COVID-19急性肾损伤的临床特点及危险因素

Jiahao Zhang, X. Rao, Liangdong Chen, Xiaofang Jiang, Cheng Yang, Fengqin Wang, Sanying Shen, L. Su, Z. Peng
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引用次数: 1

摘要

摘要目的:探讨冠状病毒病(COVID-19)患者急性肾损伤(AKI)的临床特征、危险因素及预后。方法:对2020年1月1日至3月1日全院连续456例新冠肺炎确诊患者进行回顾性研究。收集并分析患者的人口学、临床特征、危险因素及预后。结果:456例COVID-19患者中,38例发生AKI。AKI患者年龄较大,以男性为主,且更容易合并高血压、心脑血管疾病等合并症。AKI患者白细胞计数、中性粒细胞计数、中性粒细胞与淋巴细胞比值、丙氨酸转氨酶、c反应蛋白升高,淋巴细胞和血小板计数降低。多因素分析显示,年龄、高血压和淋巴细胞计数是AKI的独立危险因素。456例患者总死亡率为9.9%,AKI患者死亡率为23.7%。特别是,AKI严重程度的增加与风险增加有关。结论:COVID-19患者发生AKI的风险较高。老年、高血压和较低的淋巴细胞计数是AKI的独立危险因素。与COVID-19相关的AKI与COVID-19患者的死亡风险较高相关。
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Clinical Characteristics and Risk Factors for Acute Kidney Injury in COVID-19
ABSTRACT Objective: The objective of the study is to describe the clinical characteristics, risk factors, and prognosis for acute kidney injury (AKI) among patients with coronavirus disease (COVID-19). Methods: Retrospective study of 456 consecutive patients with confirmed COVID-19 infection at the whole hospital from January 1 to March 1, 2020 was enrolled. Demographic, clinical characteristics, the risk factors, and prognosis were collected and analyzed. Results: Of 456 patients with COVID-19, 38 patients developed AKI. Patients with AKI were older and predominantly male sex and were more likely to have comorbidities such as hypertension, cardiovascular, and cerebrovascular diseases. Among patients with AKI, the white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, alanine aminotransferase, and C-reaction protein were increased, and lymphocyte and platelet count were decreased. Multivariate analysis showed that age, hypertension, and lymphocyte count were independent risk factors for AKI. The overall mortality rate of 456 patients was 9.9%, and the mortality rate of patients with AKI was 23.7%. In particular, increasing AKI severity was associated with increased risk. Conclusions: The risk of AKI was high in patients with COVID-19. Older age, hypertension, and lower lymphocyte count were independent risk factors for AKI. COVID-19-associated AKI was associated with higher risk of death in patients with COVID-19.
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