重庆市新冠肺炎合并肾功能损害患者临床特点分析

Analysis on clinical characteristics of patients with COVID-19 complicating renal function injury in Chongqing City

目的明确重庆市新型冠状病毒肺炎(COVID-19)合并肾功能损害患者的基本特征及临床特点。方法采用多中心回顾性临床研究,从重庆市两所COVID-19定点收治医院的病例系统收集了明确诊断为COVID-19的患者信息,包括临床症状、实验室指标和治疗方式等。结果共收集了514例患者资料,最终纳入462例COVID-19患者信息,年龄38~56岁,中位年龄为48岁,51.9%为男性,总体病死率为1.1%。有9.7%的患者在住院期间发生肾功能异常,重症中10.3%(4/39)的患者、危重症中28.6%(6/21)的患者发生肾功能异常,发生时间1~7 d,中位时间为3 d,合并肾功能异常患者的病死率显著高于未发生肾损伤患者(6.7%vs.0.5%,P=0.008),合并肾功能异常的患者中有40%出院时肾功能未恢复至基线水平。急性肾损伤(AKI)总体发生率约为1.7%,病死率为37.5%,危重症患者中有28.6%发生了AKI,此类患者发生AKI的病死率为100%。结论COVID-19合并肾功能损害的发生率在重庆地区并不高,但是合并肾功能损害与患者住院期间病情严重程度及高病死率有关。

Objective To definite the basic features and clinical characteristics of the patients with COVID-19 complicating renal function injury in Chongqing City.Methods The multicenter retrospective clinical study was adopted.The information of the patients with definitely diagnosed COVID-19 from the case systems of two designated hospitals in Chongqing City was collected,including clinical symptoms,laboratory indicators,treatment methods,etc..Results The data of 514 cases of COVID-19 were collected,the information of 462 cases was eventually included,the age was 38-56 years old,the median age was 48 years old,51.9%of the cases were male,and the overall mortality rate was 1.1%.The renal dysfunction during hospitalization occurred in 9.7%of the cases,10.3%(4/39)of the severe cases and 28.6%(6/21)of the critical cases developed the abnormal renal function,the occurrence time was 1-7 d with the median time of 3 d.The mortality rate of the patients with complicating renal dysfunction was significantly higher than that of the patients without renal dysfunction(6.7%vs.0.5%,P=0.008),and 40%(18/45)of the patients with complicating renal dysfunction did not recover to the basic line level at the discharge.The overall incidence rate of acute kidney injury(AKI)was about 1.7%and the mortality rate was 37.5%.In critically ill patients,28.6%had AKI,and the mortality rate of such patients was 100%.Conclusion The incidence rate of COVID-19 complicating renal function injury is not high.However complicating renal function injury is associated with the severity and high mortality of the patients during hospitalization.