Teng Lanbo, Sun Na, Chang Wenxiu
Department of Nephrology, Tianjin First Central Hospital, Key Laboratory of Critical Care Emergency Medicine of National Health Commission, Tianjin 300110, China. Corresponding author: Chang Wenxiu, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022 May;34(5):465-470. doi: 10.3760/cma.j.cn121430-20220328-00303.
To investigate the incidence and clinical characteristics of renal involvement with Omicron coronavirus infection in age-based stratified patients.
The first batch of 430 convalescent patients with Omicron coronavirus treated in Tianjin First Central Hospital from January 21, 2022 to March 7, 2022 were enrolled in this study. The baseline information, vaccination status and laboratory examination information of patients were extracted in order to analyze the incidence of renal involvement in age-based stratified patients. Multivariate Logistic regression analysis was conducted to determine the risk factors of renal involvement in different age groups.
Excluding those younger than 1 year old and those with a history of chronic kidney disease, a total of 421 patients were included. There were 184 males and 237 females with an average age of (36.65±21.28) years. The types of renal involvement included pathological tubular urine (28.9%), proteinuria (16.9%), renal hematuria (14.7%), a slight decrease of estimated glomerular filtration rate (eGFR, 9.3%), renal glycosuria (0.5%). According to their age, all patients were divided into three groups: 113 cases of ≤ 18 years old, 244 cases of 19-59 years old and 64 cases of ≥ 60 years old. Significant difference was founded in the incidence of renal involvement among the three groups. The incidence of proteinuria, pathological tubular urine and slight decline of eGFR in the ≥ 60 years old group were significantly higher than those in the ≤ 18 years old group [28.1% (18/64) vs. 8.0% (9/112), 42.2% (27/64) vs. 19.6% (22/112), 34.9% (22/63) vs. 6.2% (7/113), respectively, all P < 0.01]. The incidence of slight decline of eGFR was significantly higher than that in 19-59 years old group [34.9% (22/63) vs. 4.1% (10/243), P < 0.01]. Multivariate Logistic regression analysis showed that age was significantly correlated with renal involvement after adjusting for the baseline situation, serological indexes and Omicron infection related indexes [odds ratio (OR) = 1.059, 95% confidence interval (95%CI) was 1.021-1.097, P = 0.002]. Compared with the group ≤ 18 years old, the risk of renal involvement in the group ≥ 60 years old was significantly increased (OR = 26.245, 95%CI was 1.357-507.458, P = 0.031). Age ≥ 60 years old was an independent risk factor for renal involvement with Omicron coronavirus infection.
Although a low incidence of severe cases in Tianjin first batch of 430 patients with Omicron coronavirus infection, there is still a high incidence of renal involvement. Advanced age is the risk factor of renal involvement. We should pay more attention to the renal involvement of elderly with Omicron coronavirus infection.
探讨不同年龄分层的奥密克戎冠状病毒感染患者肾脏受累的发生率及临床特征。
选取2022年1月21日至2022年3月7日在天津市第一中心医院接受治疗的首批430例奥密克戎冠状病毒感染康复患者纳入本研究。提取患者的基线信息、疫苗接种情况及实验室检查信息，分析不同年龄分层患者肾脏受累的发生率。进行多因素Logistic回归分析，以确定不同年龄组肾脏受累的危险因素。
排除年龄小于1岁及有慢性肾脏病病史者，共纳入421例患者。其中男性184例，女性237例，平均年龄（36.65±21.28）岁。肾脏受累类型包括病理性肾小管尿（28.9%）、蛋白尿（16.9%）、肾性血尿（14.7%）、估算肾小球滤过率轻度下降（eGFR, 9.3%）、肾性糖尿（0.5%）。根据年龄将所有患者分为三组：≤18岁组113例、19 - 59岁组244例、≥60岁组64例。三组患者肾脏受累发生率存在显著差异。≥60岁组蛋白尿、病理性肾小管尿及eGFR轻度下降的发生率显著高于≤18岁组[分别为28.1%（18/64）对8.0%（9/112）、42.2%（27/64）对19.6%（22/112）、34.9%（22/63）对6.2%（7/113），均P <0.01]；eGFR轻度下降的发生率显著高于19 - 59岁组[34.9%（22/63）对4.1%（10/243），P <0.01]。多因素Logistic回归分析显示，在调整基线情况、血清学指标及奥密克戎感染相关指标后，年龄与肾脏受累显著相关[比值比（OR）=1.059，95%置信区间（95%CI）为1.021 - 1.097，P =0.002]。与≤18岁组相比，≥60岁组肾脏受累风险显著增加（OR =26.245，95%CI为1.357 - 507.458，P =0.031）。年龄≥60岁是奥密克戎冠状病毒感染患者肾脏受累的独立危险因素。
天津市首批430例奥密克戎冠状病毒感染患者重症发生率虽低，但肾脏受累发生率仍较高。高龄是肾脏受累的危险因素。应更加关注奥密克戎冠状病毒感染老年患者的肾脏受累情况。
