ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2023, Vol. 32 ›› Issue (4): 308-312.DOI: 10.3969/j.issn.1006-298X.2023.04.002

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肾移植受者新型冠状病毒感染的临床特征和预后

  

  • 出版日期:2023-08-28 发布日期:2023-08-30

Characteristics and prognosis of COVID-19 infection in renal transplant recipients

  • Online:2023-08-28 Published:2023-08-30

摘要: 目的:分析因新型冠状病毒感染(COVID-19)住院的肾移植受者的临床特征和预后。
方法:回顾性观察2022年12月至2023年2月我国COVID-19高峰期,在东部战区总医院国家肾脏疾病临床医学研究中心住院的肾移植受者,收集并分析其一般资料、合并疾病情况、用药方案、实验室检查结果、并发症和预后情况。
结果:共纳入72例患者,平均年龄48.6岁,中型42例(58.3%)、重型16例(22.2%)和危重型14例(19.5%)。80.6%的患者合并高血压,33.3%合并糖尿病。91.7%的患者外周血淋巴细胞减低。随着临床分型加重,并发真菌和细菌感染的比例逐渐增加。8例(11.1%)患者死亡,均为危重型患者。Logistic回归分析发现,合并真菌感染(HR 10.55,95%CI 1.040~107.112,P=0.046)和合并细菌感染(HR 26.934,95%CI 2.084~348.161,P=0.012)是患者死亡的危险因素。
结论:本组住院治疗的COVID-19的肾移植受者合并症多,外周血淋巴细胞减低明显,并发真菌和细菌感染是死亡的危险因素。


关键词: 肾移植受者, 新型冠状病毒感染, 并发症, 预后

Abstract: Objective:To analyze the clinical characteristics and prognosis of hospitalized renal transplant recipients infected with Coronavirus Disease 2019 (COVID-19).
Methodology:The renal transplant recipients with COVID-19 who were hospitalized in National Clinical Research Center of Kidney Diseases, Jinling Hospital during the peak period of COVID-19 in China from December 2022 to February 2023 were retrospectively observed, the general information of patients, comorbidities, immunosuppressants, laboratory findings, and prognosis were collected and analyzed.
Results:A total of 72 cases were observed, including 42 moderate cases (58.3%), 16 severe cases (22.2%), and 14 critically severe cases (19.5%), with an average age of 48.6. 80.6% patients had hypertension, 33.3% had diabetes. 91.7% of the patients had decreased lymphocytes. As the severity of the disease worsen, proportion of concurrent fungal and bacterial infections gradually increased. Eight patients (11.1%) died, all of whom were critically severe group. Regression analysis found that fungal infection (HR 10.55,95%CI 1.040~107.112, P=0.046) and bacterial infection (HR 26.934,95%CI 2.084~348.161, P=0.012) were risk factors for death.
Conclusion:Renal transplant recipients with COVID-19 observed in our research had many comorbidities and severe lymphopenia, concurrent of fungal and bacterial infection were risk factors for death.


Key words: renal transplant recipient, COVID-19, complication, prognosis