Fisher Lori-Ann, Asnani Monika
Department of Medicine The University of the West Indies Mona Kingston Jamaica.
Caribbean Institute for Health Research The University of the West Indies Mona Kingston Jamaica.
EJHaem. 2023 Jan 7;4(1):37-44. doi: 10.1002/jha2.636. eCollection 2023 Feb.
Despite a high occurrence of acute kidney injury (AKI) with COVID-19 infection, there are no data on its incidence in sickle cell disease (SCD). We performed a single-center retrospective chart review of persons aged >1 year with SCD, COVID-19 infection and no prior dialysis requirement hospitalized from June 1, 2020 to May 31, 2022. Demographics, clinical, laboratory characteristics and outcomes were abstracted. AKI was defined using Kidney Disease Improving Global Outcomes (KDIGO) criteria. Of 38 patients meeting study criteria (60.6% female, mean age ± SD 38.6 ± 15.9 years), 3 (7.9%) were COVID vaccinated. Fifty-five percent (55%) developed AKI with 7.9% ( = 3) requiring dialysis. Participants with AKI were older (44.9 versus 30.8 years, = 0.005), with a higher proportion having baseline chronic kidney disease (52% versus 0%, = 0.001). Severe COVID infection [age-adjusted odds ratio (aOR): 8.93, 95%CI: 1.73-45.99, = 0.033], red cell transfusion (aOR 7.92, 1.47-42.69) and decrease in hemoglobin per unit from baseline (aOR 2.85, 1.24-2.28) were associated with AKI. Five persons died in hospital, with AKI resulting in higher median length of stay (12 versus 5 days, = 0.007). Targeted COVID-19 preventative measures and multinational longitudinal studies to ascertain the impact of AKI and COVID-19 infection in SCD are needed.
尽管新冠病毒感染常并发急性肾损伤（AKI），但关于镰状细胞病（SCD）中AKI发病率的数据尚无报道。我们对2020年6月1日至2022年5月31日期间住院的年龄大于1岁、患有SCD、感染新冠病毒且此前无需透析的患者进行了单中心回顾性病历审查。提取了人口统计学、临床、实验室特征及预后数据。AKI依据改善全球肾脏病预后组织（KDIGO）标准进行定义。在符合研究标准的38例患者中（女性占60.6%，平均年龄±标准差为38.6±15.9岁），3例（7.9%）接种了新冠疫苗。55%的患者发生了AKI，其中7.9%（n = 3）需要透析。发生AKI的患者年龄更大（44.9岁对30.8岁，P = 0.005），基线慢性肾脏病的比例更高（52%对0%，P = 0.001）。重症新冠病毒感染[年龄校正优势比（aOR）：8.93，95%置信区间（CI）：1.73 - 45.99，P = 0.033]、红细胞输血（aOR 7.92，1.47 - 42.69）以及血红蛋白较基线每单位下降（aOR 2.85，1.24 - 2.28）与AKI相关。5例患者在医院死亡；AKI导致中位住院时间更长（12天对5天，P = 0.007）。需要采取针对性的新冠病毒预防措施以及开展多国纵向研究，以确定AKI和新冠病毒感染对SCD的影响。
