Department of Radiology, Tongji Hospital Affiliated To Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nephrology, Tongji Hospital Affiliated To Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
Int Urol Nephrol. 2021 Dec;53(12):2567-2575. doi: 10.1007/s11255-021-02819-5. Epub 2021 Mar 5.
This paper was intended to describe the characteristics of coronavirus disease 2019 (COVID-19) patients with known chronic kidney disease (CKD) history.
Clinical information of 20 COVID-19 pneumonia patients with CKD history diagnosed between January 20th and March 1st, 2020 were collected in Tongji Hospital, Wuhan. We listed the clinical baseline data, laboratory findings, chest computed tomography (CT) changes and processed a short period of follow-up of these 20 patients.
Based on the estimated glomerular filtration rate (eGFR) on admission, 6 patients were classified as stage 2 of CKD, 5 were as 3a, 2 were as 3b, 3 were as 4 and 4 were as 5, respectively. COVID-19 patients with CKD history were elder and hypertension was the most common comorbidity. Cough and fever accounted for more than 80% of the infectious cases. Lymphopenia, increased D-dimer and elevated infectious indications such as hypersensitive C response protein (hsCRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were also common among these patients. Ground-glass opacity (GGO) and consolidation were the major manifestations in CT scans. 4 patients died and 7 patients underwent acute kidney injury (AKI) during observation. Among 16 discharged patients, 12 were with stable renal function and 4 had deteriorating renal function compared with that of admission.
Compared to general population infected with SARS-CoV-2, COVID-19 patients with CKD history had a preference to develop to severity with higher fatality rate.
本文旨在描述已知患有慢性肾脏病（CKD）的 2019 年冠状病毒病（COVID-19）患者的特征。
收集 2020 年 1 月 20 日至 3 月 1 日期间在武汉同济医院确诊的 20 例 COVID-19 肺炎合并 CKD 病史患者的临床信息。我们列出了这些 20 例患者的临床基线数据、实验室检查结果、胸部计算机断层扫描（CT）变化，并对其进行了短期随访。
根据入院时的估算肾小球滤过率（eGFR），6 例患者分别被归类为 CKD 2 期、5 例为 3a 期、2 例为 3b 期、3 例为 4 期和 4 例为 5 期。有 CKD 病史的 COVID-19 患者年龄较大，高血压是最常见的合并症。咳嗽和发热占感染病例的 80%以上。淋巴细胞减少、D-二聚体升高以及超敏 C 反应蛋白（hsCRP）、白细胞介素 6（IL-6）和肿瘤坏死因子-α（TNF-α）等感染指标升高也很常见。CT 扫描主要表现为磨玻璃影（GGO）和实变。在观察期间，4 例患者死亡，7 例患者发生急性肾损伤（AKI）。16 例出院患者中，12 例肾功能稳定，4 例与入院时相比肾功能恶化。
与一般人群感染 SARS-CoV-2 相比，有 CKD 病史的 COVID-19 患者更易发展为重症，死亡率更高。
