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Gut microbes as medical signature for the effectiveness of immunotherapy in patients with advanced non-small cell lung cancer 肠道微生物是晚期非小细胞肺癌患者免疫疗法疗效的医学标志
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-22 DOI: 10.1002/agm2.12292
Adane Adugna, Yalew Muche, Mohammed Jemal, Samuel Derbie Habtegiorgis, Habtamu Belew, Gashaw Azanaw Amare

Lung cancer (LC) is the most common cause of cancer-related death worldwide and poses a severe threat to public health. Immunotherapy with checkpoint blockers has improved the outlook for advanced non-small cell lung cancer (NSCLC) therapy. For the treatment of patients with advanced NSCLC, antibodies such as anti-programmed death 1 (anti-PD1), anti-programmed death ligand 1 (anti-PD-L1), and anti-cytotoxic T lymphocyte-associated antigen 4 (anti-CTLA-4) are of paramount importance. Anti-PD-1 and anti-PD-L1 monoclonal antibody therapies are used to block the PD-1/PD-L1 pathway and identify cancerous cells to the body's defenses. Antibodies directed against CTLA-4 (anti-CTLA-4) have also been shown to improve survival rates in patients with NSCLC. Currently, other immunotherapy approaches like neoadjuvant immune checkpoint inhibitors (NAICIs) and chimeric antigen receptor T-cell (CAR-T) therapies are applied in NSCLC patients. NAICIs are used for resectable and early stage NSCLC and CAR-T is used to find more useful epitope sites for lung tumors and destroy cancer cells. A patient's gut microbiota might influence how their immune system reacts to NSCLC immunotherapy. The majority of intestinal microbes stimulate helper/cytotoxic T cells, induce natural killer (NK) cells, activate various toll-like receptors (TLR), build up cluster of differentiation 8 (CD8), increase PD-1 production, and attract chemokine receptors towards cancer cells. Thus, they serve as immune inducers in NSCLC immunotherapy. Nonetheless, certain bacteria can function as immune suppressors by inhibiting DC proliferation, stopping CD28 trafficking, restoring CD80/CD86, increasing immunological tolerance, and upsetting Th17 cells. Therefore, they are prevalent in non-responders with NSCLC immunotherapy.

肺癌是全球最常见的癌症相关死亡原因,对公众健康构成严重威胁。使用检查点阻断剂的免疫疗法改善了晚期非小细胞肺癌(NSCLC)的治疗前景。对于晚期 NSCLC 患者的治疗,抗程序性死亡 1(anti-PD1)、抗程序性死亡配体 1(anti-PD-L1)和抗细胞毒性 T 淋巴细胞相关抗原 4(anti-CTLA-4)等抗体至关重要。抗PD-1和抗PD-L1单克隆抗体疗法用于阻断PD-1/PD-L1通路,向人体防御系统识别癌细胞。针对 CTLA-4 的抗体(抗 CTLA-4)也被证明可以提高 NSCLC 患者的生存率。目前,新辅助免疫检查点抑制剂(NAICIs)和嵌合抗原受体T细胞(CAR-T)疗法等其他免疫疗法也被应用于NSCLC患者。NAICIs用于可切除的早期NSCLC,而CAR-T则用于寻找肺部肿瘤更有用的表位位点并消灭癌细胞。患者的肠道微生物群可能会影响其免疫系统对 NSCLC 免疫疗法的反应。大多数肠道微生物会刺激辅助/毒性T细胞,诱导自然杀伤(NK)细胞,激活各种收费样受体(TLR),建立分化8群(CD8),增加PD-1的产生,并吸引趋化因子受体进入癌细胞。因此,它们是 NSCLC 免疫疗法的免疫诱导剂。然而,某些细菌可以通过抑制直流电增殖、阻止 CD28 运输、恢复 CD80/CD86、增加免疫耐受和扰乱 Th17 细胞来发挥免疫抑制作用。因此,它们在 NSCLC 免疫疗法无反应者中很常见。
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引用次数: 0
Comparison of fatigue and functional status in elderly type 2 diabetes patients versus age and gender matched individuals 老年 2 型糖尿病患者与年龄和性别匹配者的疲劳和功能状态比较
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-21 DOI: 10.1002/agm2.12289
Priyal P. Bhatt, Megha S. Sheth

Introduction

Fatigue is a common yet not frequently explored complication of diabetes. There are fewer studies available on the impact of diabetes on the severity of fatigue and the functional status of patients.

Methods

Fifty individuals meeting the inclusion criteria were included. The individuals were divided into two groups: group A (diabetic elderly individuals) and group B (nondiabetic age and gender-matched individuals). An observational analytical study was conducted. Outcome measures used were: fatigue severity scale (FSS), lower extremity functional scale (LEFS), 6-minute walk distance (6MWD), and 30-second chair stand test. SPSS 16 was used to analyze data.

Results

As per the normality test, a between-group comparison of fatigue severity scale (FSS) score, chair stand test score, and LEFS score was carried out by a nonparametric Mann–Whitney test, which showed a statistically significant difference between the groups (P < 0.05). Between-group comparison of 6MWD was carried out by parametric unpaired t test. The results showed a statistically significant difference in the distance walked by both groups.

Conclusion

Higher levels of fatigue and impaired functional status along with reduced strength and function of lower limbs was seen in elderly patients with type 2 diabetes Inclusion of symptom assessment and strategies to reduce the burden of fatigue in diabetes patient should be incorporated.

导言 疲劳是一种常见的糖尿病并发症,但并不经常被研究。有关糖尿病对患者疲劳严重程度和功能状态影响的研究较少。 方法 纳入 50 名符合纳入标准的患者。这些人被分为两组:A 组(老年糖尿病患者)和 B 组(年龄和性别匹配的非糖尿病患者)。研究采用观察分析法。结果测量指标包括:疲劳严重程度量表(FSS)、下肢功能量表(LEFS)、6 分钟步行距离(6MWD)和 30 秒椅子站立测试。数据分析采用 SPSS 16。 结果 经正态性检验,疲劳严重程度量表(FSS)评分、椅子站立测试评分和 LEFS 评分的组间比较采用非参数 Mann-Whitney 检验,结果显示组间差异有统计学意义(P <0.05)。6MWD 的组间比较采用参数非配对 t 检验。结果显示,两组的行走距离差异有统计学意义。 结论 老年 2 型糖尿病患者的疲劳程度较高,功能状态受损,下肢力量和功能减弱,应纳入症状评估和减轻糖尿病患者疲劳负担的策略。
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引用次数: 0
Salivary biomarkers: The early diagnosis of Alzheimer's disease 唾液生物标志物:阿尔茨海默病的早期诊断
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-20 DOI: 10.1002/agm2.12282
Sophia Nazir

The precise identification of Alzheimer's disease and other prevalent neurodegenerative diseases remains a difficult issue that requires the development of early detection of the disease and inexpensive biomarkers that can replace the present cerebrospinal fluid and imaging biomarkers. Blood biomarkers, such as amyloid and neurofilament light, have been emphasized as an important and practical tool in a testing or examination procedure thanks to advancements in ultra-sensitive detection techniques. Although saliva is not currently being researched for neurodegenerative diseases, it is an important source of biomarkers that can be used for the identification of diseases and has some advantages over other biofluids. While this may be true for most people, getting saliva from elderly people presents some significant challenges. In this overview, we will first discuss how saliva is created and how aging-related illnesses may affect the amount and kind of saliva produced. The findings support the use of salivary amyloid protein, tau species, and novel biomarkers in the diagnosis of Alzheimer's disease.

准确识别阿尔茨海默病和其他流行的神经退行性疾病仍然是一个难题,需要开发疾病的早期检测方法和廉价的生物标志物,以取代现有的脑脊液和成像生物标志物。由于超灵敏检测技术的进步,血液生物标志物(如淀粉样蛋白和神经丝光)已被视为检测或检查程序中重要而实用的工具。虽然目前还没有针对神经退行性疾病对唾液进行研究,但唾液是一种重要的生物标记物来源,可用于疾病的鉴定,与其他生物液体相比具有一些优势。虽然对大多数人来说都是如此,但从老年人那里获取唾液却面临着一些重大挑战。在本概述中,我们将首先讨论唾液是如何产生的,以及与衰老相关的疾病会如何影响唾液的产生量和种类。研究结果支持将唾液中的淀粉样蛋白、tau 种类和新型生物标记物用于阿尔茨海默病的诊断。
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引用次数: 0
Anti-aging effects of icariin and the underlying mechanisms: A mini-review 冰片苷的抗衰老作用及其内在机制:微型综述
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-15 DOI: 10.1002/agm2.12284
Ying Li, Zhi-Feng Wei, Long Su

Aging is an extremely intricate and progressive phenomenon that is implicated in many physiological and pathological conditions. Icariin (ICA) is the main active ingredient of Epimedium and has exhibited multiple bioactivities, such as anti-tumor, neuroprotective, antioxidant, anti-inflammatory, and anti-aging properties. ICA could extend healthspan in both invertebrate and vertebrate models. In this review, the roles of ICA in protection from declined reproductive function, neurodegeneration, osteoporosis, aging intestinal microecology, and senescence of cardiovascular system will be summarized. Furthermore, the underlying mechanisms of ICA-mediated anti-aging effects will be introduced. Finally, we will discuss some key aspects that constrain the usage of ICA in clinical practice and the corresponding strategies to solve these issues.

衰老是一种极其复杂的渐进现象,与许多生理和病理状况有关。淫羊藿素(ICA)是淫羊藿的主要活性成分,具有多种生物活性,如抗肿瘤、神经保护、抗氧化、抗炎和抗衰老特性。淫羊藿在无脊椎动物和脊椎动物模型中都能延长健康寿命。本综述将总结 ICA 在防止生殖功能衰退、神经变性、骨质疏松症、肠道微生态老化和心血管系统衰老方面的作用。此外,还将介绍 ICA 介导的抗衰老作用的基本机制。最后,我们将讨论制约 ICA 临床应用的一些关键问题,以及解决这些问题的相应策略。
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引用次数: 0
Early economic evaluation of the digital gait analysis system for fall prevention–Preliminary analysis of the GaitSmart system 预防跌倒的数字步态分析系统的早期经济评估--对 GaitSmart 系统的初步分析
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-07 DOI: 10.1002/agm2.12290
Fernando Zanghelini, Georgios Xydopoulos, Richard Fordham, Geraldine Rodgers, Saval Khanal

Objective

To develop an early economics evaluation (EEE) to assess the cost-effectiveness of the GS in reducing the RoF and FoF.

Methods

A cost-effectiveness analysis (CEA) with a return on investment (RoI) estimation was performed. CEA used the most relevant parameters, such as increased gait speed and decreased FoF, to estimate the reduction in the RoF, the impact on health care resources used and financial implications for the National Health System in the United Kingdom. Outcomes were measured as incremental cost-effectiveness ratio per quality-adjusted life years (QALYs) gained based on the reduction of the RoF and FoF. Uncertainties around the main parameters used were evaluated by probabilistic sensitivity analysis.

Results

The CEA results showed that the GS is a dominant strategy over the standard of care to improve the movements of older persons who have suffered a fall or are afraid of falling (incremental QALYs based on FoF = 0.77 and QALYs based on RoF = 1.07, cost of FoF = -£4479.57 and cost of RoF = -£2901.79). By implementing the GS, the ROI results suggest that every pound invested in the GS could result in cost savings of £1.85/patient based on the RoF reduction and £11.16/patient based on the FoF reduction. The probability of being cost saving based on the number of iterations were 79.4 percent (based on FoF) and 100 percent (based on RoF).

Conclusion

The EEE supports the main hypothesis that the GS is an effective intervention to avoid falls and is potentially cost saving.

开展早期经济学评估(EEE),评估GS在降低RoF和FoF方面的成本效益。成本效益分析采用了最相关的参数,如步速的增加和FoF的降低,来估算RoF的降低、对所使用的医疗资源的影响以及对英国国家卫生系统的财务影响。根据RoF和FoF的降低情况,以每质量调整生命年(QALYs)的增量成本效益比来衡量结果。成本效益分析结果表明,与标准护理相比,GS 是改善跌倒或害怕跌倒的老年人行动的主要策略(基于 FoF 的增量 QALYs = 0.77,基于 RoF 的增量 QALYs = 1.07,FoF 的成本 = -4479.57 英镑,RoF 的成本 = -2901.79 英镑)。通过实施 GS,投资回报率结果表明,基于 RoF 的降低,投资于 GS 的每英镑可为每位患者节省 1.85 英镑的成本,基于 FoF 的降低,可为每位患者节省 11.16 英镑的成本。根据迭代次数计算的成本节约概率分别为 79.4%(基于 FoF)和 100%(基于 RoF)。
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引用次数: 0
Effectiveness of exercise interventions on muscle mass among older adults with sarcopenic obesity: A scoping review 运动干预对肌肉疏松性肥胖老年人肌肉质量的影响:范围综述
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-06 DOI: 10.1002/agm2.12288
S. Janani, R. Sedhunivas

A disease known as sarcopenic obesity is characterized by decreased lean body mass in conjunction with excessive amounts of adipose tissue. Skeletal muscle mass, also known as SMM, is responsible for the largest share of fat-free mass in the body and plays an extremely vital role in the maintaining of metabolic health. Physical activity and exercise boosts the physiological health and overall quality of life of senior citizens. The objective of the study is to investigate the effectiveness of varied exercise interventions among the geriatric people with sarcopenic obesity. During the time period (2016–2023), a scoping review was undertaken using PubMed, orthopedic journals, and the Google Scholar database, and six literature evidences relating to the topic were discovered and subsequently analyzed. The study includes six randomized control trial publications that investigated the effectiveness and impact of exercise therapies on sarcopenic obesity. According to the pre and post-test values found in the reviewed articles, we discovered that resistance exercise is more effective than aerobic or combination exercise therapies. In conclusion, according to this scoping analysis, resistance training is more effective than other types of exercise in improving muscle mass in older people with sarcopenic obesity.

肌肉松弛性肥胖症的特点是瘦体重减少,同时脂肪组织过多。骨骼肌质量(又称 SMM)在人体无脂肪质量中所占的比例最大,在维持新陈代谢健康方面发挥着极其重要的作用。体育活动和锻炼能促进老年人的生理健康和整体生活质量。本研究的目的是调查各种运动干预措施在患有肌肉疏松性肥胖症的老年人中的有效性。在(2016-2023 年)期间,利用 PubMed、骨科期刊和谷歌学术数据库进行了范围审查,发现并随后分析了与该主题相关的六篇文献证据。研究包括六篇随机对照试验出版物,这些出版物调查了运动疗法对肌肉疏松性肥胖的效果和影响。根据所查阅文章中的前后测试值,我们发现阻力运动比有氧运动或综合运动疗法更有效。总之,根据这项范围分析,阻力训练比其他类型的运动更能有效改善肌肉疏松性肥胖症老年人的肌肉质量。
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引用次数: 0
Navigating sarcopenia in COVID-19 patients and survivors: Understanding the long-term consequences, transitioning from hospital to community with mechanisms and interventions for future preparedness 为 COVID-19 患者和幸存者的肌少症导航:了解长期后果、从医院向社区过渡的机制以及为未来做好准备的干预措施
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-02-06 DOI: 10.1002/agm2.12287
Mohammad Reza Shadmand Foumani Moghadam, Amirmohammad Vaezi, Sajedeh Jandari, Asie Araste, Reza Rezvani

The coronavirus disease 2019 (COVID-19) pandemic has caused widespread devastation, with millions of confirmed cases and deaths worldwide. Although there were efforts made to develop treatments and vaccines for COVID-19, the coexistence of sarcopenia, a muscle disorder, has been largely overlooked. It is while new variants of this disease (eg, BA.2.86) are challenging the current protocols. Sarcopenia is associated with increased mortality and disability, and shares common mechanisms with COVID-19, such as inflammation, hormonal changes, and malnutrition. This can worsen the effects of both conditions. Furthermore, survived patients with COVID-19 who have elevated risk, as well as aging, which increases the process of sarcopenia. Therefore, addressing sarcopenia in patients with COVID-19 and surviving individuals can be crucial for improving outcomes and preventing long-term disability. During hospital stays, assessing sarcopenia through indicators like muscle wasting and malnutrition is important. Nutritional interventions, such as malnutrition screening and enteral feeding, play a critical role in preventing sarcopenia in hospitals. Mental health and physical activity evaluations and interventions are also necessary. Even after recovering from COVID-19, there is a risk of developing sarcopenia, requiring continued monitoring. Nutrition and physical activity considerations are vital for prevention and management, necessitating tailored training programs and diet therapy. Mental health should not be overlooked, with regular screening, and community-based interventions. Infrastructure should support physical activity, and mental health services must become more accessible. Community engagement through support groups and peer networks can foster resilience and social connection. Efforts are needed to promote healthy diets and ensure access to nutritious foods.

冠状病毒病 2019(COVID-19)大流行造成了广泛的破坏,全球确诊病例和死亡人数达数百万。尽管人们一直在努力开发针对 COVID-19 的治疗方法和疫苗,但肌肉疏松症(一种肌肉疾病)的并发症却在很大程度上被忽视了。而这种疾病的新变种(如 BA.2.86)正在对现行方案提出挑战。肌肉疏松症与死亡率和残疾率的增加有关,与 COVID-19 有着共同的发病机制,如炎症、激素变化和营养不良。这可能会加重这两种疾病的影响。此外,存活下来的 COVID-19 患者会面临更高的风险,而衰老也会加剧肌肉疏松症的进程。因此,治疗 COVID-19 患者和存活者的肌肉疏松症对于改善预后和预防长期残疾至关重要。在住院期间,通过肌肉萎缩和营养不良等指标来评估肌肉疏松症非常重要。营养干预措施,如营养不良筛查和肠内喂养,在医院预防肌肉疏松症方面起着至关重要的作用。心理健康和体育锻炼的评估与干预也很有必要。即使从 COVID-19 中恢复过来,仍有可能出现肌肉疏松症,因此需要持续监测。营养和体育锻炼对预防和管理至关重要,因此需要量身定制训练计划和饮食疗法。心理健康也不容忽视,需要进行定期筛查和社区干预。基础设施应支持体育活动,心理健康服务必须更加便捷。通过支持小组和同侪网络进行社区参与,可以促进复原力和社会联系。需要努力推广健康饮食,确保人们能够获得有营养的食物。
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引用次数: 0
Clinical and neuropsychological characterization of SuperAgers residing in Delhi and National Capital Region of India—A cross-sectional study 居住在印度德里和国家首都地区的超级厌食症患者的临床和神经心理学特征--一项横断面研究
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-31 DOI: 10.1002/agm2.12285
Ritika Batra, Deepa Anil Kumar, Abhijith Rao, Gauri Shanker Kaloiya, Maroof Ahmad Khan, Sujata Satapathy, Avinash Chakrawarty, Nidhi Soni, Pramod Kumar, Prasun Chatterjee

Introduction

SuperAgers (SA) are older adults who exhibit cognitive capacities comparable to individuals who are three or more decades younger than them. The current study aimed to identify the characteristics of Indian SA by categorizing 55 older adults into SA and Typical Older Adults (TOA) and comparing their performance with a group of 50 younger participants (YP) (aged 25–50).

Methods

A total of 105 participants were recruited after obtaining informed written consent. The cognitive abilities of the participants were assessed using Wechsler Adult Intelligence Scale (WAIS)-IVINDIA, Color Trails Test, Boston Naming Test (BNT), and Rey Auditory Verbal Learning Test.

Results

SA outperformed TOA in all cognitive assessments (P < 0.001) and surpassed YP in BNT and WAIS-IV. SA's delayed recall scores were notably higher (12.29 ± 1.51) than TOA (6.32 ± 1.44).

Conclusion

SA excelled in all cognitive domains demonstrating resilience to age-related cognitive decline. This study highlights Indian SuperAgers' exceptional cognitive prowess.

引言 超级老年人(SuperAgers,SA)是指在认知能力上与比他们年轻三四十岁的人不相上下的老年人。本研究旨在通过将 55 名老年人分为 "SA "和 "典型老年人"(TOA),并将他们的表现与 50 名年轻参与者(YP)(25-50 岁)的表现进行比较,从而确定印度 "SA "的特征。 方法 在获得知情书面同意后,共招募了 105 名参与者。采用韦氏成人智力量表(WAIS)-IVINDIA、颜色轨迹测验、波士顿命名测验(BNT)和雷伊听觉言语学习测验对参与者的认知能力进行评估。 结果 在所有认知评估中,南澳大利亚人的成绩均优于东澳大利亚人(P <0.001),而在波士顿命名测验和 WAIS-IV 中,南澳大利亚人的成绩则超过了东澳大利亚人。SA的延迟回忆得分(12.29 ± 1.51)明显高于TOA(6.32 ± 1.44)。 结论SA在所有认知领域都表现出色,显示出对年龄相关认知衰退的适应能力。这项研究凸显了印度 "超级成年人 "卓越的认知能力。
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引用次数: 0
Unveiling the hidden impact: Subclinical hypercortisolism and its subtle influence on bone health 揭示隐藏的影响:亚临床皮质醇增多症及其对骨骼健康的微妙影响
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-31 DOI: 10.1002/agm2.12286
Yuan Lou, Luping Ren, Huan Chen, Tian Zhang, Qi Pan

In recent years, advancements in imaging technologies have led to an increased detection rate of adrenal incidentalomas (AI), with age demonstrating a significant correlation with their incidence. Among the various forms of functional adrenal incidentalomas, subclinical hypercortisolism (SH) stands out as a predominant subtype. Despite the absence of typical symptoms associated with Cushing's syndrome, both domestic and international research consistently establishes a robust link between SH and diverse metabolic irregularities, including hypertension, lipid metabolism disorders, glucose metabolism abnormalities, and disruptions in bone metabolism. Individuals with SH face an elevated risk of cardiovascular events and mortality, highlighting the clinical significance of addressing this condition. Prolonged exposure to elevated cortisol levels poses a significant threat to bone health, contributing to bone loss, alterations in bone microstructure, and an increased susceptibility to fractures. However, comprehensive reviews addressing bone metabolism changes and associated mechanisms in SH patients are currently lacking. Furthermore, the profound impact of concurrent SH on the overall health of the elderly cannot be overstated. A comprehensive understanding of the skeletal health status in elderly individuals with concomitant SH is imperative. This article aims to fill this gap by offering a detailed review of bone metabolism changes and associated mechanisms in SH patients arising from AI. Additionally, it provides a forward-looking perspective on research concerning skeletal health in elderly individuals with concurrent SH.

近年来,影像学技术的进步提高了肾上腺偶发瘤(AI)的检出率,而年龄与其发病率有着显著的相关性。在各种形式的功能性肾上腺偶发瘤中,亚临床皮质醇增多症(SH)是最主要的亚型。尽管亚临床皮质醇增多症没有库欣综合征的典型症状,但国内外的研究均证实,亚临床皮质醇增多症与高血压、脂代谢紊乱、糖代谢异常和骨代谢紊乱等多种代谢异常之间存在密切联系。SH 患者发生心血管事件和死亡的风险升高,这凸显了解决这一问题的临床意义。长期暴露于皮质醇水平升高的环境中会对骨骼健康造成严重威胁,导致骨质流失、骨骼微观结构改变以及骨折易感性增加。然而,目前还缺乏针对 SH 患者骨代谢变化和相关机制的全面综述。此外,并发 SH 对老年人整体健康的深远影响怎么强调都不为过。全面了解同时患有 SH 的老年人的骨骼健康状况势在必行。本文旨在填补这一空白,详细综述了人工智能引起的 SH 患者的骨代谢变化及相关机制。此外,文章还对并发 SH 的老年人骨骼健康研究提供了一个前瞻性的视角。
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引用次数: 0
A case of chronic kidney disease patient with rapid deterioration of renal function, hair loss, and spontaneous resolution of facial warts after COVID-19 infection 一例感染 COVID-19 病毒后肾功能迅速恶化、脱发、面部疣体自发消退的慢性肾病患者
Q3 GERIATRICS & GERONTOLOGY Pub Date : 2024-01-31 DOI: 10.1002/agm2.12281
Qishun Wu, Fei Gao, Tao Zhang, Shixi Zhang, Yun Bai, Bei Zhu, Lulu Guo, Zhenzhu Yong, Weihong Zhao, Xiaohua Pei

Background

Individuals with pre-existing chronic kidney disease (CKD) are at an increased risk of experiencing severe symptoms if infected with COVID-19. This report presents the case of a patient with CKD who contracted COVID-19 and subsequently experienced rapid deterioration of kidney function, hair loss, and spontaneous remission of facial warts.

Case presentation

A 60-year-old Chinese man with a decade-long history of abnormal serum creatinine (Scr) levels and recently heightened fatigue sought treatment. The disease was previously managed and deemed resolved in 2020. However, when he contracted the novel coronavirus on December 20, 2022, he experienced persistent fatigue without other symptoms. In early January 2023, Scr levels was examined as more than 300 μmol/L. This was followed by hair loss, including eyebrows and lashes, and the spontaneous resolution of a longstanding facial wart. During this period, although the patient received kidney-protecting drugs and a lifestyle optimization, Scr increased continuously and the disease eventually progressed to the uremic stage. As the patient still had relatively abundant urine volume, the patient chose peritoneal dialysis treatment. At a two-month follow-up, he had adhered to the CAPD protocol without complications and his hair had begun to regrow. After eight months, his hair had mostly regrown, and his Scr levels kept stable.

Conclusion

This case may represent the inaugural instance of CKD patients experiencing rapid deterioration of renal function, hair loss, and spontaneous remission of common warts. The underlying mechanisms of this unique phenomenon warrant further researches and debate.

背景已有慢性肾脏病(CKD)的患者一旦感染 COVID-19,出现严重症状的风险就会增加。本报告介绍了一例感染 COVID-19 的 CKD 患者的病例,该患者随后出现肾功能急剧恶化、脱发以及面部疣体自发缓解等症状。 病例介绍 一位 60 岁的中国男性患者,其血清肌酐(Scr)水平异常已有十年之久,最近还出现了乏力症状。该病曾在 2020 年得到控制并被认为已经痊愈。然而,当他在 2022 年 12 月 20 日感染新型冠状病毒后,出现了持续性疲劳,但没有其他症状。2023 年 1 月初,Scr 水平被检查出超过 300 μmol/L。随后,包括眉毛和睫毛在内的毛发脱落,长期存在的面部疣也自发消退。在此期间,虽然患者服用了保护肾脏的药物并优化了生活方式,但 Scr 仍在持续升高,病情最终发展到尿毒症阶段。由于患者尿量仍相对充足,患者选择了腹膜透析治疗。在两个月的随访中,他一直坚持腹膜透析治疗方案,没有出现并发症,头发也开始重新生长。8 个月后,他的头发基本再生,Scr 水平保持稳定。 结论 本病例可能是首次出现 CKD 患者肾功能迅速恶化、脱发和寻常疣自发缓解的病例。这一独特现象的内在机制值得进一步研究和讨论。
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Aging Medicine
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