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奥密克戎疫情期间上海不同肾功能状态 COVID-19 患者的临床特征和转归。

Clinical characteristics and outcomes of COVID-19 patients with varying renal functions statuses during the Omicron pandemic in Shanghai.

机构信息

Department of Nephrology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.

Institute of Nephrology, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.

出版信息

BMC Nephrol. 2023 Aug 24;24(1):253. doi: 10.1186/s12882-023-03258-3.

Abstract

OBJECTIVE

This study aims to provide an academic summary of the clinical characteristics, outcomes and risk factors associated with prolonged hospital stays among the patients with varying renal function statuses during the Omicron pandemic in Shanghai.

METHODS

Clinical data was collected from COVID-19 patients admitted to Shanghai Jiaotong University School of Medicine Ruijin Hospital Northern District. Based on their baseline eGFR, the patients were divided into three groups: Group A (eGFR > = 90ml/min/1.73m, n = 384), Group B (15ml/min/1.73m < = eGFR < 90ml/min/1.73m, n = 220), and Group C (Hemodialysis-dependent patient, n = 92). Clinical characteristics and laboratory data were compared among the three groups. The cumulative hazards of ICU admission were compared using the Kaplan-Meier method. Univariate and multivariate linear regression analyses were conducted to identify the factors influencing the duration of positive nucleic acid test.

RESULTS

Between March 25, 2022, and May 31, 2022, a total of 696 COVID-19 patients were included in the study. Among the dialysis patients, 92% (85) of dialysis patients had not received any COVID-19 vaccination, and 14.1%(13) of hemodialysis (HD) patients eventually progressed to severe or critical cases. A total of 13 (2.15%) patients were admitted to the ICU, with 8 (61.5%) were HD patients. The duration of nucleic acid positivity showed a negative correlation with eGFR (B: -0.048, 95%CI: -0.059-0.037, P = 0.000), platelet counts (B: -0.011, 95%CI: -0.017-0.005, P = 0.001) or lymphocyte counts (B: -0.658, 95%CI: -1.229~-0.086, P = 0.024).

CONCLUSIONS

The majority of Omicron patients have a favorable prognosis, while HD patients experience relatively poorer outcomes and higher rates of ICU admission. Decreased eGFR and low lymphocyte/platelet counts are the important risk factors associated with prolonged Omicron infection.

摘要

目的

本研究旨在提供一份学术总结,阐述上海奥密克戎疫情期间不同肾功能状态患者的临床特征、结局和与住院时间延长相关的危险因素。

方法

从上海交通大学医学院附属瑞金医院北部院区收治的 COVID-19 患者中收集临床数据。根据患者的基线 eGFR,将其分为三组:A 组(eGFR≥90ml/min/1.73m,n=384)、B 组(15ml/min/1.73m≤eGFR<90ml/min/1.73m,n=220)和 C 组(血液透析依赖患者,n=92)。比较三组的临床特征和实验室数据。采用 Kaplan-Meier 法比较 ICU 入住的累积风险。采用单因素和多因素线性回归分析确定影响核酸检测阳性持续时间的因素。

结果

2022 年 3 月 25 日至 2022 年 5 月 31 日,共纳入 696 例 COVID-19 患者。在透析患者中,92%(85 例)的透析患者未接种任何 COVID-19 疫苗,14.1%(13 例)的血液透析(HD)患者最终发展为重症或危重症。共有 13 例(2.15%)患者转入 ICU,其中 8 例(61.5%)为 HD 患者。核酸阳性持续时间与 eGFR 呈负相关(B:-0.048,95%CI:-0.059-0.037,P=0.000)、血小板计数(B:-0.011,95%CI:-0.017-0.005,P=0.001)或淋巴细胞计数(B:-0.658,95%CI:-1.229~-0.086,P=0.024)。

结论

奥密克戎患者的预后大多良好,而血液透析患者的结局较差,入住 ICU 的比例较高。较低的 eGFR 和低的淋巴细胞/血小板计数是与奥密克戎感染持续时间延长相关的重要危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f1c/10463636/c74900ec8c53/12882_2023_3258_Fig1_HTML.jpg

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