib0004"><label>4</label><element-citation publication-type="journal" id="sbref0004"><person-group person-group-type="author"><name><surname>Zhou</surname><given-names>P</given-names></name><name><surname>Yang</surname><given-names>X</given-names></name><name><surname>Wang</surname><given-names>X</given-names></name></person-group><article-title>A pneumonia outbreak associated with a new coronavirus of probable bat origin</article-title><source>Nature</source><year>2020</year><comment>Published: 03 February 2020</comment></element-citation></ref><ref id="bib0005"><label>5</label><mixed-citation publication-type="other" id="othref0001">WHO main website. <ext-link ext-link-type="uri" xlink:href="https://www.who.int" id="interref0001">https://www.who.int</ext-link>(25 February 2020).</mixed-citation></ref><ref id="bib0006"><label>6</label><element-citation publication-type="book" id="sbref0005"><chapter-title>New coronavirus pneumonia prevention and control program</chapter-title><year>2020</year><comment>5th ed.</comment></element-citation></ref><ref id="bib0007"><label>7</label><element-citation publication-type="journal" id="sbref0006"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>D</given-names></name><name><surname>Hu</surname><given-names>B</given-names></name><name><surname>Hu</surname><given-names>C</given-names></name></person-group><article-title>Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China</article-title><source>JAMA</source><year>2020</year></element-citation></ref><ref id="bib0008"><label>8</label><element-citation publication-type="journal" id="sbref0007"><person-group person-group-type="author"><name><surname>Shi</surname><given-names>B</given-names></name></person-group><article-title>Current development of the organ transplantation in China, past and future (in Chinese)</article-title><source>Transplantation</source><volume>10</volume><issue>01</issue><year>2019</year><fpage>32</fpage><lpage>35</lpage></element-citation></ref><ref id="bib0009"><label>9</label><element-citation publication-type="journal" id="sbref0008"><person-group person-group-type="author"><name><surname>Huang</surname><given-names>J.</given-names></name></person-group><article-title>Induction and maintenance of immunosuppression in heart transplantation (in Chinese)</article-title><source>Chinese Transplant Journal (EPUB)</source><volume>12</volume><issue>02</issue><year>2018</year><fpage>49</fpage><lpage>54</lpage></element-citation></ref><ref id="bib0010"><label>10</label><element-citation publication-type="journal" id="sbref0009"><person-group person-group-type="author"><name><surname>Peiris</surname><given-names>JS</given-names></name><name><surname>Lai</surname><given-names>ST</given-names></name><name><surname>Poon</surname><given-names>LL</given-names></name></person-group><article-title>Coronavirus as a possible cause of severe acute respiratory syndrome</article-title><source>Lancet</source><volume>361</volume><issue>9366</issue><year>2003</year><fpage>1319</fpage><lpage>1325</lpage><pub-id pub-id-type="pmid">12711465</pub-id></element-citation></ref><ref id="bib0011"><label>11</label><element-citation publication-type="journal" id="sbref0010"><person-group person-group-type="author"><name><surname>Yeung</surname><given-names>ML</given-names></name><name><surname>Yao</surname><given-names>Y</given-names></name><name><surname>Jia</surname><given-names>L</given-names></name></person-group><article-title>MERS coronavirus induces apoptosis in kidney and lung by upregulating Smad7 and FGF2</article-title><source>Nat Microbiol</source><volume>1</volume><year>2016</year><fpage>16004</fpage><pub-id pub-id-type="pmid">27572168</pub-id></element-citation></ref><ref id="bib0012"><label>12</label><element-citation publication-type="journal" id="sbref0011"><person-group person-group-type="author"><name><surname>Hung</surname><given-names>IF</given-names></name><name><surname>Cheng</surname><given-names>VC</given-names></name><name><surname>Wu</surname><given-names>AK</given-names></name></person-group><article-title>Viral loads in clinical specimens and SARS manifestations</article-title><source>Emerg Infect Dis</source><volume>10</volume><issue>9</issue><year>2004</year><fpage>1550</fpage><lpage>1557</lpage><pub-id pub-id-type="pmid">15498155</pub-id></element-citation></ref><ref id="bib0013"><label>13</label><element-citation publication-type="journal" id="sbref0012"><person-group person-group-type="author"><name><surname>Assiri</surname><given-names>A</given-names></name><name><surname>Al-Tawfiq</surname><given-names>JA</given-names></name><name><surname>Al-Rabeeah</surname><given-names>AA</given-names></name></person-group><article-title>Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study</article-title><source>Lancet Infect Dis</source><volume>13</volume><issue>9</issue><year>2013</year><fpage>752</fpage><lpage>761</lpage><pub-id pub-id-type="pmid">23891402</pub-id></element-citation></ref><ref id="bib0014"><label>14</label><element-citation publication-type="journal" id="sbref0013"><person-group person-group-type="author"><name><surname>Rahman</surname><given-names>A</given-names></name><name><surname>Sarkar</surname><given-names>A.</given-names></name></person-group><article-title>Risk Factors for Fatal Middle East Respiratory Syndrome Coronavirus Infections in Saudi Arabia: Analysis of the WHO Line List, 2013-2018</article-title><source>Am J Public Health</source><volume>109</volume><issue>9</issue><year>2019</year><fpage>1288</fpage><lpage>1293</lpage><pub-id pub-id-type="pmid">31318592</pub-id></element-citation></ref><ref id="bib0015"><label>15</label><element-citation publication-type="journal" id="sbref0014"><person-group person-group-type="author"><name><surname>Tu</surname><given-names>Y</given-names></name><name><surname>Wu</surname><given-names>X</given-names></name><name><surname>Liu</surname><given-names>F</given-names></name></person-group><article-title>A clinical report of 2 cases of renal transplant recipients with newly developed coronavirus pneumonia (in Chinese)</article-title><source>Chinese Journal of Organ Transplantation</source><volume>41</volume><issue>00</issue><year>2020</year><comment>E005-E005</comment></element-citation></ref><ref id="bib0016"><label>16</label><element-citation publication-type="journal" id="sbref0015"><person-group person-group-type="author"><name><surname>Ju</surname><given-names>C</given-names></name><name><surname>Li</surname><given-names>L</given-names></name><name><surname>Qiu</surname><given-names>T</given-names></name><name><surname>Xue</surname><given-names>W</given-names></name><name><surname>Shi</surname><given-names>B</given-names></name></person-group><article-title>Clinical characteristics of novel coronavirus pneumonia in transplant recipients and management strategies during the outbreak(1st. ed.)(in Chinese)</article-title><source>Anti-new coronary pneumonia column</source><year>2020</year><comment>19 Feb.</comment><ext-link ext-link-type="uri" xlink:href="http://www.cotdf.org/index.php?m=content&c=index&a=show&catid=19&id=1144" id="interref0002">http://www.cotdf.org/index.php?m=content&c=index&a=show&catid=19&id=1144</ext-link><comment>(2 Mar 2020)</comment></element-citation></ref><ref id="bib0017"><label>17</label><element-citation publication-type="journal" id="sbref0016"><person-group person-group-type="author"><name><surname>Gonzalez</surname><given-names>JM</given-names></name><name><surname>Gomez-Puertas</surname><given-names>P</given-names></name><name><surname>Cavanagh</surname><given-names>D</given-names></name><name><surname>Gorbalenya</surname><given-names>AE</given-names></name><name><surname>Enjuanes</surname><given-names>L</given-names></name></person-group><article-title>A comparative sequence analysis to revise the current taxonomy of the family Coronaviridae</article-title><source>Arch Virol</source><volume>148</volume><issue>11</issue><year>2003</year><fpage>2207</fpage><lpage>2235</lpage><pub-id pub-id-type="pmid">14579179</pub-id></element-citation></ref><ref id="bib0018"><label>18</label><element-citation publication-type="journal" id="sbref0017"><person-group person-group-type="author"><name><surname>Weiss</surname><given-names>S R</given-names></name><name><surname>Navas-Martin</surname><given-names>S</given-names></name></person-group><article-title>Coronavirus pathogenesis and the emerging pathogen severe acute respiratory syndrome coronavirus</article-title><source>Microbiol Mol Biol Rev</source><volume>69</volume><issue>4</issue><year>2005</year><fpage>635</fpage><lpage>664</lpage><pub-id pub-id-type="pmid">16339739</pub-id></element-citation></ref><ref id="bib0019"><label>19</label><element-citation publication-type="journal" id="sbref0018"><person-group person-group-type="author"><name><surname>Wevers</surname><given-names>B A</given-names></name><name><surname>Hoek</surname><given-names>L V D</given-names></name></person-group><article-title>Renin–angiotensin system in human coronavirus pathogenesis</article-title><source>Future Virol</source><volume>5</volume><issue>2</issue><year>2010</year><fpage>145</fpage><lpage>161</lpage><pub-id pub-id-type="pmid">32201502</pub-id></element-citation></ref><ref id="bib0020"><label>20</label><element-citation publication-type="journal" id="sbref0019"><person-group person-group-type="author"><name><surname>Kuba</surname><given-names>K</given-names></name><name><surname>Imai</surname><given-names>Y</given-names></name><name><surname>Rao</surname><given-names>S</given-names></name><name><surname>Gao</surname><given-names>H</given-names></name><name><surname>Guo</surname><given-names>F</given-names></name><name><surname>Guan</surname><given-names>B</given-names></name><name><surname>Huan</surname><given-names>Y</given-names></name><name><surname>Yang</surname><given-names>P</given-names></name><name><surname>Zhang</surname><given-names>Y</given-names></name><name><surname>Deng</surname><given-names>W</given-names></name><name><surname>Bao</surname><given-names>L</given-names></name><name><surname>Zhang</surname><given-names>B</given-names></name><name><surname>Liu</surname><given-names>G</given-names></name><name><surname>Wang</surname><given-names>Z</given-names></name><name><surname>Chappell</surname><given-names>M</given-names></name><name><surname>Liu</surname><given-names>Y</given-names></name><name><surname>Zheng</surname><given-names>D</given-names></name><name><surname>Leibbrandt</surname><given-names>A</given-names></name><name><surname>Wada</surname><given-names>T</given-names></name><name><surname>Slutsky</surname><given-names>AS</given-names></name><name><surname>Liu</surname><given-names>D</given-names></name><name><surname>Qin</surname><given-names>C</given-names></name><name><surname>Jiang</surname><given-names>C</given-names></name><name><surname>Penninger</surname><given-names>JM</given-names></name></person-group><article-title>A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus–induced lung injury</article-title><source>Nat Med</source><volume>11</volume><issue>8</issue><year>2005</year><fpage>875</fpage><lpage>879</lpage><pub-id pub-id-type="pmid">16007097</pub-id></element-citation></ref><ref id="bib0021"><label>21</label><element-citation publication-type="journal" id="sbref0020"><person-group person-group-type="author"><name><surname>Li</surname><given-names>W</given-names></name><name><surname>Moore</surname><given-names>MJ</given-names></name><name><surname>Vasilieva</surname><given-names>N</given-names></name></person-group><article-title>Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus</article-title><source>Nature</source><volume>426</volume><issue>6965</issue><year>2003</year><fpage>450</fpage><lpage>454</lpage><pub-id pub-id-type="pmid">14647384</pub-id></element-citation></ref><ref id="bib0022"><label>22</label><element-citation publication-type="journal" id="sbref0021"><person-group person-group-type="author"><name><surname>Xu</surname><given-names>X</given-names></name><name><surname>Chen</surname><given-names>P</given-names></name><name><surname>Wang</surname><given-names>J</given-names></name></person-group><article-title>Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission</article-title><source>Science China. Life sciences</source><year>2020</year></element-citation></ref><ref id="bib0023"><label>23</label><element-citation publication-type="journal" id="sbref0022"><person-group person-group-type="author"><name><surname>Hao</surname><given-names>X</given-names></name><name><surname>Liang</surname><given-names>Z</given-names></name><name><surname>Jiaxin</surname><given-names>D</given-names></name></person-group><article-title>High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa</article-title><source>Int J Oral Sci</source><volume>12</volume><issue>1</issue><year>2020</year><fpage>8</fpage><pub-id pub-id-type="pmid">32094336</pub-id></element-citation></ref><ref id="bib0024"><label>24</label><element-citation publication-type="journal" id="sbref0023"><person-group person-group-type="author"><name><surname>Kurdi</surname><given-names>M</given-names></name><name><surname>De Mello</surname><given-names>W C</given-names></name><name><surname>Booz</surname><given-names>G W</given-names></name></person-group><article-title>Working outside the system: an update on the unconventional behavior of the renin-angiotensin system components</article-title><source>Int J Biochem Cell Biol</source><volume>37</volume><issue>7</issue><year>2005</year><fpage>1357</fpage><lpage>1367</lpage><pub-id pub-id-type="pmid">15833268</pub-id></element-citation></ref><ref id="bib0025"><label>25</label><element-citation publication-type="journal" id="sbref0024"><person-group person-group-type="author"><name><surname>Gallagher</surname><given-names>PE</given-names></name><name><surname>Chappell</surname><given-names>MC</given-names></name><name><surname>Ferrario</surname><given-names>CM</given-names></name><name><surname>Tallant</surname><given-names>EA</given-names></name></person-group><article-title>Distinct roles for ANG II and ANG-(1–7) in the regulation of angiotensin-converting enzyme 2 in rat astrocytes</article-title><source>Am J Physiol Cell Physiol</source><volume>290</volume><issue>2</issue><year>2006</year><fpage>C420</fpage><lpage>C426</lpage><pub-id pub-id-type="pmid">16176966</pub-id></element-citation></ref><ref id="bib0026"><label>26</label><element-citation publication-type="journal" id="sbref0025"><person-group person-group-type="author"><name><surname>Letizia</surname><given-names>C</given-names></name><name><surname>D'Ambrosio</surname><given-names>C</given-names></name><name><surname>De Ciocchis</surname><given-names>A</given-names></name><name><surname>Scavo</surname><given-names>D</given-names></name><name><surname>Pozzilli</surname><given-names>P</given-names></name></person-group><article-title>Serum angiotensin-converting enzyme levels in patients with recent-onset insulin-dependent diabetes after one year of low-dose cyclosporin therapy</article-title><source>IMDIAB Study Group. Int J Clin Pharmacol Res</source><volume>15</volume><issue>5-6</issue><year>1995</year><fpage>209</fpage></element-citation></ref><ref id="bib0027"><label>27</label><element-citation publication-type="journal" id="sbref0026"><person-group person-group-type="author"><name><surname>Hoskova</surname><given-names>L</given-names></name><name><surname>Malek</surname><given-names>I</given-names></name><name><surname>Kautzner</surname><given-names>J</given-names></name></person-group><article-title>Tacrolimus-induced hypertension and nephrotoxicity in Fawn-Hooded rats are attenuated by dual inhibition of renin-angiotensin system</article-title><source>Hypertens Res</source><volume>37</volume><issue>8</issue><year>2014</year><fpage>724</fpage><lpage>732</lpage><pub-id pub-id-type="pmid">24718302</pub-id></element-citation></ref><ref id="bib0028"><label>28</label><element-citation publication-type="journal" id="sbref0027"><person-group person-group-type="author"><name><surname>Kupferman</surname><given-names>JC</given-names></name><name><surname>Beaudoin</surname><given-names>R</given-names></name><name><surname>Carr</surname><given-names>R</given-names></name></person-group><article-title>Activation of the renal renin-angiotensin system by cyclosporine A and FK 506 in the rat</article-title><source>Transplant Proc</source><volume>26</volume><issue>5</issue><year>1994</year><fpage>2891</fpage><lpage>2893</lpage><pub-id pub-id-type="pmid">7524224</pub-id></element-citation></ref><ref id="bib0029"><label>29</label><element-citation publication-type="journal" id="sbref0028"><person-group person-group-type="author"><name><surname>Julien</surname><given-names>J</given-names></name><name><surname>Farge</surname><given-names>D</given-names></name><name><surname>Kreft-Jais</surname><given-names>C</given-names></name></person-group><article-title>Cyclosporine-induced stimulation of the renin-angiotensin system after liver and heart transplantation</article-title><source>Transplantation</source><volume>56</volume><issue>4</issue><year>1993</year><fpage>885</fpage><lpage>891</lpage><pub-id pub-id-type="pmid">8212212</pub-id></element-citation></ref><ref id="bib0030"><label>30</label><element-citation publication-type="journal" id="sbref0029"><person-group person-group-type="author"><name><surname>Schreiber</surname><given-names>S L</given-names></name><name><surname>Crabtree</surname><given-names>G R</given-names></name></person-group><article-title>The mechanism of action of cyclosporin A and FK506</article-title><source>Immunol Today</source><volume>13</volume><issue>4</issue><year>1992</year><fpage>136</fpage><lpage>142</lpage><pub-id pub-id-type="pmid">1374612</pub-id></element-citation></ref><ref id="bib0031"><label>31</label><element-citation publication-type="journal" id="sbref0030"><person-group person-group-type="author"><name><surname>Ferrario</surname><given-names>CM</given-names></name><name><surname>Jessup</surname><given-names>J</given-names></name><name><surname>Chappell</surname><given-names>MC</given-names></name><name><surname>Averill</surname><given-names>DB</given-names></name><name><surname>Brosnihan</surname><given-names>KB</given-names></name><name><surname>Tallant</surname><given-names>EA</given-names></name><name><surname>Diz</surname><given-names>DI</given-names></name><name><surname>Gallagher</surname><given-names>PE</given-names></name></person-group><article-title>Effect of Angiotensin-Converting Enzyme Inhibition and Angiotensin II Receptor Blockers on Cardiac Angiotensin-Converting Enzyme 2</article-title><source>Circulation</source><volume>111</volume><issue>20</issue><year>2005</year><fpage>2605</fpage><lpage>2610</lpage><pub-id pub-id-type="pmid">15897343</pub-id></element-citation></ref><ref id="bib0032"><label>32</label><element-citation publication-type="journal" id="sbref0031"><person-group person-group-type="author"><name><surname>Zumla</surname><given-names>A</given-names></name><name><surname>Hui</surname><given-names>DS</given-names></name><name><surname>Azhar</surname><given-names>EI</given-names></name><name><surname>Memish</surname><given-names>ZA</given-names></name><name><surname>Maeurer</surname><given-names>M</given-names></name></person-group><article-title>Reducing mortality from 2019-nCoV: host-directed therapies should be an option</article-title><source>The Lancet</source><volume>395</volume><issue>10224</issue><year>2020</year><fpage>e35</fpage><lpage>e36</lpage></element-citation></ref><ref id="bib0033"><label>33</label><element-citation publication-type="journal" id="sbref0032"><person-group person-group-type="author"><name><surname>Xu</surname><given-names>Z</given-names></name><name><surname>Shi</surname><given-names>L</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name></person-group><article-title>Pathological findings of COVID-19 associated with acute respiratory distress syndrome</article-title><source>Lancet Respir Med</source><year>2020</year></element-citation></ref><ref id="bib0034"><label>34</label><element-citation publication-type="journal" id="sbref0033"><person-group person-group-type="author"><name><surname>Nicholls</surname><given-names>JM</given-names></name><name><surname>Poon</surname><given-names>LL</given-names></name><name><surname>Lee</surname><given-names>KC</given-names></name></person-group><article-title>Lung pathology of fatal severe acute respiratory syndrome</article-title><source>Lancet</source><volume>361</volume><issue>9371</issue><year>2003</year><fpage>1773</fpage><lpage>1778</lpage><pub-id pub-id-type="pmid">12781536</pub-id></element-citation></ref><ref id="bib0035"><label>35</label><element-citation publication-type="journal" id="sbref0034"><person-group person-group-type="author"><name><surname>Fu</surname><given-names>R</given-names></name><name><surname>Tajima</surname><given-names>S</given-names></name><name><surname>Suetsugu</surname><given-names>K</given-names></name></person-group><article-title>Biomarkers for individualized dosage adjustments in immunosuppressive therapy using calcineurin inhibitors after organ transplantation</article-title><source>Acta Pharmacol Sin</source><volume>40</volume><issue>2</issue><year>2019</year><fpage>151</fpage><lpage>159</lpage><pub-id pub-id-type="pmid">29950613</pub-id></element-citation></ref><ref id="bib0036"><label>36</label><element-citation publication-type="journal" id="sbref0035"><person-group person-group-type="author"><name><surname>Liu</surname><given-names>J</given-names></name><name><surname>Farmer</surname><given-names>JJ</given-names></name><name><surname>Lane</surname><given-names>WS</given-names></name></person-group><article-title>Calcineurin is a common target of cyclophilin-cyclosporin A and FKBP-FK506 complexes</article-title><source>Cell</source><volume>66</volume><issue>4</issue><year>1991</year><fpage>807</fpage><lpage>815</lpage><pub-id pub-id-type="pmid">1715244</pub-id></element-citation></ref><ref id="bib0037"><label>37</label><element-citation publication-type="journal" id="sbref0036"><person-group person-group-type="author"><name><surname>Liu</surname><given-names>J</given-names></name><name><surname>Albers</surname><given-names>MW</given-names></name><name><surname>Wandless</surname><given-names>TJ</given-names></name></person-group><article-title>Inhibition of T cell signaling by immunophilin-ligand complexes correlates with loss of calcineurin phosphatase activity</article-title><source>Biochemistry</source><volume>31</volume><issue>16</issue><year>1992</year><fpage>3896</fpage><lpage>3901</lpage><pub-id pub-id-type="pmid">1373650</pub-id></element-citation></ref><ref id="bib0038"><label>38</label><element-citation publication-type="journal" id="sbref0037"><person-group person-group-type="author"><name><surname>Eugui</surname><given-names>EM</given-names></name><name><surname>Almquist</surname><given-names>SJ</given-names></name><name><surname>Muller</surname><given-names>CD</given-names></name><name><surname>Allison</surname><given-names>AC</given-names></name></person-group><article-title>Lymphocyte-selective cytostatic and immunosuppressive effects of mycophenolic acid in vitro: role of deoxyguanosine nucleotide depletion</article-title><source>Scand J Immunol</source><volume>33</volume><issue>2</issue><year>1991</year><fpage>161</fpage><lpage>173</lpage><pub-id pub-id-type="pmid">1826793</pub-id></element-citation></ref><ref id="bib0039"><label>39</label><element-citation publication-type="journal" id="sbref0038"><person-group person-group-type="author"><name><surname>Blaheta</surname><given-names>RA</given-names></name><name><surname>Leckel</surname><given-names>K</given-names></name><name><surname>Wittig</surname><given-names>B</given-names></name></person-group><article-title>Mycophenolate mofetil impairs transendothelial migration of allogeneic CD4 and CD8 T-cells</article-title><source>Transplant Proc</source><volume>31</volume><issue>1-2</issue><year>1999</year><fpage>1250</fpage><lpage>1252</lpage><pub-id pub-id-type="pmid">10083559</pub-id></element-citation></ref><ref id="bib0040"><label>40</label><element-citation publication-type="journal" id="sbref0039"><person-group person-group-type="author"><name><surname>Takahira</surname><given-names>R</given-names></name><name><surname>Yonemura</surname><given-names>K</given-names></name><name><surname>Fujise</surname><given-names>Y</given-names></name><name><surname>Hishida</surname><given-names>A</given-names></name></person-group><article-title>Dexamethasone attenuates neutrophil infiltration in the rat kidney in ischemia/reperfusion injury: the possible role of nitroxyl</article-title><source>Free Radic Biol Med</source><volume>31</volume><issue>6</issue><year>2001</year><fpage>809</fpage><lpage>815</lpage><pub-id pub-id-type="pmid">11557319</pub-id></element-citation></ref><ref id="bib0041"><label>41</label><element-citation publication-type="journal" id="sbref0040"><person-group person-group-type="author"><name><surname>Abe</surname><given-names>M</given-names></name><name><surname>Thomson</surname><given-names>A W</given-names></name></person-group><article-title>Dexamethasone preferentially suppresses plasmacytoid dendritic cell differentiation and enhances their apoptotic death</article-title><source>Clin Immunol</source><volume>118</volume><issue>2-3</issue><year>2006</year><fpage>300</fpage><lpage>306</lpage><pub-id pub-id-type="pmid">16330256</pub-id></element-citation></ref><ref id="bib0042"><label>42</label><element-citation publication-type="journal" id="sbref0041"><person-group person-group-type="author"><name><surname>Ehrchen</surname><given-names>J</given-names></name><name><surname>Steinmuller</surname><given-names>L</given-names></name><name><surname>Barczyk</surname><given-names>K</given-names></name></person-group><article-title>Glucocorticoids induce differentiation of a specifically activated, anti-inflammatory subtype of human monocytes</article-title><source>Blood</source><volume>109</volume><issue>3</issue><year>2007</year><fpage>1265</fpage><lpage>1274</lpage><pub-id pub-id-type="pmid">17018861</pub-id></element-citation></ref><ref id="bib0043"><label>43</label><element-citation publication-type="journal" id="sbref0042"><person-group person-group-type="author"><name><surname>Suda</surname><given-names>T</given-names></name><name><surname>Chida</surname><given-names>K</given-names></name><name><surname>Matsuda</surname><given-names>H</given-names></name></person-group><article-title>High-dose intravenous glucocorticoid therapy abrogates circulating dendritic cells</article-title><source>J Allergy Clin Immunol</source><volume>112</volume><issue>6</issue><year>2003</year><fpage>1237</fpage><lpage>1239</lpage><pub-id pub-id-type="pmid">14657889</pub-id></element-citation></ref><ref id="bib0044"><label>44</label><element-citation publication-type="journal" id="sbref0043"><person-group person-group-type="author"><name><surname>Cupic</surname><given-names>B</given-names></name><name><surname>Breljak</surname><given-names>D</given-names></name><name><surname>Gabrilovac</surname><given-names>J</given-names></name></person-group><article-title>Receptor-mediated down-regulation of neutral endopeptidase (NEP; EC 3.4.24.11; CD10) on immature B lymphocytes by dexamethasone</article-title><source>Int J Mol Med</source><volume>15</volume><issue>6</issue><year>2005</year><fpage>1023</fpage><lpage>1031</lpage><pub-id pub-id-type="pmid">15870909</pub-id></element-citation></ref><ref id="bib0045"><label>45</label><element-citation publication-type="journal" id="sbref0044"><person-group person-group-type="author"><name><surname>Youinou</surname><given-names>P</given-names></name><name><surname>Pers</surname><given-names>J O</given-names></name></person-group><article-title>The late news on baff in autoimmune diseases</article-title><source>Autoimmun Rev</source><volume>9</volume><issue>12</issue><year>2010</year><fpage>804</fpage><lpage>806</lpage><pub-id pub-id-type="pmid">20656068</pub-id></element-citation></ref><ref id="bib0046"><label>46</label><element-citation publication-type="journal" id="sbref0045"><person-group person-group-type="author"><name><surname>Harr</surname><given-names>MW</given-names></name><name><surname>Rong</surname><given-names>Y</given-names></name><name><surname>Bootman</surname><given-names>MD</given-names></name><name><surname>Roderick</surname><given-names>HL</given-names></name><name><surname>Distelhorst</surname><given-names>CW</given-names></name></person-group><article-title>Glucocorticoid-mediated inhibition of Lck modulates the pattern of T cell receptor-induced calcium signals by down-regulating inositol 1,4,5-trisphosphate receptors</article-title><source>J Biol Chem</source><volume>284</volume><issue>46</issue><year>2009</year><fpage>31860</fpage><lpage>31871</lpage><pub-id pub-id-type="pmid">19776014</pub-id></element-citation></ref></ref-list><ack id="ack0001"><sec id="sec0006"><title>Acknowledgments</title><p id="para0026">We acknowledge all health-workers involved in the diagnosis and treatment of patients in China. We thank WHO for sharing data collection templates publicly on the website. This study was supported by grants from <funding-source id="gs0003">National Natural Science Foundation of China</funding-source> (81501376) and <funding-source id="gs0004">Postdoctoral Reasearch Foundation of China</funding-source> (2017M620339).</p></sec><sec id="sec0007"><title>Competing interests</title><p id="para0027">All authors have declared no competing interest.</p></sec><sec id="sec0008"><title>Ethical approval</title><p id="para0028">This study was approved by the ethical review committee of Renmin Hospital of Wuhan University.</p></sec><sec id="sec0009"><title>Editor's Note</title><p id="para0029">The article published from China may include patients transplanted at a time when concerns existed with unethical procurement of organ donors, and therefore may represent a violation of the publication policy. However, the editors have chosen to override this aspect, due to the critical importance of the information provided in such a paper for the benefit and help of our patients while recognizing the dignity of those from whom the unethical organs were most probably obtained.</p></sec></ack><fn-group><fn id="d32e1013"><p id="notep0002"><bold>Funding:</bold> This study was supported by grants from <funding-source id="gs0001">National Natural Science Foundation of China</funding-source> (81501376) and <funding-source id="gs0002">Postdoctoral Reasearch Foundation of China</funding-source> (2017M620339)</p></fn></fn-group></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SrasV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001147 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 001147 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= SrasV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:7102567
|texte= EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF HEART TRANSPLANT RECIPIENTS DURING THE 2019 CORONAVIRUS OUTBREAK IN WUHAN, CHINA: A DESCRIPTIVE SURVEY REPORT
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:32115364" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a SrasV1
| This area was generated with Dilib version V0.6.33. |  |