摘要
Objective:To describe the clinical features and outcomes of arboviral infections in solid organ transplant recipients(SOTRs).Methods:This study included SOTRs identified from a passive surveillance cohort of 1466 patients with acute undifferentiated febrile illness between 2012 and 2019.Diagnosis of arboviral infection was confirmed using RT-PCR and/or serological testing.Clinical,laboratory,and outcome data were extracted and analyzed descriptively.Results:Eleven SOTRs(10 kidney,1 heart transplant recipient)were diagnosed with arboviral infections:8 with dengue(DENV),2 with chikungunya virus(CHIKV),and 1 with Zika virus(ZIKV)infection.The median time from transplantation to symptom onset was 35.0 days(IQR 28.5-111.0).DENV infection was associated with severe disease,including dengue shock syndrome(50%,4/8)and dengue hemorrhagic fever(25%,2/8).Six patients(75%,6/8)required ICU admission.Common laboratory abnormalities in dengue patients included leukopenia(100%,8/8),thrombocytopenia(100%,8/8),elevated transaminases(87.5%,7/8),and acute kidney injury(50%,4/8).CHIKV and ZIKV cases presented as mild,self-limiting febrile illnesses without complications.All patients recovered without long-term morbidity.Conclusions:DENV infection in SOTRs is associated with significant morbidity,particularly early post-transplant,and requires heightened clinical vigilance.In contrast,CHIKV and ZIKV infections tend to follow a benign course.Enhanced vector control,early diagnostic testing,supportive management,and consideration of dengue vaccination in appropriate candidates are essential to mitigate the impact of arboviral infections in transplant recipients in endemic areas.
