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新冠病毒检测呈阳性的维持性血液透析患者的临床特征及预后：一项来自印度的研究。

Clinical Characteristics and Outcomes of COVID-Positive Maintenance Hemodialysis Patients: A Study from India.

作者信息

Yadla Manjusha, Vadakkeveetil Anupama Kankokkaran

机构信息

Department of Nephrology, Gandhi Medical College, Hyderabad, Telangana, India.

出版信息

Indian J Nephrol. 2024 Sep-Oct;34(5):448-452. doi: 10.25259/ijn_288_21. Epub 2024 Jul 15.

DOI:10.25259/ijn_288_21
PMID:39372615
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11450881/
Abstract

BACKGROUND

This study describes to the clinical features and outcomes of patients on maintenance hemodialysis infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant.

MATERIALS AND METHODS

This was a retrospective analysis of case records of patients on maintenance hemodialysis admitted for management of coronavirus disease (COVID) infection. Our teaching hospital, being a state-designated referral center, had COVID admissions from March 2020 till December 2020. Epidemiological and clinical data were collected and analyzed. Factors influencing survival and the survival curve analysis were assessed.

RESULTS

Of a total of 21,228 admissions during the period, 400 patients were referred for nephrology services. Of the 400 referrals, 226 were maintenance hemodialysis patients. Mean age of the group was 50 years, and fever was the most common presenting symptom. On multivariate analysis, factors influencing mortality were found to be older age, presence of diabetes, leukopenia, thrombocytopenia, hypoxemia, need for support, and a higher qSOFA score. The probability of survival of dialysis patients at the end of 19 days was 60%.

CONCLUSION

During the pandemic by SARS-CoV-2 delta variant, majority of the nephrology referrals were for maintenance hemodialysis patients. Mortality was 38% in the study group, and the factors associated with mortality with a significant hazard ratio were older age and diabetes.

摘要

背景

本研究描述了感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）德尔塔变异株的维持性血液透析患者的临床特征和预后。

材料与方法

这是一项对因冠状病毒病（COVID）感染入院治疗的维持性血液透析患者病例记录的回顾性分析。我们的教学医院作为国家指定的转诊中心，在2020年3月至2020年12月期间接收了COVID患者。收集并分析了流行病学和临床数据。评估了影响生存的因素和生存曲线分析。

结果

在此期间的21228例入院患者中，400例被转诊至肾病科。在这400例转诊患者中，226例为维持性血液透析患者。该组患者的平均年龄为50岁，发热是最常见的首发症状。多因素分析发现，影响死亡率的因素包括年龄较大、患有糖尿病、白细胞减少、血小板减少、低氧血症、需要支持以及qSOFA评分较高。透析患者在19天结束时的生存概率为60%。

结论

在SARS-CoV-2德尔塔变异株大流行期间，大多数肾病转诊患者为维持性血液透析患者。研究组的死亡率为38%，与死亡率相关且具有显著风险比的因素是年龄较大和患有糖尿病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/a6b9719b5ee1/IJN-34-5-448-g6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/0d8b94576981/IJN-34-5-448-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/9a4fc6244774/IJN-34-5-448-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/9bfb9f49025e/IJN-34-5-448-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/7f021de8f7f8/IJN-34-5-448-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/a9cb56fd72b7/IJN-34-5-448-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/a6b9719b5ee1/IJN-34-5-448-g6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/0d8b94576981/IJN-34-5-448-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/9a4fc6244774/IJN-34-5-448-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/9bfb9f49025e/IJN-34-5-448-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/7f021de8f7f8/IJN-34-5-448-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/a9cb56fd72b7/IJN-34-5-448-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefe/11450881/a6b9719b5ee1/IJN-34-5-448-g6.jpg

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本文引用的文献

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Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe.欧洲透析患者和肾移植受者的 ERA-EDTA 注册中心研究结果表明，他们因 COVID-19 导致的死亡率很高。
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Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients.
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Outcomes of patients with end-stage kidney disease hospitalized with COVID-19.伴有 COVID-19 的终末期肾病患者的住院结果。
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COVID-19 Outbreak in a Large Hemodialysis Center in Lombardy, Italy.意大利伦巴第大区一家大型血液透析中心的新冠疫情。
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J Am Soc Nephrol. 2020 Aug;31(8):1815-1823. doi: 10.1681/ASN.2020040534. Epub 2020 Jun 19.
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COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain.COVID-19：西班牙 36 名血液透析患者的临床病程和转归。
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A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection.布雷西亚肾脏 COVID 工作组关于 SARS-CoV-2 感染血液透析患者的临床特征和短期结局的报告。
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