Chawki Sylvain, Buchard Albert, Sakhi Hamza, Dardim Karim, El Sakhawi Karim, Chawki Mokhtar, Boulanger Henri, Kofman Tomek, Dahmane Djamal, Rieu Philippe, Attaf David, Ahriz-Saksi Salima, Masoumi Afshin, Diddaoui Ali Zineddine, Fromentin Luc, Michaut Patrick, Nebbad Rachida, Desassis Jean-François, Nicolet Laurence, Sohier-Attias Julie, Besson Frederic, Boula Remy, Hafi Ali, Ghazali Abderrahmane, Lamriben Larbi, Arezki Adem, Dupuis Emmanuel, Rifard Mohamad-Khair, Joly Dominique, Attias Philippe, El Karoui Khalil
Institut National de la Santé et de la Recherche Médicale Unité U944, Université de Paris, Paris, France.
BIOS Health, Cambridge, UK.
Clin Kidney J. 2021 Sep 27;15(2):262-268. doi: 10.1093/ckj/sfab166. eCollection 2022 Feb.
Maintenance haemodialysis (MHD) patients have a high risk of initial mortality from coronavirus disease 2019 (COVID-19). However, long-term consequences of this disease in the MHD population are poorly described. We report the clinical presentation, outcome and long-term follow-up of MHD patients affected by COVID-19 in a multicentric cohort from the Paris, France area.
We conducted a retrospective analysis of clinical presentation and long-term follow-up of MHD patients affected by COVID-19 in 19 MHD centres in the Paris, France area.
In this cohort of 248 patients with an initial mortality rate of 18%, age, comorbidities, dyspnoea and previous immunosuppressive treatment were associated with death at <30 days. Among the 203 surviving patients following the acute phase, long-term follow-up (median 180 days) was available for 189 (93%) patients. Major adverse events occurred in 30 (16%) patients during follow-up, including 12 deaths (6%) after a median of 78 days from onset of symptoms. Overall, cardiovascular events, infections and gastrointestinal bleeding were the main major adverse events. Post-COVID-19 cachexia was observed in 25/189 (13%) patients. Lower initial albuminaemia was significantly associated with this cachexia. No reinfection with severe acute respiratory syndrome coronavirus 2 was observed.
This work demonstrates the long-term consequences of COVID-19 in MHD patients, highlighting both initial and long-term severity of the disease, including severe cachexia.
维持性血液透析（MHD）患者感染2019冠状病毒病（COVID-19）后初始死亡风险很高。然而，关于该疾病在MHD人群中的长期后果描述甚少。我们报告了法国巴黎地区一个多中心队列中受COVID-19影响的MHD患者的临床表现、结局及长期随访情况。
我们对法国巴黎地区19个MHD中心受COVID-19影响的MHD患者的临床表现及长期随访情况进行了回顾性分析。
在这个包含248例患者的队列中，初始死亡率为18%，年龄、合并症、呼吸困难及既往免疫抑制治疗与30天内死亡相关。急性期后存活的203例患者中，189例（93%）患者获得了长期随访（中位时间180天）。随访期间30例（16%）患者发生了主要不良事件，包括症状出现后中位78天有12例（6%）死亡。总体而言，心血管事件、感染及胃肠道出血是主要的主要不良事件。189例患者中有25例（13%）出现了COVID-19后恶病质。较低的初始白蛋白血症与这种恶病质显著相关。未观察到严重急性呼吸综合征冠状病毒2再次感染情况。
这项研究证明了COVID-19在MHD患者中的长期后果，突出了该疾病的初始及长期严重性，包括严重恶病质。
