Chinese expert consensus on diagnosis and treatment strategies for SARS-CoV-2 infection in immunocompromised populations (2023 edition-2)

Abstract:

Since the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)infection has swept the world, bringing great harm to human society and significantly increasing the health burden. Due to stronger infectivity, faster transmission, and higher reinfection rate of the Omicron variant, it has now replaced the Delta variant as the main epidemic strain for both imported and local outbreaks in China. Chinese Diagnosis and treatment protocol for SARS-CoV-2 infection (10th trial version) emphasizes "strengthening the protection of key populations, " which includes the increasing number of immunocompromised population. These people have a high incidence of severe diseases and a high fatality rate after infected with SARS-CoV-2, and belong to the high-risk populations of severe or critical diseases. Moreover, due to underlying diseases, these people take immunosuppressants and other related drugs chronically. The interactions between anti-SARS-CoV-2 infection treatment drugs and original drugs are complicated, thus bring significant challenges to the treatment after the SARS-CoV-2 infection. Currently, there is a lack of guidelines or consensus on the diagnosis and treatment of SARS-CoV-2 infection among immunocompromised population. Therefore, the Guangzhou Institute of Respiratory Health and National Center for Respiratory Medicine organized experts from multiple disciplines (respiratory and critical care medicine, organ transplantation, rheumatology and immunology, hematology, infection, critical care medicine, etc.) in China. After multiple rounds of discussions, 13 items of recommendations are made as the reference for peers based on evidence-based medical evidence, so as to provide a theoretical and practical reference for the diagnosis and treatment strategies of this population.