Allan P J, Ambrose T, Mountford C, Bond A, Donnellan C, Boyle R, Calvert C, Cernat E, Clarke E, Cooper S C, Donnelly S, Evans B, Glynn M, Hewett R, Holohan A S, Leitch E F, Louis-Auguste J, Mehta S, Naik S, Nightingale J, Rafferty G, Rodrigues A, Sharkey L, Small M, Teubner A, Urs A, Wyer N, Lal S
Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Department of Gastroenterology, Freeman Hospital, Newcastle, UK.
JPEN J Parenter Enteral Nutr. 2021 Aug;45(6):1369-1375. doi: 10.1002/jpen.2087. Epub 2021 May 6.
The direct effect of the coronavirus disease 2019 (COVID-19) pandemic on patients with intestinal failure (IF) has not been described.
We conducted a nationwide study of UK IF centers to evaluate the infection rates, presentations, and outcomes in patients with types 2 and 3 IF.
A total of 45 patients with IF contracted COVID-19 between March and August 2020; this included 26 of 2191 (1.2%) home parenteral nutrition (HPN)-dependent adults and 19 of 298 (6.4%) adults hospitalized with type 2 IF. The proportion of patients receiving nursing care for HPN administration was higher in those with community-acquired COVID-19 (66.7%) than the proportion in the entire HPN cohort (26.1%; P < .01). Two HPN-dependent and 1 hospitalized patient with type 2 IF died as a direct consequence of the virus (6.7% of 45 patients with types 2 or 3 infected).
This is the first study to describe the outcomes of COVID-19 in a large cohort of patients requiring long-term PN. Methods to reduce hospital and community nosocomial spread would likely be beneficial.
2019冠状病毒病(COVID-19)大流行对肠衰竭(IF)患者的直接影响尚未见描述。
我们对英国的IF中心进行了一项全国性研究,以评估2型和3型IF患者的感染率、临床表现及预后。
2020年3月至8月期间,共有45例IF患者感染了COVID-19;其中包括2191例依赖家庭肠外营养(HPN)的成人患者中的26例(1.2%),以及298例因2型IF住院的成人患者中的19例(6.4%)。社区获得性COVID-19患者中接受HPN护理的比例(66.7%)高于整个HPN队列中的比例(26.1%;P < .01)。2例依赖HPN的患者和1例2型IF住院患者因病毒直接导致死亡(45例2型或3型感染患者中的6.7%)。
这是第一项描述大量需要长期PN的患者中COVID-19预后情况的研究。减少医院和社区医院内传播的方法可能会有益处。