Risk factors for severity of COVID-19 in chronic dialysis patients from a multicentre French cohort.
Risk factors for severity of COVID-19 in chronic dialysis patients from a multicentre French cohort.
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来自多中心法国人群的慢性透析患者的COVID-19严重程度的危险因素。
DOI：
10.1093/ckj/sfaa199
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发表时间：
2020-10
影响因子：
4.6
通讯作者：
Rieu P
中科院分区：
文献类型：
--
作者：
Lano G;Braconnier A;Bataille S;Cavaille G;Moussi-Frances J;Gondouin B;Bindi P;Nakhla M;Mansour J;Halin P;Levy B;Canivet E;Gaha K;Kazes I;Noel N;Wynckel A;Debrumetz A;Jourde-Chiche N;Moal V;Vial R;Scarfoglière V;Bobot M;Gully M;Legris T;Pelletier M;Sallee M;Burtey S;Brunet P;Robert T;Rieu P
冠状病毒病2019(新冠肺炎)是一种新发传染病，与严重急性呼吸综合征冠状病毒2型感染有关。极少有终末期肾病(ESRD)患者的数据。我们对法国两个不同地区的11个透析中心的新冠肺炎患者进行了一项观察性队列研究，以检查该人群中新冠肺炎的流行病学和临床特征，并确定疾病严重性(定义为包括重症监护病房入院或死亡在内的综合结果)和死亡率的危险因素。在入选的2,336名患者中，5.5%的患者确诊为新冠肺炎。在随访超过28 天的122名患者中，37%达到综合结果，28%死亡。多因素分析显示，确诊时氧疗和淋巴细胞计数下降是与疾病严重程度和死亡率相关的独立危险因素。长期使用血管紧张素II受体阻滞剂(ARB)(18%的患者)与降低死亡率有关。在单变量和多变量分析中，使用阿奇霉素和羟氯喹(AZT/HCQ)治疗(46%的患者)与综合结果和死亡无关。新冠肺炎是终末期肾病的严重疾病，预后差。对ARB的常规治疗似乎对关键的演变和死亡率具有保护作用。没有证据表明AZT/HCQ联合应用有临床益处。
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease, related to severe acute respiratory syndrome coronavirus 2 infection. Few data are available in patients with end-stage renal disease (ESRD). We conducted an observational cohort study of COVID-19 patients at 11 dialysis centres in two distinct districts of France to examine the epidemiological and clinical characteristics of COVID-19 in this population, and to determine risk factors of disease severity (defined as a composite outcome including intensive care unit admission or death) and mortality. Among the 2336 patients enrolled, 5.5% had confirmed COVID-19 diagnosis. Of the 122 patients with a follow-up superior to 28 days, 37% reached the composite outcome and 28% died. Multivariate analysis showed that oxygen therapy on diagnosis and a decrease in lymphocyte count were independent risk factors associated with disease severity and with mortality. Chronic use of angiotensin II receptor blockers (ARBs) (18% of patients) was associated with a protective effect on mortality. Treatment with azithromycin and hydroxychloroquine (AZT/HCQ) (46% of patients) were not associated with the composite outcome and with death in univariate and multivariate analyses. COVID-19 is a severe disease with poor prognosis in patients with ESRD. Usual treatment with ARBs seems to be protective of critical evolution and mortality. There is no evidence of clinical benefit with the combination of AZT/HCQ.
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影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
Cao, Bin
影响因子：
0.9
作者：
Arslan, Hande;Musabak, Ugur;Haberal, Mehmet
通讯作者：
Haberal, Mehmet
影响因子：
39
作者：
Wu, Chaomin;Chen, Xiaoyan;Song, Yuanlin
通讯作者：
Song, Yuanlin
影响因子：
120.7
作者：
Fosbol, Emil L.;Butt, Jawad H.;Kober, Lars
通讯作者：
Kober, Lars
影响因子：
158.5
作者：
Mancia, Giuseppe;Rea, Federico;Corrao, Giovanni
通讯作者：
Corrao, Giovanni