机构:[1]Tongji School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China,[2]Tongji-Rongcheng Center for Biomedicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China,[3]Department of Pharmacy, School of Pharmacy, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan 430065, China,[4]Department of Pharmacy and the Center of Information, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Road, Wuhan 430021, Hubei, China[5]Department of Urology, Medical Record Statistics, and Pharmacy, Wuhan Third Hospital and Tongren Hospital of Wuhan University, 241 Pengliuyang Road, Wuhan 430060, China
Background: Patients on dialysis were susceptible to coronavirus disease 2019 (COVID-19) and were prone to severe clinical characteristics after infection; acute kidney injury was related to mortality in COVID-19 cases. Limited is known about the characteristics of COVID-19 patients with end-stage renal disease not requiring renal replacement therapy (RRT). Aim: Evaluate clinical characteristics, course and outcomes of COVID-19 patients with chronic kidney disease (CKD) who did not require RRT and those on dialysis. Design: A two-center retrospective study. Methods: A total of 836 adult patients with COVID-19 (24 CKD not on dialysis; 15 dialysis-dependent CKD) were included. The study includes no patients with renal transplantation. Risk factors were explored. Results: CKD not requiring RRT is an independent risk factor for in-hospital death [adjusted odds ratio (aOR) 7.35 (95% CI 2.41-22.44)] and poor prognosis [aOR 3.01 (95% CI 1.23-7.33)]. Compared with COVID-19 cases without CKD, those with CKD not requiring RRT showed similar percentage of initial moderate cases (75.00% vs. 73.65%) but higher incidence of in-hospital neutrophilia (50.00% vs. 27.30%) or death (50.00% vs. 9.03%). The odds ratio of dialysis associated to mortality in CKD patients was 2.00 (95% CI 0.52-7.63), suggesting COVID-19 patients with dialysis-dependent CKD were at greater risk of in-hospital death. For COVID-19 patients with CKD not requiring RRT, statins reduced the risk of neutrophilia [OR 0.10 (95% CI 0.01-0.69)] while diuretics increased the risk of neutrophilia [OR 15.4 (95% CI 1.47-160.97)], although both showed no association to mortality. Conclusion: COVID-19 patients with CKD presented high incidence of neutrophilia, poor prognosis and in-hospital death, with dialysis patients being more vulnerable.
基金:
Tongji-Rongcheng Center for Biomedicine, Huazhong University of Science and Technology
第一作者机构:[1]Tongji School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China,[2]Tongji-Rongcheng Center for Biomedicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China,
共同第一作者:
通讯作者:
通讯机构:[5]Department of Urology, Medical Record Statistics, and Pharmacy, Wuhan Third Hospital and Tongren Hospital of Wuhan University, 241 Pengliuyang Road, Wuhan 430060, China[*1]Department of Pharmacy, Wuhan Third Hospital and Tongren Hospital of Wuhan University, 241 Pengliuyang Road, Wuhan 430060, China.
推荐引用方式(GB/T 7714):
Yang D.,Xiao Y.,Chen J.,et al.COVID-19 and chronic renal disease: clinical characteristics and prognosis[J].QJM-AN INTERNATIONAL JOURNAL OF MEDICINE.2020,113(11):799-805.doi:10.1093/qjmed/hcaa258.
APA:
Yang, D.,Xiao, Y.,Chen, J.,Chen, Y.,Luo, P....&Peng, A..(2020).COVID-19 and chronic renal disease: clinical characteristics and prognosis.QJM-AN INTERNATIONAL JOURNAL OF MEDICINE,113,(11)
MLA:
Yang, D.,et al."COVID-19 and chronic renal disease: clinical characteristics and prognosis".QJM-AN INTERNATIONAL JOURNAL OF MEDICINE 113..11(2020):799-805