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4
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中国襄阳 COVID-19 感染患者的急性肾损伤的临床特征和结局。

Clinical Features and Outcomes of Acute Kidney Injury in Patients Infected with COVID-19 in Xiangyang, China.

机构信息

Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.

Department of Nephrology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China,

出版信息

Blood Purif. 2021;50(4-5):513-519. doi: 10.1159/000513163. Epub 2020 Dec 14.

DOI:10.1159/000513163
PMID:33316799
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7801975/
Abstract

BACKGROUND

In December 2019, pneumonia associated with COVID-19 has spread from Wuhan to other areas in China. In the present study, we aimed to further clarify the clinical features and outcomes of acute kidney injury (AKI) in patients infected with COVID-19 in Xiangyang, Hubei, China.

METHODS

All confirmed cases of COVID-19 with AKI in Xiangyang Central Hospital from January 22 to May 31, 2020, were included in this retrospective study. Data of epidemiological, clinical, laboratory, radiological tests, treatment, complication, and outcomes were collected and analyzed. Patients were divided into intensive care unit (ICU) group and isolation ward (non-ICU) group.

RESULTS

Of the total patients, 33.3% in the non-ICU group and 85.7% in the ICU group had chronic diseases. In addition, 85.7% of patients in the ICU group died. The most common symptoms were fever, cough, and fatigue. The lymphocyte count in the ICU group was significantly reduced compared with the non-ICU group. The chest computed tomography (CT) images appeared showed multiple mottles and ground-glass opacity. Strip shadow could be found in chest CT images of some recovered patients. All patients received antiviral treatment. Most patients in the ICU group were given methylprednisolone, immunoglobulin, antibiotics, and mechanical ventilation and 35.7% of patients in the ICU group received continuous renal replacement therapy.

CONCLUSIONS

Elderly with chronic comorbidities were more susceptible to COVID-19, showing a higher mortality rate due to multiple organ damage, and 35.7% of patients with AKI in ICU received renal replacement therapy. Moreover, part of the cured patients might need additional time to recover for poor lung function.

摘要

背景

2019 年 12 月,与 COVID-19 相关的肺炎已从武汉蔓延至中国其他地区。在本研究中,我们旨在进一步阐明中国湖北襄阳感染 COVID-19 的患者的急性肾损伤(AKI)的临床特征和结局。

方法

本回顾性研究纳入了 2020 年 1 月 22 日至 5 月 31 日期间在襄阳市中心医院确诊的伴有 AKI 的 COVID-19 患者。收集并分析了流行病学、临床、实验室、影像学检查、治疗、并发症和结局的数据。患者分为重症监护病房(ICU)组和隔离病房(非 ICU)组。

结果

非 ICU 组中 33.3%的患者和 ICU 组中 85.7%的患者有慢性疾病。此外,ICU 组中 85.7%的患者死亡。最常见的症状是发热、咳嗽和乏力。ICU 组的淋巴细胞计数明显低于非 ICU 组。胸部计算机断层扫描(CT)图像显示多发性斑点和磨玻璃影。部分恢复患者的胸部 CT 图像可见条纹影。所有患者均接受抗病毒治疗。ICU 组患者大多接受甲基强的松龙、免疫球蛋白、抗生素和机械通气治疗,35.7%的 ICU 组患者接受连续性肾脏替代治疗。

结论

患有慢性合并症的老年人更容易感染 COVID-19,由于多器官损伤导致死亡率更高,35.7%的 ICU 中伴有 AKI 的患者接受了肾脏替代治疗。此外,部分治愈患者可能因肺部功能较差而需要额外的时间来恢复。