儿童新型冠状病毒感染合并肾损伤的临床特征

Clinical features of novel coronavirus infection with renal injury in children

目的 探讨儿童新型冠状病毒感染合并肾损伤的临床特征。方法 对2022年12月至2023年1月宁夏医科大学总医院儿科重症监护室(PICU)确诊的新型冠状病毒感染患儿临床资料进行回顾性研究。结果 确诊新型冠状病毒感染的41例患儿中,5例(12.2%)肾损伤,10例(24.4%)尿液分析异常[镜下血尿和(或)蛋白尿]。入院时血清尿素、肌酐升高,钠、钾降低及尿液分析异常的患儿,出院时恢复正常。5例肾损伤患儿中4例病情危重死亡,1例完全康复出院。多因素logistic回归分析提示,女性和发热是肾损伤的危险因素[比值比(OR)=1.87,95%可信区间1.02~3.50,P=0.035;OR=2.21,95%CI 1.18~4.30,P=0.012]。结论 儿童新型冠状病毒感染发生肾损伤风险高,应采取有效措施预防,从而降低该类患儿的死亡率。

Objective To investigate the clinical features of novel coronavirus infection complicated with renal injury in children.Methods The clinical data of children diagnosed with novel coronavirus infection in the Pediatric Intensive Care Unit(PICU),General Hospital of Ningxia Medical University from December 2022 to January 2023 were retrospectively studied.Results Among the 41 children with confirmed novel coronavirus infection,5 cases(12.2%)had renal injury and 10 cases(24.4%)had abnormal urinalysis(microscopic hematuria and/or proteinuria).Children with elevated serum urea and creatinine,decreased sodium,potassium and abnormal urine analysis on admission returned to normal at discharge.Among the 5 children with renal injury,4 cases died in critical condition,and one recovered completely and was discharged.Multifactor logistic regression analysis suggested that female and fever were risk factors for renal injury[odds ratio(OR)=1.87,95%confidence interval(95%CI)1.02-3.50,P=0.035;OR=2.21,95%CI 1.18-4.30,P=0.012].Conclusion Children with novel coronavirus infection have a high risk of renal injury,and effective measures should be taken to prevent it,so as to reduce the mortality of such children.