Wang Xiaolong, Cao Xueying, Liang Shuang, Cai Guangyan
Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing, People's Republic of China.
Ther Clin Risk Manag. 2024 May 18;20:275-288. doi: 10.2147/TCRM.S458859. eCollection 2024.
To investigate the clinical characteristics of hospitalized patients with chronic kidney disease (CKD) and novel coronavirus (SARS-CoV-2) infection and identify potential risk factors that contribute to mortality.
This is a retrospective study, conducted on patients with CKD who were admitted to the First Medical Center of the People's Liberation Army General Hospital between December 1, 2022, and February 28, 2023. All patients were also infected with SARS-CoV-2. We analyzed the clinical characteristics of patients, and the patients were categorized into a survival group and a death group whose characteristics were compared. Cox regression analysis was used to identify risk factors that affected patient prognosis.
A total of 406 patients were enrolled in this study, including 298 males (73.4%). The average age was 80.5 (67.0, 88.0) years, and the patients had an average estimated glomerular filtration rate (eGFR) of 50.3 (25.0-79.0) mL/min/1.73m². A total of 158 individuals died during hospitalization, resulting in a mortality rate of 38.9%. Renal function was worse in the death group than in the survival group (P < 0.001). Patients in the death group had more severe COVID-19 disease and higher CKD staging than those in the survival group (all P values < 0.001). Multivariate Cox regression analysis identified several risk factors that affected patient mortality, including being male, a higher resting heart rate (RHR) upon admission, dyspnea, a low lymphocyte count (Lym), a high international standardized ratio (INR), a high Acute Physiology and Chronic Health Evaluation II (APACHE II) score, heart failure, and the need for mechanical ventilation during the disease.
Hospitalized patients with CKD who were infected with SARS-CoV-2 (38.9%) had a relatively high mortality rate (38.9%). Furthermore, a marked correlation was observed between a reduced eGFR and an increased risk of mortality.
探讨慢性肾脏病（CKD）合并新型冠状病毒（SARS-CoV-2）感染住院患者的临床特征，并确定导致死亡的潜在危险因素。
本研究为回顾性研究，对象为2022年12月1日至2023年2月28日期间入住中国人民解放军总医院第一医学中心的CKD患者。所有患者均感染了SARS-CoV-2。我们分析了患者的临床特征，并将患者分为生存组和死亡组，比较两组特征。采用Cox回归分析确定影响患者预后的危险因素。
本研究共纳入406例患者，其中男性298例（73.4%）。平均年龄为80.5（67.0，88.0）岁，患者的平均估算肾小球滤过率（eGFR）为50.3（25.0 - 79.0）mL/min/1.73m²。共有158例患者在住院期间死亡，死亡率为38.9%。死亡组的肾功能比生存组更差（P < 0.001）。与生存组相比，死亡组患者的新型冠状病毒肺炎病情更严重，CKD分期更高（所有P值均< 0.001）。多因素Cox回归分析确定了几个影响患者死亡率的危险因素，包括男性、入院时静息心率（RHR）较高、呼吸困难、淋巴细胞计数（Lym）较低、国际标准化比值（INR）较高、急性生理与慢性健康状况评分系统II（APACHE II）评分较高、心力衰竭以及疾病期间需要机械通气。
感染SARS-CoV-2的CKD住院患者死亡率相对较高（38.9%）。此外，观察到eGFR降低与死亡风险增加之间存在显著相关性。
