Characteristics of COVID-19 patients with preexisting CKD history.
Characteristics of COVID-19 patients with preexisting CKD history.
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DOI：
10.1007/s11255-021-02819-5
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发表时间：
2021-12
影响因子：
2
通讯作者：
Han M
中科院分区：
文献类型：
--
作者：
Xu C;Zhang T;Zhu N;Han M
本文旨在描述具有已知慢性肾脏病 (CKD) 病史的 2019 冠状病毒病 (COVID-19) 患者的特征。收集2020年1月20日至3月1日在武汉同济医院确诊的20例有CKD病史的COVID-19肺炎患者的临床信息。我们列出了这 20 名患者的临床基线数据、实验室检查结果、胸部计算机断层扫描 (CT) 变化，并对这 20 名患者进行了短期随访。根据入院时估计的肾小球滤过率（eGFR），6名患者被分类为CKD 2期，其中5名患者为3a期，2名患者为3b期，3名患者为4期，4名患者为5期。有 CKD 病史的 COVID-19 患者年龄较大，高血压是最常见的合并症。咳嗽、发烧占感染病例的80%以上。这些患者中也常见淋巴细胞减少、d-二聚体增加和感染迹象升高，例如超敏 C 反应蛋白 (hsCRP)、白细胞介素 6 (IL-6) 和肿瘤坏死因子 α (TNF-α)。 CT扫描的主要表现是毛玻璃样混浊（GGO）和实变。观察期间有 4 名患者死亡，7 名患者出现急性肾损伤（AKI）。 16例出院患者中，与入院时相比，12例肾功能稳定，4例肾功能恶化。与感染 SARS-CoV-2 的普通人群相比，有 CKD 病史的 COVID-19 患者倾向于发展至死亡率更高的严重程度。
This paper was intended to describe the characteristics of coronavirus disease 2019 (COVID-19) patients with known chronic kidney disease (CKD) history. Clinical information of 20 COVID-19 pneumonia patients with CKD history diagnosed between January 20th and March 1st, 2020 were collected in Tongji Hospital, Wuhan. We listed the clinical baseline data, laboratory findings, chest computed tomography (CT) changes and processed a short period of follow-up of these 20 patients. Based on the estimated glomerular filtration rate (eGFR) on admission, 6 patients were classified as stage 2 of CKD, 5 were as 3a, 2 were as 3b, 3 were as 4 and 4 were as 5, respectively. COVID-19 patients with CKD history were elder and hypertension was the most common comorbidity. Cough and fever accounted for more than 80% of the infectious cases. Lymphopenia, increased d-dimer and elevated infectious indications such as hypersensitive C response protein (hsCRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were also common among these patients. Ground-glass opacity (GGO) and consolidation were the major manifestations in CT scans. 4 patients died and 7 patients underwent acute kidney injury (AKI) during observation. Among 16 discharged patients, 12 were with stable renal function and 4 had deteriorating renal function compared with that of admission. Compared to general population infected with SARS-CoV-2, COVID-19 patients with CKD history had a preference to develop to severity with higher fatality rate.
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