ABSTRACT
Coronavirus disease 2019 (COVID-19) is a novel and lethal infectious disease, posing a threat to global health security. The number of cases has increased rapidly, but no data concerning kidney transplant (KTx) recipients infected with COVID-19 are available. To present the epidemiological, clinical, and therapeutic characteristics of KTx recipients infected with COVID-19, we report on a case series of five patients who were confirmed as having COVID-19 through nucleic acid testing (NAT) from January 1, 2020 to February 28, 2020. The most common symptoms on admission to hospital were fever (five patients, 100%), cough (five patients, 100%), myalgia or fatigue (three patients, 60%), and sputum production (three patients, 60%); serum creatinine or urea nitrogen levels were slightly higher than those before symptom onset. Four patients received a reduced dose of maintenance immunosuppressive therapy during hospitalization. As of March 4, 2020 NAT was negative for COVID-19 in three patients twice in succession, and their computed tomography scans showed improved images. Although greater patient numbers and long-term follow-up data are needed, our series demonstrates that mild COVID-19 infection in KTx recipients can be managed using symptomatic support therapy combined with adjusted maintenance immunosuppressive therapy.
Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Immunosuppressive Agents/adverse effects , Kidney Transplantation/adverse effects , Opportunistic Infections/diagnosis , Pneumonia, Viral/diagnosis , Transplant Recipients , Adult , Betacoronavirus/genetics , Betacoronavirus/immunology , COVID-19 , COVID-19 Testing , China , Coronavirus Infections/therapy , Coronavirus Infections/virology , Female , Humans , Immunocompromised Host , Immunosuppressive Agents/administration & dosage , Male , Middle Aged , Opportunistic Infections/therapy , Opportunistic Infections/virology , Pandemics , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Predictive Value of Tests , SARS-CoV-2 , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
Based on the data of the second soil survey and field sampling in 2009 and 2010, temporal-spatial variations of total nitrogen (TN) in the degraded grassland 0-10 cm, 10-20 cm and 30-50 cm beneath the surface soil at the Three-River Headwaters region in Qinghai Province for a 30-year period (1980-2010) were evaluated using geostatistics and geographic information system (GIS). After exclusion of the outliers, the results showed a downward trend from the surface to the bottom in the mean TN values measured in the samples collected during the two periods. For the same soil layers, the average TN contents and the coefficient of variation in 1980 were higher than those in 2010. The TN contents of the two periods showed a log-normal distribution. Semivariograms analysis of the experiments indicated that the nugget effect in the same soil layer was lower in 2010 than in 1980; suggesting that the spatial distribution autocorrelation of TN in the Three-River Headwaters region in Qinghai Province was strengthened and structural factors played a more and more important role on the spatial distribution of TN. The results of ordinary kriging showed that there were regional differences in variations of the total nitrogen content. There were significant decreases in the southern, central and eastern regions, while the increase mainly occurred in the western areas.