Results from the IRoc-GN international registry of patients with COVID-19 and glomerular disease suggest close monitoring.
Results from the IRoc-GN international registry of patients with COVID-19 and glomerular disease suggest close monitoring.
复制标题
DOI：
10.1016/j.kint.2020.10.032
复制
发表时间：
2021-01
影响因子：
19.6
通讯作者：
Cravedi P
中科院分区：
文献类型：
--
作者：
Waldman M;Soler MJ;García-Carro C;Lightstone L;Turner-Stokes T;Griffith M;Torras J;Valenzuela LM;Bestard O;Geddes C;Flossmann O;Budge KL;Cantarelli C;Fiaccadori E;Delsante M;Morales E;Gutierrez E;Niño-Cruz JA;Martinez-Rueda AJ;Comai G;Bini C;La Manna G;Slon MF;Manrique J;Agraz I;Sinaii N;Cravedi P
SARS-CoV-2感染对免疫介导的肾小球肾炎患者的影响尚不清楚，这些患者经常接受免疫抑制治疗。因此，我们创建了肾小球肾炎COVID感染国际登记处（IRoc-GN），并在北美和欧洲的中心确定了40例肾小球肾炎和COVID-19患者。记录了肾小球肾炎诊断、肾脏参数和感染前基线免疫抑制的详细信息，以及COVID-19的临床表现、实验室检查值、治疗、并发症和结局。将该队列与80例来自普通人群的COVID阳性对照病例进行了比较，这些病例在感染时间上与肾小球肾炎相匹配。大多数（70%）肾小球肾炎患者和所有对照组住院治疗。与对照组相比，肾小球肾炎患者的死亡率（分别为15%和5%）和急性肾损伤（39%和14%）显著更高，而两组之间对肾脏替代治疗的需求没有统计学差异。在肾小球肾炎队列中，接受免疫抑制或肾素-血管紧张素-醛固酮系统抑制剂治疗并不增加死亡或急性肾损伤的风险。在肾小球肾炎队列中，表现时血清白蛋白较低和肾小球疾病持续时间较短与急性肾损伤风险较高和需要肾脏替代治疗相关。原发性肾小球肾炎患者与系统性自身免疫性疾病（狼疮或血管炎）相关的肾小球肾炎患者之间的结局无差异。因此，由于急性肾损伤的死亡率和风险高于无肾小球肾炎的一般人群，因此应仔细监测肾小球肾炎和COVID-19患者，特别是当他们存在低血清白蛋白水平时。
The effects of SARS-CoV-2 infection on individuals with immune-mediated glomerulonephritis, who are often undergoing immunosuppressive treatments, are unknown. Therefore, we created the International Registry of COVID infection in glomerulonephritis (IRoc-GN) and identified 40 patients with glomerulonephritis and COVID-19 followed in centers in North America and Europe. Detailed information on glomerulonephritis diagnosis, kidney parameters, and baseline immunosuppression prior to infection were recorded, as well as clinical presentation, laboratory values, treatment, complications, and outcomes of COVID-19. This cohort was compared to 80 COVID-positive control cases from the general population without glomerulonephritis matched for the time of infection. The majority (70%) of the patients with glomerulonephritis and all the controls were hospitalized. Patients with glomerulonephritis had significantly higher mortality (15% vs. 5%, respectively) and acute kidney injury (39% vs. 14%) than controls, while the need for kidney replacement therapy was not statistically different between the two groups. Receiving immunosuppression or renin-angiotensin-aldosterone system inhibitors at presentation did not increase the risk of death or acute kidney injury in the glomerulonephritis cohort. In the cohort with glomerulonephritis, lower serum albumin at presentation and shorter duration of glomerular disease were associated with greater risk of acute kidney injury and need for kidney replacement therapy. No differences in outcomes occurred between patients with primary glomerulonephritis versus glomerulonephritis associated with a systemic autoimmune disease (lupus or vasculitis). Thus, due to the higher mortality and risk of acute kidney injury than in the general population without glomerulonephritis, patients with glomerulonephritis and COVID-19 should be carefully monitored, especially when they present with low serum albumin levels.
登录
查看更多内容
DOI：
10.1053/j.ajkd.2020.09.003
发表时间：
2021-03
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Flythe JE;Assimon MM;Tugman MJ;Chang EH;Gupta S;Shah J;Sosa MA;Renaghan AD;Melamed ML;Wilson FP;Neyra JA;Rashidi A;Boyle SM;Anand S;Christov M;Thomas LF;Edmonston D;Leaf DE;STOP-COVID Investigators
通讯作者：
STOP-COVID Investigators
影响因子：
8.8
作者：
Hartzell, Susan;Bin, Sofia;Cravedi, Paolo
通讯作者：
Cravedi, Paolo
影响因子：
19.6
作者：
Cheng, Yichun;Luo, Ran;Xu, Gang
通讯作者：
Xu, Gang
DOI：
10.1136/heartjnl-2020-317393
发表时间：
2020-10
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Hippisley-Cox J;Young D;Coupland C;Channon KM;Tan PS;Harrison DA;Rowan K;Aveyard P;Pavord ID;Watkinson PJ
通讯作者：
Watkinson PJ
DOI：
10.2215/cjn.04650420
发表时间：
2020-10-07
影响因子：
9.8
作者：
Cheng, Yichun;Luo, Ran;Xu, Gang
通讯作者：
Xu, Gang