Department of Nephrology, Wuhan No. 1 Hospital, Wuhan, China.
Medicine (Baltimore). 2023 Sep 8;102(36):e35063. doi: 10.1097/MD.0000000000035063.
Maintenance hemodialysis (MHD) patients are the high-risk population of infection and death of novel coronavirus disease 2019 (COVID-19), our study aimed to investigate the infection status and clinical characteristics of COVID-19 in MHD patients at a single-center in Wuhan during the Omicron pandemic. In this retrospective, single-center study, we analyzed the clinical data of all MHD patients in Hemodialysis Center of Wuhan No. 1 Hospital from December 2, 2022 to January 6, 2023 during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron pandemic outbreak. We analyzed the epidemiological and clinical characteristics of deaths and survivors of MHD patients. The infection rate of SARS-CoV-2 in MHD patients was 93.32% (573/614), mortality rate was 8.14% (50/614), hospitalization rate was 23.29% (143/614), and the vaccination rate of COVID-19 was 4.89% (30/614). The median survival time of dead patients was 11 days, the mortality rate of male MHD patients was significantly higher than female. Elderly MHD patients had a higher mortality rate, with a average age of death higher than 70 years old. Additionally, the mortality rate of MHD patients infected with SARS-CoV-2 was higher if the primary disease was hypertensive renal damage or diabetic nephropathy. Laboratory results showed that the lower the albumin level and the higher the C-reactive protein level of MHD patients who died of SARS-CoV-2 infection and severe and critical survival patients. In surviving MHD patients infected with SARS-CoV-2, the most common symptoms were hypodynamia (84.70%), decreased appetite (81.26%) and cough (80.69%). The symptoms of fever, chest tightness and panting, cough, pharyngalgia, hypodynamia, decreased appetite in surviving MHD patients with severe and critical type were significantly higher than those in patients with mild and moderate type. MHD patients are a highly vulnerable population at increased risk of mortality during the Omicron pandemic. Elderly, male, primary disease was hypertensive renal damage or diabetic nephropathy, hypoproteinemia and high C-reactive protein level, all of which will lead to increased mortality in MHD patients.
维持性血液透析（MHD）患者是感染和死于 2019 年新型冠状病毒病（COVID-19）的高危人群，本研究旨在调查奥密克戎大流行期间武汉某单一中心 MHD 患者 COVID-19 的感染状况和临床特征。在这项回顾性、单中心研究中，我们分析了 2022 年 12 月 2 日至 2023 年 1 月 6 日期间武汉第一医院血液透析中心所有 MHD 患者的临床资料。我们分析了 MHD 患者死亡和幸存者的流行病学和临床特征。MHD 患者 SARS-CoV-2 感染率为 93.32%（573/614），死亡率为 8.14%（50/614），住院率为 23.29%（143/614），COVID-19 疫苗接种率为 4.89%（30/614）。死亡患者的中位生存时间为 11 天，男性 MHD 患者的死亡率明显高于女性。老年 MHD 患者死亡率较高，平均死亡年龄高于 70 岁。此外，如果原发性疾病是高血压肾损害或糖尿病肾病，MHD 患者感染 SARS-CoV-2 的死亡率较高。实验室结果表明，死于 SARS-CoV-2 感染和严重及危重症存活患者的 MHD 患者白蛋白水平越低，C 反应蛋白水平越高。在感染 SARS-CoV-2 的存活 MHD 患者中，最常见的症状是乏力（84.70%）、食欲不振（81.26%）和咳嗽（80.69%）。在严重和危重症的存活 MHD 患者中，发热、胸闷、喘息、咳嗽、咽痛、乏力、食欲不振的症状明显高于轻症和中度患者。MHD 患者是奥密克戎大流行期间死亡率增加的高危人群。老年、男性、原发性疾病为高血压肾损害或糖尿病肾病、低蛋白血症和高 C 反应蛋白水平都会导致 MHD 患者死亡率增加。
