Covid-19大流行对常染色体显性多囊肾成人患者的影响:一项横断面研究

Alok Shetty, Anthony Atalla, Charalett Diggs, Terry Watnick, Stephen Seliger
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引用次数: 0

摘要

背景 Covid-19 大流行极大地影响了慢性病患者,影响了他们获得医疗服务和寻求医疗服务的行为。该流行病对常染色体显性遗传多囊肾病(ADPKD)成人患者的影响尚未进行调查。方法 从马里兰大学一项纵向研究的 239 名 ADPKD 患者中招募参与者。正在接受肾脏替代治疗的患者除外。N = 66 名患者参加了 2022 年 6 月至 2022 年 12 月的电话问卷调查,内容涉及 ADPKD 相关并发症、对感染 Covid-19 的担忧、2020 年 3 月前后的医疗保健寻求行为和远程医疗利用情况。结果 N = 34(51.5%)名参与者报告了阳性的 Covid-19 检测结果,N = 29(44%)名参与者表示非常担心感染 Covid-19。至少有一次避免就医的参与者(17 人,占 25.8%)与没有避免就医的参与者具有相似的人口统计学特征和 ADPKD 严重程度,但报告了更多的远程医疗使用率(88.2% 对 42.9%,p = 0.002),更多使用非处方药物治疗或预防 Covid-19 (35.3% 对 8.2%,p = 0.01),并且更有可能感染 Covid-19(76.5% 对 42.9%,p = 0.02)。在大流行前报告 ADPKD 疾病管理非常好或优秀的 N = 53 人中,有 N = 47 人(89%)报告在大流行期间没有显著变化。结论 在这个平均年龄为 46.1 岁、受过高等教育的高收入人群中,大多数人在大流行前都报告说 ADPKD 得到了很好的控制。这也许可以解释为什么只有不到一半的参与者对感染 Covid-19 表示高度担忧。总体而言,自我报告的 ADPKD 管理水平并没有出现与大流行相关的明显下降,这可能是由于远程医疗服务的便捷性和使用率很高。值得注意的是,每 4 位参与者中就有 1 位报告了逃避医疗保健的行为,其影响可能要在数年后才能显现出来。未来的研究应该调查回避行为的潜在影响,并将调查范围扩大到更多样化的人群,因为他们的医疗服务可能不容易过渡到远程医疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterizing the Impact of the Covid-19 Pandemic on Adults with Autosomal Dominant Polycystic Kidney Disease: A Cross-Sectional Study.

Background: The Covid-19 pandemic greatly affected those with chronic diseases, impacting healthcare access and healthcare seeking behaviors. The impact of the pandemic on adults with Autosomal Dominant Polycystic Kidney Disease (ADPKD) has not been investigated.

Methods: Participants were recruited from a cohort of 239 ADPKD patients enrolled in a longitudinal study at the University of Maryland. Patients on renal replacement therapy were excluded. N = 66 patients participated in a phone questionnaire from June 2022-December 2022 about ADPKD-related complications, concern about contracting Covid-19, healthcare-seeking behaviors, and telehealth utilization before and after March 2020.

Results: N = 34 (51.5%) of participants reported a positive Covid-19 test result and N = 29 (44%) expressed high concern of contracting Covid-19. Those who avoided medical care at least once (N = 17, 25.8%) had similar demographics and ADPKD severity to those who did not, but reported greater telehealth utilization (88.2% vs. 42.9%, p = 0.002), greater use of non-prescribed medication for Covid-19 treatment or prevention (35.3% vs. 8.2%, p = 0.01), and were more likely to contract Covid-19 (76.5% vs. 42.9%, p = 0.02). Among the N = 53 who reported very good or excellent ADPKD disease management pre-pandemic, N = 47(89%) reported no significant change during the pandemic.

Conclusions: In this highly educated, high-income cohort with a mean age of 46.1 years, most people reported well-managed ADPKD prior to the pandemic. This may explain why less than half of participants expressed high concern for contracting Covid-19. Overall, there was no significant pandemic-related decline in self-reported ADPKD management, like due to excellent access to, and uptake of, telehealth services. Notably, 1 in 4 participants reported healthcare avoidant behavior, the effect of which may only be seen years from now. Future studies should investigate potential impacts of avoidant behaviors, as well as expand investigation to a more diverse cohort whose care may not have been as easily transitioned to telehealth.

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