功能在预测COVID-19严重程度和临床结果中的作用:回顾性分析
Victor Muniz de Freitas1, Érika Bevilaqua Rangel1,2
1Department of Medicine, Nephrology Division, Federal University of São Paulo, Borges Lagoa Street, 783, 6th Floor, Vila Clementino, São Paulo 04038-031, SP, Brazil.
Infectious disease reports
|July 23, 2025
概括
在COVID-19患者中,功能下降 (eGFR < 60) 显著增加死亡风险和需要重症监护的需求. 这种简单的措施可以帮助早期识别高风险个体.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 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:
- COVID-19呈现出复杂的免疫失调,细胞因子风暴,内皮损伤和血栓形成.
- 功能越来越被认为是COVID-19严重性的关键因素.
- 了解功能障碍对COVID-19结果的影响对于患者管理至关重要.
研究的目的:
- 评估功能对住院COVID-19患者的临床,实验室和结果参数的影响.
- 为了确定估计的膜过率 (eGFR) 是否可以作为早期风险分层工具.
- 为了确定不同EGFR水平的COVID-19患者之间的特定临床和实验室差异.
主要方法:
- 在最初的流行病浪潮期间对359名COVID-19患者的回顾性分析.
- 基于估计的淋巴膜过率 (eGFR < 60 与 ≥ 60 mL/min/1.73 m2) 的分层.
- 采集和分析人口统计,生命体征,实验室和临床结果数据,包括死亡率,血液透析,ICU入院和机械呼吸,使用回归和ROC分析.
主要成果:
- 具有eGFR < 60的患者年龄较大,并患有更多的并发病 (高血压,慢性病,移植病史,免疫抑制).
- 较低的eGFR组表现出明显更高的死亡率 (41.6%与19.2%相比),血液透析 (32.3%与9.6%相比),ICU入院 (50.9%与37.9%相比) 和机械通风 (39.8%与21.2%) 的比率.
- 低EGFR组的实验室检测结果包括酸化,贫血,淋巴缺血,炎症标志物升高和高血症.
结论:
- 接收eGFR<60mL/min/1.73m2与COVID-19患者的不良临床结果密切相关.
- 降低功能在住院COVID-19病例中作为风险分层的简单有效的早期标志物.
- 早期识别患有功能障碍的患者可以指导主动管理策略和资源配置.
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