Asmara I Gede Yasa, Agustriadi I Gusti Ngurah Ommy, Sujaya I Made, Thalib Salim Said, Lestari Rina, Fatrullah Suryani Padua, Widiasari Komang Sri Rahayu, Ajmala Indana Eva
Department of Internal Medicine, Faculty of Medicine, University of Mataram - West Nusa Tenggara General Hospital, Mataram, Indonesia.
Department of Pulmonology, Faculty of Medicine, University of Mataram - West Nusa Tenggara General Hospital, Mataram, Indonesia.
Caspian J Intern Med. 2024 Spring;15(2):273-279. doi: 10.22088/cjim.15.2.273.
The unique role of eosinophil in coronavirus disease 2019 (COVID-19) patients has been shown in several studies, but its role in end-stage kidney disease (ESKD) patients who contracted COVID-19 is less reported. This study investigated eosinopenia's predictive value as a mortality marker in ESKD patients with COVID-19.
It is a retrospective study of ESKD patients who contracted COVID-19 between May 2020 and October 2021 in West Nusa Tenggara General Hospital, Indonesia. Comparative analysis was carried out between the death dan survival group. Logistic regression analysis was done to investigate the role of eosinopenia on the outcome after controlling other significant variables.
The analyses included one hundred fifteen confirmed COVID-19 in ESKD patients. The average age was 50, 53% of patients were males, 41% were newly diagnosed with ESKD, and the mortality rate was 25.2%. This study's prevalence of eosinopenia, high neutrophil-to-lymphocyte ratio (NLR), and high C-reactive protein (CRP) in the nonsurvivors was 51.4%, 39.3%, and 30.8%, respectively. Diastolic blood pressure <90 mmHg (P=0.004), respiratory rate >22 x/minutes (P=0.011), oxygen saturation <93% (P=0.008), NLR >6 (p<0.001), eosinophil count <0.01 x10/uL (p<0.001), CRP >20 mg/L (P=0.047), and isolation hemodialysis (HD) therapy (p<0.001) were independently associated with mortality of COVID-19 in ESKD patients. However, on multivariate logistic regression analysis, eosinopenia (P=0.019) and HD (P=0.001) were risk factors that remained significant prognostic mortality factors.
Eosinopenia was common in ESKD patients with COVID-19, particularly in the death group. Eosinopenia at admission and HD during hospitalization were risk factors for COVID-19 mortality in ESKD patients.
多项研究已表明嗜酸性粒细胞在2019冠状病毒病（COVID-19）患者中的独特作用，但其在感染COVID-19的终末期肾病（ESKD）患者中的作用报道较少。本研究调查了嗜酸性粒细胞减少作为COVID-19的ESKD患者死亡标志物的预测价值。
这是一项对2020年5月至2021年10月期间在印度尼西亚西努沙登加拉总医院感染COVID-19的ESKD患者的回顾性研究。对死亡组和存活组进行了比较分析。在控制其他显著变量后，进行逻辑回归分析以研究嗜酸性粒细胞减少对结局的作用。
分析纳入了115例确诊感染COVID-19的ESKD患者。平均年龄为50岁，53%的患者为男性，41%为新诊断的ESKD患者，死亡率为25.2%。本研究中，非存活者嗜酸性粒细胞减少、高中性粒细胞与淋巴细胞比值（NLR）和高C反应蛋白（CRP）的患病率分别为51.4%、39.3%和30.8%。舒张压<90 mmHg（P=0.004）、呼吸频率>22次/分钟（P=0.011）、血氧饱和度<93%（P=0.008）、NLR>6（P<0.001）、嗜酸性粒细胞计数<0.01×10⁹/L（P<0.001）、CRP>20 mg/L（P=0.047）和隔离血液透析（HD）治疗（P<0.001）与ESKD患者COVID-19的死亡率独立相关。然而，在多变量逻辑回归分析中，嗜酸性粒细胞减少（P=0.019）和HD（P=0.001）是仍然显著的预后死亡风险因素。
嗜酸性粒细胞减少在感染COVID-19的ESKD患者中很常见，尤其是在死亡组。入院时嗜酸性粒细胞减少和住院期间进行HD是ESKD患者COVID-19死亡的风险因素。
