METHODS: This retrospective single-center study included 151 patients undergoing MHD. Healthcare workers were selected as control group were assessed from December 1, 2022 to March 31, 2023. Clinical data, laboratory test results, treatment protocols, and prognoses were collected and analyzed.
RESULTS: The study population included 146 patients with MHD, 93 (63.7%) of whom were infected with SARS-CoV-2. The number of non-severe, severe, and critical cases was 84 (90.3%), 4 (4.3%), and 5 (5.3%), respectively. Six patients (6.5%) died during the study period. The main symptoms of SARS-CoV-2 infection, including fever, cough, and fatigue, were less common in patients with MHD than the controls. During SARS-CoV-2 infection, the C-reactive protein (2.9 vs. 11.8 mg/dl, p < 0.0001) and ferritin levels(257.7 vs. 537 ng/l, p < 0.0001) were elevated. The hemoglobin(113vs 111 g/L, p = 0.0001) and albumin levels(39.4 vs. 36.1 g/L, p < 0.0001) decreased. Generally, it took two months for the hemoglobin levels to recover. Positivity rate for SARS-COV-2 serum immunoglobin G (IgG) antibodies and IgG titers were lower in dialysis patients than the controls. Age was positively associated with disease severity, while age and hyponatremia were associated with death.
CONCLUSIONS: Patients with MHD and COVID-19 were primarily classified as non-severe. SARS-CoV-2 infection would soon lead to the increase of inflammation related acute response protein in dialysis patients, and then lead to the decrease of hemoglobin and albumin. About 9.6% in HD patients were severe cases and had poor prognosis. Advanced age and hyponatremia were associated with disease severity and prognosis.
方法:这项回顾性单中心研究包括151例接受MHD的患者。选择医务人员作为对照组,从2022年12月1日至2023年3月31日进行评估。临床数据,实验室测试结果,治疗方案,并对预后进行了收集和分析。
结果:研究人群包括146例MHD患者,93例(63.7%)感染SARS-CoV-2。非严重的数量,严重,危重病例为84例(90.3%),4(4.3%),和5(5.3%),分别。6名患者(6.5%)在研究期间死亡。SARS-CoV-2感染的主要症状,包括发烧,咳嗽,和疲劳,MHD患者比对照组更少见。在SARS-CoV-2感染期间,C反应蛋白(2.9vs.11.8mg/dl,p<0.0001)和铁蛋白水平(257.7vs.537纳克/升,p<0.0001)升高。血红蛋白(113vs111g/L,p=0.0001)和白蛋白水平(39.4vs.36.1g/L,p<0.0001)下降。一般来说,血红蛋白水平需要两个月才能恢复。透析患者SARS-COV-2血清免疫球蛋白G(IgG)抗体和IgG滴度的阳性率低于对照组。年龄与疾病严重程度呈正相关,而年龄和低钠血症与死亡有关。
结论:MHD和COVID-19患者主要被归类为非重症。SARS-CoV-2感染很快会导致透析患者炎症相关急性反应蛋白的增加,然后导致血红蛋白和白蛋白的减少。HD患者中约有9.6%为重症病例,预后不良。高龄和低钠血症与疾病严重程度和预后相关。