University of Bologna, Department of Medical and Surgical Sciences, Italy; Centre for Chronic Intestinal Failure, Clinical Nutrition and Metabolism Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.
Home Nutrition Support, Cleveland Clinic Foundation, Cleveland, OH, USA.
Clin Nutr ESPEN. 2023 Jun;55:212-220. doi: 10.1016/j.clnesp.2023.03.008. Epub 2023 Mar 30.
To investigate the incidence and the severity of COVID-19 infection in patients enrolled in the database for home parenteral nutrition (HPN) for chronic intestinal failure (CIF) of the European Society for Clinical Nutrition and Metabolism (ESPEN).
Period of observation: March 1st, 2020 March 1st, 2021.
patients included in the database since 2015 and still receiving HPN on March 1st, 2020 as well as new patients included in the database during the period of observation. Data related to the previous 12 months and recorded on March 1st 2021: 1) occurrence of COVID-19 infection since the beginning of the pandemic (yes, no, unknown); 2) infection severity (asymptomatic; mild, no-hospitalization; moderate, hospitalization no-ICU; severe, hospitalization in ICU); 3) vaccinated against COVID-19 (yes, no, unknown); 4) patient outcome on March 1st 2021: still on HPN, weaned off HPN, deceased, lost to follow up.
Sixty-eight centres from 23 countries included 4680 patients. Data on COVID-19 were available for 55.1% of patients. The cumulative incidence of infection was 9.6% in the total group and ranged from 0% to 21.9% in the cohorts of individual countries. Infection severity was reported as: asymptomatic 26.7%, mild 32.0%, moderate 36.0%, severe 5.3%. Vaccination status was unknown in 62.0% of patients, non-vaccinated 25.2%, vaccinated 12.8%. Patient outcome was reported as: still on HPN 78.6%, weaned off HPN 10.6%, deceased 9.7%, lost to follow up 1.1%. A higher incidence of infection (p = 0.04), greater severity of infection (p < 0.001) and a lower vaccination percentage (p = 0.01) were observed in deceased patients. In COVID-19 infected patients, deaths due to infection accounted for 42.8% of total deaths.
In patients on HPN for CIF, the incidence of COVID-19 infection differed greatly among countries. Although the majority of cases were reported to be asymptomatic or have mild symptoms only, COVID-19 was reported to be fatal in a significant proportion of infected patients. Lack of vaccination was associated with a higher risk of death.
调查纳入欧洲临床营养与代谢学会（ESPEN）家庭肠外营养（HPN）数据库的慢性肠道衰竭（CIF）患者中 COVID-19 感染的发生率和严重程度。
观察期：2020 年 3 月 1 日至 2021 年 3 月 1 日。
自 2015 年起纳入数据库且截至 2020 年 3 月 1 日仍接受 HPN 的患者，以及在观察期内纳入数据库的新患者。与前 12 个月相关的数据并于 2021 年 3 月 1 日记录：1）自大流行开始以来 COVID-19 感染的发生情况（是，否，未知）；2）感染严重程度（无症状；轻度，无需住院；中度，住院但无需 ICU；严重，住院 ICU）；3）COVID-19 疫苗接种情况（是，否，未知）；4）2021 年 3 月 1 日患者结局：仍在接受 HPN 治疗、已停用 HPN、死亡、失访。
来自 23 个国家的 68 个中心纳入了 4680 名患者。55.1%的患者提供了 COVID-19 相关数据。总人群的累积感染发生率为 9.6%，各国队列中的感染发生率范围为 0%至 21.9%。感染严重程度报告为：无症状 26.7%，轻度 32.0%，中度 36.0%，重度 5.3%。62.0%的患者疫苗接种状态未知，未接种疫苗占 25.2%，接种疫苗占 12.8%。患者结局报告为：仍在接受 HPN 治疗 78.6%，已停用 HPN 治疗 10.6%，死亡 9.7%，失访 1.1%。死亡患者的感染发生率更高（p=0.04），感染严重程度更高（p<0.001），疫苗接种比例更低（p=0.01）。在 COVID-19 感染患者中，感染导致的死亡占总死亡人数的 42.8%。
在接受 CIF 家庭肠外营养治疗的患者中，COVID-19 感染的发生率在各国之间差异很大。尽管大多数病例报告为无症状或仅有轻度症状，但 COVID-19 在很大比例的感染患者中被报告为致命的。缺乏疫苗接种与更高的死亡风险相关。
