Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients
Low incidence of SARS-CoV-2, risk factors of mortality and the course of illness in the French national cohort of dialysis patients
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DOI：
10.1016/j.kint.2020.07.042
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发表时间：
2020-12-01
影响因子：
19.6
通讯作者：
Moranne, Olivier
中科院分区：
文献类型：
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作者：
Couchoud, Cecile;Bayer, Florian;Moranne, Olivier
本研究的目的是估计法国全国透析患者中COVID-19疾病的发病率及其病程，并确定与死亡率相关的危险因素。我们的研究纳入了2020年4月法国REIN登记处记录的所有透析患者。记录确诊病例（可疑临床症状、胸部扫描特征性体征或逆转录聚合酶链反应阳性）末次随访时的临床特征和病情严重程度随时间的演变情况。从2020年3月16日至2020年5月4日，REIN登记处共报告了1621名感染患者。其中344人死亡。不同地区的COVID-19患者患病率从不到1%到10%不等。在男性、糖尿病患者、需要协助转院或在自我护理单位治疗的患者中，成为病例的可能性更高。家庭透析与吸烟者、前吸烟者、活动性恶性肿瘤患者或周围血管疾病患者感染的可能性较低有关。确诊病例的死亡率（21%）与一般人群的原因相同。较高的年龄、低白蛋白血症和缺血性心脏病的存在在统计学上与较高的死亡风险独立相关。在自我护理单位接受治疗的风险较低。因此，我们的研究显示，与假设相反，透析患者中COVID-19的频率相对较低。
The aim of this study was to estimate the incidence of COVID-19 disease in the French national population of dialysis patients, their course of illness and to identify the risk factors associated with mortality. Our study included all patients on dialysis recorded in the French REIN Registry in April 2020. Clinical characteristics at last follow-up and the evolution of COVID-19 illness severity over time were recorded for diagnosed cases (either suspicious clinical symptoms, characteristic signs on the chest scan or a positive reverse transcription polymerase chain reaction) for SARS-CoV-2. A total of 1,621 infected patients were reported on the REIN registry from March 16th, 2020 to May 4th, 2020. Of these, 344 died. The prevalence of COVID-19 patients varied from less than 1% to 10% between regions. The probability of being a case was higher in males, patients with diabetes, those in need of assistance for transfer or treated at a self-care unit. Dialysis at home was associated with a lower probability of being infected as was being a smoker, a former smoker, having an active malignancy, or peripheral vascular disease. Mortality in diagnosed cases (21%) was associated with the same causes as in the general population. Higher age, hypoalbuminemia and the presence of an ischemic heart disease were statistically independently associated with a higher risk of death. Being treated at a selfcare unit was associated with a lower risk. Thus, our study showed a relatively low frequency of COVID-19 among dialysis patients contrary to what might have been assumed.