Features of the course of the new coronavirus infection COVID-19 in patients with chronic kidney disease

V. O. Bochkareva, M. M. Petrova, N. Shimokhina, I. V. Demko, I. A. Obukhova, E. V. Kozlov
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Abstract

BACKGROUND: CKD is one of the main comorbidities in those who die from COVID-19. Renal injury is the most common nonpulmonary infection of SARS-CoV-2 and has a wide range of manifestations, ranging from mild proteinuria and hematuria to progressive acute kidney injury (AKI) requiring renal replacement therapy (RRT).THE AIM: to study the features of the course of the new coronavirus infection COVID-19 in patients with chronic kidney disease.PATIENTS AND METHODS: The study included 79 patients with confirmed new coronavirus infection COVID-19 who hospitalized. The first group consisted of people with a history of CKD (44 people), the second group included people without a history of CKD (35 people). The diagnosis of CKD established based on the calculation of glomerular filtration rate using the CKD-EPI formula. The comorbidity index calculated using two scales: Charlson and CIRS-G. Statistical data analysis carried out using the Statistica 12.0 application package (StatSoft Inc., USA).RESULTS: Patients with COVID-19 and CKD had a higher comorbidity index: according to the Charlson index in one group of patients the indicator was 7 [5.0-9.0], and in group 2 it was 5 [4.0-6.0] (p<0.001). According to the CIRS-G index, in one group the indicator was 9 [7-11.5], in two group it was 4 [2-6] (p <0.001). Patients in one group had a greater degree of damage to the lung tissue according to MSCT of the OGK; in laboratory tests, the levels of CRP, ferritin, LDH, and d-dimer were higher; leukocytosis with a neutrophil shift in the leukocyte count observed.CONCLUSION: Patients with a history of chronic kidney disease (CKD) had more severe COVID-19 and higher mortality.
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慢性肾病患者感染新型冠状病毒 COVID-19 的病程特点
背景:CKD 是 COVID-19 死亡者的主要合并症之一。肾损伤是 SARS-CoV-2 最常见的非肺部感染,表现范围广泛,从轻度蛋白尿和血尿到需要肾脏替代治疗(RRT)的进行性急性肾损伤(AKI)。第一组包括有慢性肾脏病病史者(44 人),第二组包括无慢性肾脏病病史者(35 人)。根据 CKD-EPI 公式计算出的肾小球滤过率确定了 CKD 诊断。合并症指数使用两种量表计算:Charlson 和 CIRS-G。结果:COVID-19 和 CKD 患者的合并症指数较高:根据 Charlson 指数,一组患者的合并症指数为 7 [5.0-9.0],第二组为 5 [4.0-6.0](P<0.001)。根据 CIRS-G 指数,一组患者的指数为 9 [7-11.5],两组患者的指数为 4 [2-6](P<0.001)。根据 OGK 的 MSCT,一组患者的肺组织损伤程度更高;在实验室检查中,CRP、铁蛋白、LDH 和 d-二聚体的水平更高;观察到白细胞增多,白细胞计数中出现中性粒细胞偏移。
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