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不同慢性肾脏病分期的住院 COVID-19 患者的死亡率和再入院率:一项多中心回顾性队列研究。

Mortality and readmission rates among hospitalized COVID-19 patients with varying stages of chronic kidney disease: a multicenter retrospective cohort.

机构信息

Center for Experimental and Molecular Medicine, Amsterdam UMC, Amsterdam, The Netherlands.

The Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Amsterdam, The Netherlands.

出版信息

Sci Rep. 2022 Feb 10;12(1):2258. doi: 10.1038/s41598-022-06276-7.

Abstract

Chronic kidney disease (CKD) has been recognized as a highly prevalent risk factor for both the severity of coronavirus disease 2019 (COVID-19) and COVID-19 associated adverse outcomes. In this multicenter observational cohort study, we aim to determine mortality and readmission rates of patients hospitalized for COVID-19 across varying CKD stages. We performed a multicenter cohort study among COVID-19 patients included in the Dutch COVIDPredict cohort. The cohort consists of hospitalized patients from March 2020 until July 2021 with PCR-confirmed SARS-CoV-2 infection or a highly suspected CT scan-based infection with a CORADS score ≥ 4. A total of 4151 hospitalized COVID-19 patients were included of who 389 had a history of CKD before admission. After adjusting for all confounding covariables, in patients with CKD stage 3a, stage 3b, stage 4 and patients with KTX (kidney transplantation), odds ratios of death and readmission compared to patients without CKD ranged from 1.96 to 8.94. We demonstrate an evident increased 12-week mortality and readmission rate in patients with chronic kidney disease. Besides justified concerns for kidney transplant patients, clinicians should also be aware of more severe COVID-19 outcomes and increased vulnerability in CKD patients.

摘要

慢性肾脏病(CKD)已被认为是 2019 年冠状病毒病(COVID-19)严重程度和 COVID-19 相关不良结局的高度流行危险因素。在这项多中心观察性队列研究中,我们旨在确定不同 CKD 阶段 COVID-19 住院患者的死亡率和再入院率。我们对荷兰 COVIDPredict 队列中包括的 COVID-19 患者进行了多中心队列研究。该队列包括 2020 年 3 月至 2021 年 7 月期间因 PCR 确诊的 SARS-CoV-2 感染或高度疑似 CT 扫描感染(CORADS 评分≥4)住院的患者。共纳入 4151 例 COVID-19 住院患者,其中 389 例在入院前有 CKD 病史。在调整所有混杂协变量后,与无 CKD 患者相比,CKD 3a 期、3b 期、4 期和 KTX(肾移植)患者的死亡和再入院的比值比范围为 1.96 至 8.94。我们证明了慢性肾脏病患者的 12 周死亡率和再入院率明显增加。除了对肾移植患者的合理关注外,临床医生还应意识到 CKD 患者的 COVID-19 结局更严重,且易受影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8c5/8831646/8702445e5692/41598_2022_6276_Fig1_HTML.jpg

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