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慢性肾脏病预示着 COVID-19 患者预后不良。

Chronic kidney disease predicts poor outcomes of COVID-19 patients.

机构信息

Nephrology Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey.

Internal Medicine Department, Sultan Abdulhamid Han Training Hospital, Istanbul, Turkey.

出版信息

Int Urol Nephrol. 2021 Sep;53(9):1891-1898. doi: 10.1007/s11255-020-02758-7. Epub 2021 Jan 4.

Abstract

PURPOSE

The recent outbreak of COVID-19 rapidly spread worldwide. Comorbid diseases are determinants of the severity of COVID-19 infection and mortality. The aim of this study was to explore the potential association between chronic kidney disease (CKD) and the severity of COVID-19 infection.

METHODS

The study included 609 consecutive adult patients (male: 54.52%, mean age: 59.23 ± 15.55 years) hospitalized with the diagnosis of COVID-19 in a tertiary level hospital. Data were collected from the electronic health records of the hospital. The patients were separated into two groups: Group I included COVID-19-positive patients with CKD stage 1-2, and Group II included COVID-19-positive with CKD stage 3-5. The relationships were examined between CKD stage, laboratory parameters and mortality.

RESULTS

Significant differences were determined between the groups in respect of the inflammation parameters and the parameters used in prognosis. In Group II, statistically significantly higher rates were determined of comorbid diseases [hypertension (p < 0.001) and diabetes mellitus (p < 0.001), acute kidney injury (AKI), which was found to be associated with mortality (p < 0.001), and mortality (p < 0.001)]. In multivariate regression analysis, CKD stage 3-5, AKI, male gender, hypertension, DM and malignancy were found to be significant independent variables increasing mortality.

CONCLUSION

The prevelance of CKD stage 3-5 on admission is associated with a high risk of in-hospital mortality in patients with COVID-19. Close follow-up can be recommended for patients with a reduced glomerular filtration rate (GFR).

摘要

目的

COVID-19 的爆发迅速在全球范围内蔓延。合并症是 COVID-19 感染严重程度和死亡率的决定因素。本研究旨在探讨慢性肾脏病(CKD)与 COVID-19 感染严重程度之间的潜在关联。

方法

本研究纳入了一家三级医院因 COVID-19 住院的 609 例连续成年患者(男性:54.52%,平均年龄:59.23±15.55 岁)。数据来自医院的电子健康记录。将患者分为两组:I 组包括 CKD 1-2 期的 COVID-19 阳性患者,II 组包括 CKD 3-5 期的 COVID-19 阳性患者。检查了 CKD 分期、实验室参数和死亡率之间的关系。

结果

两组在炎症参数和预后参数方面存在显著差异。在 II 组中,确定了更高的合并症发生率[高血压(p<0.001)和糖尿病(p<0.001)、与死亡率相关的急性肾损伤(AKI)(p<0.001)和死亡率(p<0.001)]。在多变量回归分析中,发现 CKD 3-5 期、AKI、男性、高血压、DM 和恶性肿瘤是增加死亡率的显著独立变量。

结论

入院时 CKD 3-5 期的患病率与 COVID-19 患者住院死亡率高风险相关。建议对肾小球滤过率(GFR)降低的患者进行密切随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a26a/8380228/27fcdcc093a6/11255_2020_2758_Fig1_HTML.jpg

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