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COVID-19 疫情对糖尿病肾病患者随访队列的影响调查研究。

COVID-19 epidemic investigation study of a follow-up cohort of patients with diabetic kidney disease.

机构信息

Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, China.

出版信息

Front Cell Infect Microbiol. 2024 Aug 20;14:1388260. doi: 10.3389/fcimb.2024.1388260. eCollection 2024.

Abstract

INTRODUCTION

The impact of coronavirus disease 2019 (COVID-19) on diabetic kidney disease (DKD) patients in China is not fully understood. This study aimed to investigate infection status in a DKD cohort post-renal biopsy and analyze vaccination and infection rates, as well as symptom severity, across various renal pathologies in DKD patients.

METHODS

This epidemiological survey, centered on COVID-19, employed a Chinese DKD and renal puncture follow-up cohort. A customized questionnaire enabled standardized data gathering. It collected data on clinical characteristics, vaccination and infection statuses, and diverse pathological types. The study analyzed the relationship between vaccination and infection statuses across various pathological types, evaluating characteristics and treatment outcomes in patients with infections.

RESULTS

In total, 437 patients with DKD from 26 Chinese provinces were followed up for a median of 44.6 ± 20 months. COVID-19 infection, vaccination, and novel coronavirus pneumonia (NCP) rates were 73.68%, 59.3%, and 6.63%, respectively. Ten patients with NCP had severe pneumonia or died of COVID-19. Renal pathology revealed that 167 (38.22%) patients had diabetic nephropathy (DN), 171 (39.13%) had non-diabetic renal disease (NDRD), and 99 had DN and NDRD (22.65%). The DN group had the lowest vaccination (54.5%), highest all-cause mortality (3.6%), and highest endpoint rates (34.10%). Compared to patients who were not vaccinated pre-infection (117 cases), vaccinated patients (198 cases) had reduced NCP (6.6% vs. 13.7%), severity (1.0% vs. 3.4%), and endpoint (9.10% vs. 31.60%) rates.

CONCLUSION

Vaccination can prevent infection and diminish COVID-19 severity in patients with DKD; therefore, increasing vaccination rates is particularly important.

CLINICAL TRIAL REGISTRATION

ClinicalTrails.gov, NCT05888909.

摘要

简介

新型冠状病毒 2019(COVID-19)对中国糖尿病肾病(DKD)患者的影响尚不完全清楚。本研究旨在调查肾活检后 DKD 队列的感染状况,并分析不同 DKD 病理类型患者的疫苗接种和感染率以及症状严重程度。

方法

这项以 COVID-19 为中心的流行病学调查采用了中国 DKD 和肾穿刺随访队列。使用定制的问卷进行标准化数据收集。它收集了临床特征、疫苗接种和感染状况以及各种病理类型的数据。该研究分析了不同病理类型之间疫苗接种和感染状况的关系,评估了感染患者的特征和治疗结果。

结果

共随访了来自中国 26 个省份的 437 名 DKD 患者,中位随访时间为 44.6±20 个月。COVID-19 感染、疫苗接种和新型冠状病毒肺炎(NCP)的发生率分别为 73.68%、59.3%和 6.63%。10 名 NCP 患者患有严重肺炎或因 COVID-19 死亡。肾脏病理显示 167 例(38.22%)患者患有糖尿病肾病(DN),171 例(39.13%)患者患有非糖尿病肾病(NDRD),99 例患者患有 DN 和 NDRD(22.65%)。DN 组疫苗接种率最低(54.5%),全因死亡率最高(3.6%),终点发生率最高(34.10%)。与未感染前未接种疫苗的患者(117 例)相比,接种疫苗的患者(198 例)NCP 发生率(6.6% vs. 13.7%)、严重程度(1.0% vs. 3.4%)和终点(9.10% vs. 31.60%)发生率均降低。

结论

疫苗接种可以预防 DKD 患者的感染并减轻 COVID-19 的严重程度,因此,提高疫苗接种率尤为重要。

临床试验注册

ClinicalTrials.gov,NCT05888909。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd69/11368908/dd54418f02f9/fcimb-14-1388260-g001.jpg

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