血液透析患者SARS-CoV-2组粒变异感染的特点及预后因素:中国单中心研究

IF 2.2 3区医学 Q3 HEMATOLOGY

Blood Purification Pub Date : 2024-01-01 Epub Date: 2023-11-16 DOI:10.1159/000535244

Fan Zhang, Guoli Li, Jie Yu, Yiyu Shen, Yiya Yang, Shuangshuang Fu, Kanghan Liu, Yumei Liang, Xun Luo, Yinyin Chen

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引用次数: 0

摘要

前言:本研究旨在评价维持性血液透析(HD)患者的特点及预后因素。方法:选取2022年12月1日至2023年1月31日收治的所有感染了严重急性呼吸综合征冠状病毒2型(SARS-Cov-2)的HD患者。肺炎患者进一步分为轻、中、重、危重症。收集临床症状、实验室结果、放射学表现、治疗和临床结果。通过多变量回归分析确定进展为危重疾病和住院死亡率的独立危险因素。采用带曲线下面积(AUC)的受试者工作特征(ROC)分析评估发展危急状态和住院死亡率的预测性能。结果:共纳入182例COVID-19合并HD患者，平均年龄61.55岁。无肺炎84例(46.1%)，有肺炎98例(53.8%)。肺炎患者中，中度疾病48例(49.0%)，重度疾病26例(26.5%)，危重疾病24例(24.5%)。年龄[HR (95% CI): 1.07 (1.01-1.13)， p]结论:年龄、CRP、PCT和LDH可用于预测HD合并COVID-19肺炎患者的阴性临床结局。

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Characteristics and Prognostic Factors of SARS-CoV-2 Omicron Variant Infection in Hemodialysis Patients: A Single-Center Study in China.

Introduction: This study aimed to evaluate the characteristics and prognostic factors for coronavirus disease 2019 (COVID-19) patients on maintenance hemodialysis (HD).

Methods: All admitted HD patients who were infected with SARS-CoV-2 from December 1, 2022, to January 31, 2023, were included. Patients with pneumonia were further classified into the mild, moderate, severe, and critical illness. Clinical symptoms, laboratory results, radiologic findings, treatment, and clinical outcomes were collected. Independent risk factors for progression to critical disease and in-hospital mortality were determined by the multivariate regression analysis. The receiver operating characteristic analysis with the area under the curve was used to evaluate the predictive performance of developing critical status and in-hospital mortality.

Results: A total of 182 COVID-19 patients with HD were included, with an average age of the 61.55 years. Out of the total, 84 (46.1%) patients did not have pneumonia and 98 (53.8%) patients had pneumonia. Among patients with pneumonia, 48 (49.0%) had moderate illness, 26 (26.5%) severe illness, and 24 (24.5%) critical illness, respectively. Elder age [HR (95% CI): 1.07 (1.01-1.13), p <0.01], increased levels of lactate dehydrogenase (LDH) [1.01 (1.003-1.01), p <0.01], and C-reactive protein (CRP) [1.01 (1.00-1.01), p = 0.04] were risk factors for developing critical illness. Elder age [1.11 (1.03-1.19), p = 0.01], increased procalcitonin (PCT) [1.07 (1.02-1.12), p = 0.01], and LDH level [1.004 (1-1.01), p = 0.03] were factors associated with increased risk of in-hospital mortality.

Conclusion: Age, CRP, PCT, and LDH can be used to predict negative clinical outcomes for HD patients with COVID-19 pneumonia.

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.