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基线功能对患者和COVID-19患者的结局的影响:一项多国观察性研究
Harin Rhee1,2, Etienne Macedo1, Gary Cutter3
1Department of Medicine, University of California San Diego, San Diego, CA 92093, USA.
Journal of clinical medicine
|February 26, 2025
概括
患有急性损伤 (AKI) 的COVID-19患者通常具有潜在的功能障碍. 基线急性病 (AKD) 或慢性病 (CKD) 会增加住院后死亡或恢复不良的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 急性损伤 (AKI) 是冠状病毒疾病-19 (COVID-19) 的常见并发症.
- 预先存在的功能对COVID-19患者AKI结果的影响尚不清楚.
- 基线健康状况可能会显著影响AKI的过程和预后.
研究的目的:
- 调查基线功能与AKI住院COVID-19患者的结果之间的关联.
- 确定先前存在的病 (CKD,ESKD,KT) 或新发现的AKD是否会影响死亡率和恢复.
- 分析基线状况对AKI严重程度和医疗保健利用的影响.
主要方法:
- 多国,多中心,回顾性队列研究,包括4158名住院的成人COVID-19患者 (2020年1月~2022年3月).
- 根据基线功能分类的患者:未知病 (NKD),急性病 (AKD),慢性病 (CKD),移植 (KT) 接受者.
- 结合结果定义为离院时死亡或不恢复;用于分析的多变量回归模型.
主要成果:
- 在3038名AKI患者中,55%的患者有基线AKD,23.3%的CKD,3.3%的KT接受者和31.8%的NKD.
- 与NKD相比,患有AKD或CKD的患者对结合结果 (死亡或不恢复) 的风险更高.
- 在幸存者中,CKD和KT接受者的部分或非恢复风险显著更高.
结论:
- 近三分之二的AKI的COVID-19患者有先前存在的功能障碍.
- 在COVID-19患者的基线AKD与出院时不良结果的风险增加有关.
- 基础脏健康显著影响AKI结果在COVID-19的背景下,无论收入水平.
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