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影响患有慢性肾脏病的COVID-19患者死亡率的因素。

Factors Affecting Mortality in COVID-19 Patients with Pre-Existing Chronic Kidney Disease.

作者信息

Shyama Shyama, Vardhan Harsh, Ojha Vishnu Shankar, Biswas Ratnadeep, Ahmad Shamshad, Kumar Amit

机构信息

Department of General Medicine, All India Institute of Medical Sciences, Patna, Bihar, India.

Department of Nephrology, Patna Medical College, All India Institute of Medical Sciences, Patna, Bihar, India.

出版信息

Indian J Nephrol. 2024 Nov-Dec;34(6):643-645. doi: 10.25259/IJN_67_2024. Epub 2024 Jun 29.

DOI:10.25259/IJN_67_2024
PMID:39649310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11619041/
Abstract

The emergence of COVID-19 triggered a global health crisis, sparking concerns within the medical community about its interaction with chronic kidney disease (CKD) and the heightened vulnerability of individuals with compromised renal function to severe viral infection and mortality. This retrospective study encompassed all adult patients with laboratory-confirmed COVID-19 and pre-existing CKD admitted between May 2020 and May 2023. Their demographic data, relevant clinical parameters, and laboratory values were collected. Kaplan-Meier curve analysis and Log Rank test were employed to compare survival times between CKD patients and those developing acute kidney injury (AKI), while Cox regression analyses were conducted to pinpoint factors influencing the hazard of a fatal outcome. The study, involving 150 COVID-19 patient records with pre-existing CKD, revealed that male gender, advanced age, requirement for invasive ventilation, and elevated levels of inflammatory markers such as total leukocyte count, lactate dehydrogenase, C-reactive protein, D-dimer, and IL-6 significantly increased the risk of death. These findings underscore the necessity for tailored care and meticulous management in COVID-19 patients with coexisting CKD, emphasizing the importance of addressing factors such as gender, age, and inflammatory status to mitigate mortality risks effectively.

摘要

新冠病毒病(COVID-19)的出现引发了一场全球健康危机,引发了医学界对其与慢性肾脏病(CKD)相互作用的担忧,以及肾功能受损个体对严重病毒感染和死亡的更高易感性。这项回顾性研究纳入了2020年5月至2023年5月期间所有实验室确诊为COVID-19且患有CKD的成年患者。收集了他们的人口统计学数据、相关临床参数和实验室值。采用Kaplan-Meier曲线分析和Log Rank检验比较CKD患者与发生急性肾损伤(AKI)患者的生存时间,同时进行Cox回归分析以确定影响致命结局风险的因素。该研究涉及150份患有CKD的COVID-19患者记录,结果显示男性、高龄、需要有创通气以及炎症标志物水平升高,如总白细胞计数、乳酸脱氢酶、C反应蛋白、D-二聚体和白细胞介素-6,均显著增加死亡风险。这些发现强调了对合并CKD的COVID-19患者进行个性化护理和精心管理的必要性,突出了应对性别、年龄和炎症状态等因素以有效降低死亡风险的重要性。

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本文引用的文献

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Acute Kidney Injury in COVID-19.新型冠状病毒肺炎相关急性肾损伤。
Int J Mol Sci. 2021 Jul 28;22(15):8081. doi: 10.3390/ijms22158081.
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Relative lymphocytosis in COVID-19 - a ray of hope.新型冠状病毒肺炎中的相对淋巴细胞增多——一线希望。
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