糖尿病合并慢性肾病出院患者的COVID-19: 1年随访与评价

IF 5.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Frontiers in Endocrinology Pub Date : 2025-02-04 eCollection Date: 2025-01-01 DOI:10.3389/fendo.2025.1519993
Enrong Ran, Yutong Zou, Chuanyi Zhao, Kai Liu, Jiamin Yuan, Wenjie Yang, Lijun Zhao, Qing Yang, Jia Yang, Xuegui Ju, Linli Cai, Yanlin Lang, Xingyuan Li, Ke Liu, Fang Liu
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摘要

目的:评价2019冠状病毒病(COVID-19)合并慢性肾脏疾病(CKD)患者出院后的全因死亡率和肾脏预后。方法:本单中心前瞻性观察研究纳入了2022年12月至2023年1月四川大学华西医院收治的187例2019冠状病毒病合并糖尿病和CKD的出院患者。采用Cox回归分析评估死亡风险,采用logistic回归分析确定出院后CKD快速进展的危险因素。结果:1年随访期间,全因死亡率为26.7%,与covid -19相关的急性肾损伤(AKI)发生率为35.3%,35.8%的患者出院后CKD进展迅速。Cox比例风险回归显示脓毒症和机械通气是出院后全因死亡率的主要危险因素。Logistic回归发现基线eGFR < 60 mL/min/1.73 m²是CKD快速进展的独立危险因素。结论:在一年的随访期间,我们观察到糖尿病和CKD患者在急性感染COVID-19后表现出更高的全因死亡率和肾功能迅速恶化。这强调了持续的纵向随访对于更准确地跟踪COVID-19对糖尿病和CKD患者的长期健康影响的重要性。
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COVID-19 in discharged patients with diabetes and chronic kidney disease: one-year follow-up and evaluation.

Purpose: To evaluate the all-cause mortality rate and renal outcomes in patients with diabetes and chronic kidney disease (CKD) following hospital discharge for COVID-19.

Methods: This single-center prospective observational study included 187 discharged COVID-19 patients with diabetes and CKD, admitted between December 2022 and January 2023 at West China Hospital, Sichuan University. Cox regression analysis was used to assess mortality risk, and logistic regression was applied to identify risk factors for rapid CKD progression after discharge.

Results: During the one-year follow-up, the all-cause mortality rate was 26.7%, with a COVID-19-related acute kidney injury (AKI) incidence of 35.3%, and 35.8% of patients experienced rapid CKD progression after discharge. Cox proportional hazards regression indicated that sepsis and mechanical ventilation were major risk factors for post-discharge all-cause mortality. Logistic regression identified baseline eGFR < 60 mL/min/1.73 m² as an independent risk factor for rapid CKD progression.

Conclusions: During the one-year follow-up period, we observed that patients with diabetes and CKD exhibited higher all-cause mortality and experienced rapid deterioration of kidney function after acute infection with COVID-19. This underscores the importance of ongoing longitudinal follow-up to more accurately track the long-term health effects of COVID-19 on patients with diabetes and CKD.

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来源期刊
Frontiers in Endocrinology
Frontiers in Endocrinology Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.70
自引率
9.60%
发文量
3023
审稿时长
14 weeks
期刊介绍: Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series. In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology. Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.
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