Vardhan Harsh, Kumar Amit, Shyama Shyama, Chaudhary Neha, Pandey Sanjay, Rai Deependra K, Kumar Deepak, Kumar Sanyal
Nephrology, All India Institute of Medical Sciences, Patna, Patna, IND.
General Medicine, All India Institute of Medical Sciences, Patna, Patna, IND.
Cureus. 2021 Aug 14;13(8):e17170. doi: 10.7759/cureus.17170. eCollection 2021 Aug.
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 disease is the third coronavirus to have emerged in the last 20 years. The COVID-19 infection causes more severe illness in patients with comorbid diseases, especially in patients with diabetes, hypertension and kidney failure. Methods This is a retrospective study using electronic records and laboratory data of adult patients hospitalised at All India Institute of Medical Sciences (AIIMS), Patna between May 1st, 2020 and March 31st, 2021, who were diagnosed with COVID-19 and needed haemodialysis. The demographic characteristics, co-morbidities, symptoms, clinical course, laboratory parameters, and treatments were recorded. The aim of this study is to evaluate the clinical profile and outcome of patients on hemodialysis with COVID-19 infection. Results The study included 261 COVID-19 patients who needed haemodialysis. The most common symptoms on admission were fever (72.8%), cough (64.3%) and dyspnoea (46.6%). The mean age was 58.4 +/-15 years. A total of 195 patients (74.7%) were male. The most common co-morbid condition was hypertension (85.1%) followed by diabetes (71.9%). A total of 118 (45.2) patients had acute on chronic kidney disease (CKD), 40 (15.3) were on maintenance haemodialysis (MHD) and 103 (39.5) were having acute kidney injury (AKI). Eight patients were renal transplant recipients. At presentation, 183 (70.1%) patients were having mild to moderately severe infection and 78 (29.9%) patients were having severe disease. A total of 213 patients required ICU admissions, 186 (75.3%) of whom required invasive ventilation. Overall mortality was 66% (172/261) and the rest were discharged. Conclusion The study suggests that COVID-19 disease has a significantly more severe course and poorer outcome in patients requiring haemodialysis.
引言 导致新冠肺炎疾病的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是过去20年中出现的第三种冠状病毒。新冠肺炎感染在患有合并症的患者中会导致更严重的疾病，尤其是糖尿病、高血压和肾衰竭患者。方法 这是一项回顾性研究，使用了2020年5月1日至2021年3月31日期间在巴特那全印度医学科学研究所（AIIMS）住院的成年新冠肺炎确诊患者且需要血液透析的电子记录和实验室数据。记录了人口统计学特征、合并症、症状、临床病程、实验室参数和治疗情况。本研究的目的是评估感染新冠肺炎的血液透析患者的临床特征和结局。结果 该研究纳入了261名需要血液透析的新冠肺炎患者。入院时最常见的症状是发热（72.8%）、咳嗽（64.3%）和呼吸困难（46.6%）。平均年龄为58.4±15岁。共有195名患者（74.7%）为男性。最常见的合并症是高血压（85.1%），其次是糖尿病（71.9%）。共有118名（45.2%）患者患有慢性肾脏病急性加重（CKD），40名（15.3%）正在接受维持性血液透析（MHD），103名（39.5%）患有急性肾损伤（AKI）。8名患者是肾移植受者。就诊时，183名（70.1%）患者患有轻度至中度严重感染，78名（29.9%）患者患有严重疾病。共有213名患者需要入住重症监护病房（ICU），其中186名（75.3%）需要有创通气。总体死亡率为66%（172/261），其余患者出院。结论 该研究表明，新冠肺炎疾病在需要血液透析的患者中病程明显更严重，结局更差。
