Sciarrone Alibrandi Maria Teresa, Vespa Marta, Joli Giancarlo, Bucci Romina, Brioni Elena, Rivera Rodolfo F
University Vita Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milano, Italia.
U.O. Nefrologia e Dialisi, Ospedale di Desio - ASST - Brianza, Desio, Italia.
G Ital Nefrol. 2021 Apr 14;38(2):2021-vol2.
The SARS-CoV-2 (Covid-19) has infected about 124 million people worldwide and the total amount of casualties now sits at a staggering 2.7 million. One enigmatic aspect of this disease is the protean nature of the clinical manifestations, ranging from total absence of symptoms to extremely severe cases with multiorgan failure and death. Chronic Kidney Disease (CKD) has emerged as the primary risk factor in the most severe patients, apart from age. Kidney disease and acute kidney injury have been correlated with a higher risk of death. Notably the Italian Society of Nephrology have reported a 10-fold increase in mortality in patients undergoing dialysis compared to the rest of the population, especially during the second phase of the pandemic (26% vs 2.4). These dramatic numbers require an immediate response. At the moment of writing, three Covid-19 vaccines are being administered already , two of which, Pfizer-BioNTech and Moderna, share the same mRNA mechanism and Vaxzevria (AstraZeneca) based on a more traditional approach. All of them are completely safe and reliable. The AIFA scientific commission has suggested that the mRNA vaccines should be administered to older and more fragile patients, while the Vaxzevria (AstraZeneca) vaccine should be reserved for younger subjects above the age of 18. The near future looks bright: there are tens of other vaccines undergoing clinical and preclinical validation, whose preliminary results look promising. The high mortality of CKD and dialysis patients contracting Covid-19 should mandate top priority for their vaccination.
严重急性呼吸综合征冠状病毒2（新冠病毒）已在全球感染了约1.24亿人，目前的总死亡人数高达270万，令人震惊。这种疾病的一个神秘之处在于其临床表现具有多变性，从完全没有症状到出现多器官衰竭和死亡的极其严重的病例都有。除年龄外，慢性肾脏病（CKD）已成为最严重患者的主要风险因素。肾脏疾病和急性肾损伤与更高的死亡风险相关。值得注意的是，意大利肾脏病学会报告称，与其他人群相比，接受透析的患者死亡率增加了10倍，尤其是在疫情的第二阶段（26%对2.4%）。这些惊人的数据需要立即做出应对。在撰写本文时，已有三种新冠疫苗正在接种，其中两种，辉瑞-生物科技疫苗和莫德纳疫苗，采用相同的信使核糖核酸机制，而阿斯利康疫苗则基于更传统的方法。所有这些疫苗都完全安全可靠。意大利药品管理局科学委员会建议，信使核糖核酸疫苗应接种给年龄较大和身体较为虚弱的患者，而阿斯利康疫苗应留给18岁以上的年轻人群。不久的将来前景光明：还有数十种其他疫苗正在进行临床和临床前验证，其初步结果看起来很有希望。感染新冠病毒的慢性肾脏病患者和透析患者的高死亡率应使其接种疫苗成为首要优先事项。
