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[新冠疫情期间杜阿拉总医院终末期肾病血液透析患者的流行病学与临床特征及90天生存率:经验总结]

[Epidemiologic and clinical profile, 90 days survival of incident end stage renal patient in haemodialysis during SARS-CoV2 pandemic: Experience of the General Hospital of Douala].

作者信息

Fouda Menye Epse Ebana Hermine Danielle, Halle Marie-Patrice, Mbele Onana Charles, Mbatchou Bertrand Hugo, Luma Namme Henry, Ashuntantang Enow Gloria

机构信息

Hôpital général de Douala, BP 4856, Douala, Cameroun; Faculté de médecine et des sciences biomédicales, université de Yaoundé I, BP 1364, Yaoundé, Cameroun.

Hôpital général de Douala, BP 4856, Douala, Cameroun; Faculté de médecine et des sciences pharmaceutiques de Douala, BP 2701, Douala, Cameroun.

出版信息

Nephrol Ther. 2021 Aug;17(4):226-232. doi: 10.1016/j.nephro.2020.12.002. Epub 2021 Jan 6.

Abstract

BACKGROUND

The effect of COVID-19 pandemic on end stage renal disease patient who should initiated dialysis are limited in Sub-Saharan Africa is unknown. We sought to describe the epidemiologic and clinical profile of newly admitted patient in chronic haemodialysis during the COVID-19 pandemic in Cameroon and evaluate their survival between 90days of dialysis initiation.

MATERIAL AND METHOD

We conducted a cohort study of 6months from April to October 2020. End stage renal disease patients newly admitted in the haemodialysis facility of the General Hospital of Douala were included. Patients with confirmed or suspected COVID-19 were identified. Socio-demographic, clinical and biological data at dialysis initiation as well as mortality between the 90days of dialysis initiation were registered.

RESULTS

A total of 57 incident patients were recorded from April to October 2020 with a monthly mean of 9.5 patients. The mean age was 46.95±13.12years. Twenty-four COVID-19 were identified with a frequency of 49% among emergency admission. Pulmonary œdema (79.2% vs. 42.4%; P=0.006) and uremic encephalopathy (83.4% vs. 53.6%; P=0.022) were more common in COVID-19. The overall survival at 90days was 48% with a tendency to poor survival among COVID-19 and patients with low socioeconomic level. In Cox regression, low socioeconomic level increase the risk of instant death by 3.08.

CONCLUSION

SARS-CoV2 seem to increase nephrology emergency and poor survival in haemodialysis at 90days.

摘要

背景

在撒哈拉以南非洲,新冠疫情对本应开始透析的终末期肾病患者的影响尚不清楚。我们试图描述喀麦隆新冠疫情期间新入院接受慢性血液透析患者的流行病学和临床特征,并评估他们在开始透析90天内的生存率。

材料与方法

我们在2020年4月至10月进行了一项为期6个月的队列研究。纳入杜阿拉总医院血液透析设施新入院的终末期肾病患者。识别出确诊或疑似新冠病毒感染的患者。记录开始透析时的社会人口统计学、临床和生物学数据以及开始透析90天内的死亡率。

结果

2020年4月至10月共记录了57例新发病例,月平均9.5例。平均年龄为46.95±13.12岁。在急诊入院患者中,24例确诊为新冠病毒感染,频率为49%。肺水肿(79.2%对42.4%;P=0.006)和尿毒症脑病(83.4%对53.6%;P=0.022)在新冠病毒感染患者中更为常见。90天的总生存率为48%,新冠病毒感染患者和社会经济水平较低的患者生存率有较差的趋势。在Cox回归分析中,社会经济水平低使即刻死亡风险增加3.08倍。

结论

新冠病毒似乎增加了肾病急诊情况,并导致血液透析患者90天生存率较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7cf/7832063/a80b136b7f2d/gr1_lrg.jpg

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