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大流行医院中血液透析和肾移植患者 COVID-19 感染分析。

Analysis of COVID-19 infection in hemodialysis and kidney transplant patients in a pandemic hospital.

机构信息

Health Sciences University, Gazi Yaşargil Educational and Research Hospital, General Surgery Clinic, Organ Transplant Center, Diyarbakır, Turkey.

Health Sciences University, Gazi Yaşargil Educational and Research Hospital, Department of Nephrology, Organ Transplant Center, Diyarbakır, Turkey.

出版信息

J Infect Dev Ctries. 2022 Jun 30;16(6):1016-1024. doi: 10.3855/jidc.15829.

Abstract

INTRODUCTION

The mortality rate for any infection is often higher in patients with a kidney transplant (KT) and hemodialysis (HD), which may also be the case in novel coronavirus disease 2019 (COVID-19).

METHODOLOGY

In this study, the demographic, clinic, laboratory, and radiologic signs of KT and HD patients diagnosed with COVID-19 infection between 11th March 2020 and 11th March 2021 were evaluated prospectively.

RESULTS

In the present study, 72 HD (median age, 57.5 Q1-Q3:43-65; female: 36/50%) and 58 KT patients (median age, 44.5 Q1-Q3:28.75-55.25; female: 21/36.2%) with COVID-19 infection were enrolled. Fifteen patients with HD (20.8%) died. Age, diabetes mellitus (DM), abnormal hemoglobin levels, albumin, C-reactive protein (CRP), ferritin, D-dimer, and procalcitonin were significant in the univariate analysis of survival in patients with HD. However, only age was significant in the Cox-regression analysis [Hazard ratio (HR) (95% CI 1.070 (19.016-1.126)]. Nine (15.5%) KT patients died. The median time from symptoms onset to admission was three days (2-5). This rate was two (2-3) and five (4-5.75) days, respectively, for patients followed up in our center and the external centers (p < 0.001). Although age, DM, shortness of breath, bilateral involvement in CT images, abnormal levels of CRP, urea, leukocyte count, ferritin, and follow-ups of patients from the external center were significant in the univariate analysis of survival in patients with KT, no variables were significant in the cox-regression analysis.

CONCLUSIONS

Increased mortality is expected in both HD and KT patients. Early diagnosis of COVID-19 in those patients with COVID-19 infection can be life-saving.

摘要

简介

肾移植(KT)和血液透析(HD)患者的任何感染死亡率通常都较高,在新型冠状病毒病 2019(COVID-19)中也可能如此。

方法

本研究前瞻性评估了 2020 年 3 月 11 日至 2021 年 3 月 11 日期间诊断为 COVID-19 感染的 KT 和 HD 患者的人口统计学、临床、实验室和影像学特征。

结果

本研究纳入了 72 例 HD(中位年龄,四分位距 1-Q3:43-65;女性:36/50%)和 58 例 KT 患者(中位年龄,四分位距 1-Q3:28.75-55.25;女性:21/36.2%)。15 例 HD 患者(20.8%)死亡。年龄、糖尿病(DM)、血红蛋白水平异常、白蛋白、C 反应蛋白(CRP)、铁蛋白、D-二聚体和降钙素原在 HD 患者生存的单因素分析中具有显著意义。然而,只有年龄在 Cox 回归分析中具有显著意义[风险比(HR)(95%置信区间 1.070(19.016-1.126)]。9 例(15.5%)KT 患者死亡。症状出现到入院的中位时间为 3 天(2-5)。在本中心和外部中心接受随访的患者,这一比例分别为 2(2-3)和 5(4-5.75)天(p<0.001)。虽然年龄、DM、呼吸急促、CT 图像双侧受累、CRP、尿素、白细胞计数、铁蛋白异常水平以及外部中心患者的随访在 KT 患者生存的单因素分析中具有显著意义,但 Cox 回归分析中没有变量具有显著意义。

结论

HD 和 KT 患者的死亡率预计会增加。对 COVID-19 感染患者进行早期 COVID-19 诊断可以挽救生命。

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