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终末期肾病合并重症冠状病毒病患者:肾脏病科的临床特征、生物学数据及死亡率,简短通讯

End-stage kidney disease patients with severe coronavirus disease: clinical characteristics, biological data, and mortality in nephrology unit, short communication.

作者信息

Ramdani Malika, Oujidi Hanae, Elmaghraoui Hicham, Abda Naima, Bentata Yassamine

机构信息

Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine Oujda.

Nephrology-Dialysis and Kidney Transplantation Unit, University Hospital Mohammed VI, University Mohammed Premier, Oujda, Morocco.

出版信息

Ann Med Surg (Lond). 2023 Jun 28;85(8):4182-4186. doi: 10.1097/MS9.0000000000000962. eCollection 2023 Aug.

Abstract

UNLABELLED

Patients suffering from end-stage kidney disease (ESKD) are particularly vulnerable to SARS-CoV-2 infection, and their risk of death is higher than for the general population. The objective was to determine the epidemiologic profile at admission and mortality among patients presenting EKSD with severe coronavirus disease (COVID-19).

METHODS

A retrospective study was conducted in the Nephrology unit between October 2020 and February 2022. Were included all adult patients who presented ESKD on dialysis, or not on dialysis with an estimated glomerular filtration rate less than or equal to 15 ml/min/1.73 m and presenting a confirmed COVID-19. Patients with ESKD who were immediately admitted to the ICU were excluded.

RESULTS

Sixty-five patients' data were collected. The mean age was 58.9 ±16.7 years and 60% were males. Hypertension arterial and diabetes observed in 75% and 56.3% of cases, respectively. 52.3% were on haemodialysis, 4.6% were on peritoneal dialysis and 43.1% not were on dialysis. 94% of the patients were symptomatic of COVID-19, dominated by dyspnoea (87.5%), cough (65.6%), and fever (58.5%). More than half of patients (58.5%) showed signs of gravity and 62% required oxygen therapy. According to thoracic scan, 72.3% were classified COVID-19 Raw Data System 5 and 6. Most patients had severe anaemia (58.5%), lymphopenia (81.3%), and high levels of C-reactive protein (54%), D-Dimer (93.6%) and ferritin (91.2%). 38.5% of patients presented complications of whom 60% were transferred to ICU. Mortality was observed in 8% of cases.

CONCLUSION

Rigorous monitoring is necessary for patients in ESKD, particularly those with comorbidities, to reduce the risk of severe form of COVID-19.

摘要

未标注

终末期肾病(ESKD)患者特别容易感染新型冠状病毒2(SARS-CoV-2),其死亡风险高于普通人群。目的是确定患有严重冠状病毒病(COVID-19)的ESKD患者入院时的流行病学特征和死亡率。

方法

于2020年10月至2022年2月在肾脏病科进行了一项回顾性研究。纳入所有患有ESKD且正在透析或估计肾小球滤过率小于或等于15 ml/min/1.73 m²且未透析且确诊为COVID-19的成年患者。立即入住重症监护病房(ICU)的ESKD患者被排除。

结果

收集了65例患者的数据。平均年龄为58.9±16.7岁,60%为男性。分别在75%和56.3%的病例中观察到动脉高血压和糖尿病。52.3%接受血液透析,4.6%接受腹膜透析,43.1%未接受透析。94%的患者有COVID-19症状,以呼吸困难(87.5%)、咳嗽(65.6%)和发热(58.5%)为主。超过一半的患者(58.5%)显示出病情严重的迹象,62%需要氧疗。根据胸部扫描,72.3%被归类为COVID-19原始数据系统5级和6级。大多数患者有严重贫血(58.5%)、淋巴细胞减少(81.3%)以及高水平的C反应蛋白(54%)、D-二聚体(93.6%)和铁蛋白(91.2%)。38.5%的患者出现并发症,其中60%被转入ICU。8%的病例观察到死亡。

结论

对于ESKD患者,尤其是患有合并症的患者,进行严格监测对于降低COVID-19重症风险是必要的。

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Initial Effects of COVID-19 on Patients with ESKD.COVID-19 对 ESKD 患者的初始影响。
J Am Soc Nephrol. 2021 Jun 1;32(6):1444-1453. doi: 10.1681/ASN.2021010009. Epub 2021 Apr 8.

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