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COVID-19 康复者的肾脏移植物功能变化。

Changes in Kidney Graft Function in COVID-19 Convalescents.

机构信息

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.

出版信息

Transplant Proc. 2022 May;54(4):884-887. doi: 10.1016/j.transproceed.2022.03.003. Epub 2022 Mar 16.

Abstract

BACKGROUND

Kidney transplant recipients (KTRs) are at an increased risk of infection with severe acute respiratory syndrome coronavirus 2, with mortality from 13% to over 30%. However, data concerning the influence of COVID-19 on long-term graft function in convalescents is lacking. The aim of this study was to evaluate the influence of COVID-19 on graft function at 6 months after recovery.

METHODS

A longitudinal controlled study was conducted in a group of 1058 KTRs. Of 180 patients with COVID-19 in the past, 77 KTRs (45 male) with a mean age 50.57 ± 13.37 years, Charlson Comorbidity Index of 3 (median; interquartile range [IQR], 3-5), Fragility Score of 3 (median; IQR, 3-3), and minimum 6 months after acute COVID-19 were included. The most common symptoms were weakness (75.33%), fever (74.03%), cough (51.95%), and loss of appetite (48.05%). Thirty-three patients were hospitalized; none required invasive ventilation therapy, but 16 required oxygen support. The treatment of COVID-19 included antibiotics (38.96%), thromboprophylaxis (25.97%), and nonsteroidal anti-inflammatory drugs, or paracetamol (25.97%).

RESULTS

The median (IQR) values of serum creatinine 3 months before the onset and 6 months after COVID-19 were 1.25 (0.98-1.86) and 1.26 (1.03-1.78) mg/dL (nonsignificant difference); in strata analysis, there were also no differences with regards to patients with higher and lower comorbidity (3 < Charlson Comorbidity Index < 3) and fragility (3 < Fragility Score < 3). Furthermore, creatinine concentration in KTRs and controls did not differ.

CONCLUSIONS

In the group of KTRs with a mild course of COVID-19, no negative impact of the infection on graft function was observed 6 months after transplantation.

摘要

背景

肾移植受者(KTR)感染严重急性呼吸综合征冠状病毒 2 的风险增加,死亡率为 13%至 30%以上。然而,关于 COVID-19 对康复后长期移植物功能的影响的数据尚缺乏。本研究旨在评估 COVID-19 对康复后 6 个月移植物功能的影响。

方法

对一组 1058 名 KTR 进行了一项纵向对照研究。在过去的 180 例 COVID-19 患者中,纳入了 77 名 KTR(45 名男性),平均年龄 50.57±13.37 岁,Charlson 合并症指数为 3(中位数;四分位距[IQR],3-5),脆弱指数为 3(中位数;IQR,3-3),且在急性 COVID-19 后至少 6 个月。最常见的症状是乏力(75.33%)、发热(74.03%)、咳嗽(51.95%)和食欲不振(48.05%)。33 名患者住院,无患者需要有创通气治疗,但 16 名患者需要氧疗支持。COVID-19 的治疗包括抗生素(38.96%)、血栓预防(25.97%)和非甾体抗炎药或对乙酰氨基酚(25.97%)。

结果

发病前 3 个月和 COVID-19 后 6 个月血清肌酐的中位数(IQR)值分别为 1.25(0.98-1.86)和 1.26(1.03-1.78)mg/dL(无显著差异);在分层分析中,对于合并症较高和较低(3<Charlson 合并症指数<3)和脆弱性较高和较低(3<脆弱性评分<3)的患者,也没有差异。此外,KTR 和对照组的肌酐浓度没有差异。

结论

在 COVID-19 轻度发作的 KTR 组中,感染对移植物功能没有负面影响,在移植后 6 个月观察到。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dee/8923994/cf6b2ccb70d0/gr1_lrg.jpg

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