Yuav Ua Li Cas Raum Transplant Recipientst Khaws Raum
Mar 12, 2022
Hu rau: Audrey Hu Whatsapp / hp: 0086 13880143964 Email:audrey.hu@wecistanche.com
Kitty J. Jager, Anneke Kramer, Nicholas C. Chesnaye, Ce´ cile Couchoud, J. Emilio Sa´nchez-A´ lvarez, & et al.
Abstract
AIM: Lub hom phiaj ntawm txoj kev tshawb no yog txhawm rau tshawb xyuas {{0}}hnub kev tuag tom qab COVID-19 kuaj mob hauv European raum hloov kho cov pej xeem. Tsis tas li ntawd, peb tau txiav txim siab lub luag haujlwm ntawm tus neeg mob tus yam ntxwv, kev kho mob, thiab lub teb chaws ntawm kev pheej hmoo tuag nrog kev siv ERAEDTA Cov ntaub ntawv sau npe ntawm cov neeg mob tau txais kev kho mob raum hauv Tebchaws Europe txij Lub Ob Hlis 1, 2020, txog Lub Plaub Hlis 30, 2020. Cov ntaub ntawv ntxiv ntawm txhua tus. Cov neeg mob uas kuaj pom tus kab mob COVID-19 tau sau los ntawm 7 lub tebchaws nyob sab Europe suav nrog 4298 tus neeg mob. KEVID-19- cov neeg tuag uas muaj feem cuam tshuam tau suav nrog siv cov qhab nia sib npaug ntawm cov ntaub ntawv keeb kwm kev tswj hwm thiab tom qab 28 hnub ntawm kev soj ntsuam yog 20.0 feem pua (95 feem pua ntawm kev ntseeg siab 18.7 feem pua -21.4 feem pua) hauv 3285 cov neeg mob tau lim ntshav thiab 19.9 feem pua ( 17.5 feem pua -22.5 feem pua) hauv 1013 tus neeg tau txais kev hloov pauv. Peb tau txheeb xyuas qhov sib txawv ntawm COVID-19 kev tuag thoob plaws lub tebchaws thiab muaj kev pheej hmoo tuag ntau ntxiv hauv cov neeg laus uas tau txais kev kho lub raum hloov thiab cov txiv neej cov neeg mob tau lim ntshav. Hauv cov neeg tau txais kev hloov lub raum ‡75 xyoo, 44.3 feem pua (35.7 feem pua – 53.9 feem pua) tsis muaj sia nyob COVID-19. Kev pheej hmoo tuag yog 1.28 (1.02–1.60) lub sijhawm siab dua hauv cov neeg tau txais kev hloov pauv piv nrog cov neeg mob ntshav lim ntshav sib tw. Yog li, tus kab mob kis thoob qhov txhia chaw tau muaj kev cuam tshuam loj heev rau kev tuag ntawm cov neeg mob uas tau txais kev kho mob raum, cov neeg muaj kev pheej hmoo siab heev vim muaj kab mob hauv lub raum ntev thiab muaj kev sib kis ntau ntau. Raum International (2020) 98, 1540–1548; https://doi.org/10.1016/j.kint.2020.09.006
KEYWORDS: attributable mortality; COVID-19, kev lim ntshav, hloov lub raum, kho, sau npe, hloov pauv.
Copyright ª 2020, International Society of Nephrology. Tshaj tawm los ntawm Elsevier Inc. Qhov no yog ib tsab xov xwm qhib-access nyob rau hauv daim ntawv tso cai CC BY
Cistanche txiaj ntsig: txhim kho kev tiv thaiv
Txij li thaum pib muaj tus kab mob tshwm sim hauv Wuhan, Tuam Tshoj, thaum Lub Kaum Ob Hlis 2{{10}}19, tus kab mob coronavirus 2019 (COVID-19) tau nthuav dav thoob plaws ntiaj teb, ua rau muaj kev cuam tshuam loj heev. kev tawm mus thoob ntiaj teb. Tus kab mob-ua los ntawm tus mob hnyav ua pa nyuaj ua rau tus mob coronavirus 2 (SARS-CoV-2) virus-ua rau mob ntsws, tab sis kuj cuam tshuam rau lwm yam kabmob. Raws li European Lub Chaw Tiv Thaiv thiab Tiv Thaiv Kab Mob, tus naj npawb ntawm tshaj tawm COVID-19 cov neeg mob hauv European Union (EU) yog 2783 (ntau 281–6648) ib lab pej xeem (pmp), sawv cev 0.28 feem pua (ntau 0.03 feem pua -0.66 feem pua) ntawm EU cov pej xeem, nrog rau kev sib txawv ntawm cov lej nyob ntawm kev tswj hwm tsoomfwv, kev txhais cov xwm txheej, thiab kev sim ntsuas.1Kev tuag vim yog tus kab mob SARS-CoV-2 yog siab dua piv nrog rau lwm cov kab mob sib kis. Txawm hais tias tus neeg mob tuag ntawm 2.3 feem pua tau tshaj tawm los ntawm Tuam Tshoj,2qhov nruab nrab tus nqi yog 11.7 feem pua (ntau yam 0.6 feem pua – 18.9 feem pua) nyob rau hauv EU cov pej xeem.1Ntawm cov neeg mob pw hauv tsev kho mob hauv tebchaws United Kingdom raug kev txom nyem los ntawm COVID-19, tus neeg mob tuag txog 26 feem pua.3
Cov neeg mob kho nrog raum hloov kho (KRT; dialysis lossis hloov lub raum) sawv cev rau cov neeg tsis muaj zog. Raws li cov xwm txheej ib txwm muaj, cov hnub nyoog-tus qauv ntawm cov hlab plawv thiab cov hlab plawv tsis ua haujlwm hauv cov neeg mob ntshav qab zib yog 8.8 thiab 8.1 npaug ntau dua li cov pej xeem, feem,4thiab piv nrog lawv cov hnub nyoog- thiab kev sib deev-muab sib deev hauv cov pej xeem, cov neeg tau txais kev hloov lub raum tau ntsib 30 feem pua -50 feem pua txo lub neej expectancy.5Tej zaum nws yuav xav tias COVID-19 ua rau muaj kev tuag ntau heev hauv ob qho tib si lim ntshav thiab hloov lub raum cov neeg vim lawv cov kab mob hauv lub raum tsis zoo thiab muaj cov kab mob sib kis loj heev xws li ntshav qab zib mellitus thiab kab mob plawv. Hauv cov neeg tau txais kev hloov pauv, qhov muaj peev xwm ntawm lawv txoj kev siv tshuaj tiv thaiv kab mob mus ntev yog qhov teeb meem ntawm kev sib cav. Qee qhov sib cav tias lawv yuav muaj kev pheej hmoo ntau dua ntawm kev kis mob hnyav vim tias lawv lub cev tsis muaj zog,6hos lwm tus kwv yees tias kev tiv thaiv kab mob tiv thaiv kab mob tuaj yeem tiv thaiv vim nws tuaj yeem hais txog COVID-19-induced cytokine cua daj cua dub.7
Txawm hais tias tsis muaj neeg tuag tau tshaj tawm ntawm 5 COVID-19 tus neeg mob ntawm hemodialysis hauv ib lub chaw suav teb,8ob peb rooj plaub los ntawm Ltalis (n ¼ 41, n ¼ 94),9,10Spain (n ¼ 36),11thiab Tebchaws Meskas (n ¼ 59)12nrog kev sib txawv ntawm kev soj ntsuam qhia pom tias muaj kev tuag ntau hauv cov neeg mob ntshav lim ntshav nrog cov nqi ntawm 29 feem pua rau 41 feem pua. Cov ntawv ceeb toom ua ntej hauv cov neeg tau txais kev hloov pauv zoo li qhia me ntsis kev tuag tsawg dua, nrog kev kwv yees li ntawm 13 feem pua (n ¼ 15) hauv Tebchaws Meskas mus rau 25 feem pua hauv Ltalis (n ¼ 20).13–15 Txoj kev tshawb fawb loj tshaj plaws rau hnub tim yog los ntawm Spain, qhia txog ib pab pawg ntawm 868 KRT cov neeg mob (67 feem pua cov neeg mob lim ntshav thiab 33 feem pua cov neeg mob hloov pauv) nrog kev tuag ntawm 23 feem pua.16
Kev pheej hmoo kwv yees los ntawm cov kev tshawb fawb nrog cov qauv me me tau paub tias raug kev txom nyem los ntawm qhov tsis raug vim qhov sib txawv tsis sib xws. Tsis tas li ntawd, vim qee qhov piv txwv saum toj no tau muab los ntawm cov neeg nyob hauv tsev kho mob, qhov kev kwv yees qhia txog kev pheej hmoo hauv ib pab pawg neeg mob hnyav dua thiab yuav tsis tuaj yeem ua rau cov neeg mob KRT dav dav. Tsis tas li ntawd, feem ntau ntawm cov kev tshawb fawb no, suav nrog qhov loj tshaj plaws, siv cov ntaub ntawv kev tuag los ntawm kev ntsuas kev tuag, uas feem ntau suav nrog thaum tus neeg tau txais txiaj ntsig (rov qab los yog tuag) tsuas yog paub rau feem feem ntawm cov neeg mob.17Txog niaj hnub no, cov kev tshawb fawb loj ntawm cov pej xeem ntawm kev tuag hauv KRT cov pej xeem uas tsis muaj cov ntaub ntawv rov qab ua tiav. Yog li ntawd, thawj lub hom phiaj ntawm txoj kev tshawb fawb tam sim no yog txhawm rau tshawb xyuas COVID-19 qhov tshwm sim ntawm kev tuag 28 hnub tom qab kuaj pom hauv European kev lim ntshav thiab hloov lub raum nrog kev siv keeb kwm ntawm pawg neeg lim ntshav thiab hloov cov neeg mob tsis muaj COVID{{4} }. Lub hom phiaj thib ob yog los sib piv kev tuag ntawm kev lim ntshav thiab hloov cov neeg mob nrog COVID-19. Thaum kawg, peb tsom los txiav txim siab txog lub luag haujlwm ntawm tus neeg mob tus yam ntxwv, KRT cov yam ntxwv ntsig txog kev kho mob, thiab lub teb chaws uas muaj feem cuam tshuam rau kev tuag ntawm ob pawg.
Cistanche txiaj ntsig: txhawb kev tiv thaiv kab mob
TSEEM CEEB
Cov neeg mob
Txij Lub Ob Hlis Ntuj Tim 1, 2{{30}}20, txog rau lub Plaub Hlis 30, 2020, tag nrho ntawm 4298 KRT cov neeg mob tau kuaj pom tias muaj COVID-19, ntawm 3285 (76.4 feem pua ) nyob rau hauv kev lim ntshav-3160 ntawm hemodialysis thiab 125 ntawm peritoneal dialysis-thiab 1013 (23.6 feem pua) tau nyob nrog kev hloov pauv ua haujlwm (Table 1). Feem ntau ntawm cov neeg mob lim ntshav kuaj pom tias muaj COVID{15}} los ntawm Fabkis (49.6 feem pua) thiab Spain (29.7 feem pua). Hauv cov neeg mob dialysis, lub hnub nyoog nruab nrab ntawm COVID{20}} kev kuaj mob yog 71.7 xyoo (interquartile range [IQR] 60.6–80.5), txij li 63.2 xyoo hauv Romania mus rau 74.0 xyoo hauv Spain. Ob feem peb yog $65 xyoo, yuav luag ob feem peb yog txiv neej, yuav luag ib nrab ntawm cov mob ntshav qab zib mellitus (25.5 feem pua) los yog kub siab / kab mob reovascular (RVD) (21.2 feem pua) ua tus kab mob hauv lub raum (PRD), thiab 96.2. feem pua yog nyob rau hauv hemodialysis. Muaj pes tsawg tus neeg hloov pauv cov neeg mob nrog COVID-19 muaj nyob hauv Fab Kis (50.5 feem pua) thiab Spain (49.5 feem pua). Cov neeg tau txais kev hloov pauv tsis muaj hnub nyoog qis dua cov kev lim ntshav (P < 0.001),="" nrog="" rau="" hnub="" nyoog="" nruab="" nrab="" ntawm="" 60.9="" xyoo="" (iqr="" 51.1–69.4)="" thiab="" 37.3="" feem="" pua="" yog="" $="" 65="" xyoo.="" ib="" yam="" li="" cov="" neeg="" mob="" lim="" ntshav,="" 65.4="" feem="" pua="" yog="" txiv="" neej="" (p="" ¼="" 0.23),="" txawm="" li="" cas="" los="" xij,="" feem="" ntawm="" cov="" neeg="" mob="" ntshav="" qab="" zib="" mellitus="" (12.8="" feem="" pua)="" thiab="" kub="" siab="" rvd="" (10.6="" feem="" pua)="" raws="" li="" prd="" qis="">
Thaum Lub Tsib Hlis 1, 2020, COVID-19 cov neeg mob sawv cev w2.9 feem pua ntawm tag nrho cov neeg mob uas muaj kev lim ntshav (lub teb chaws thaj tsam 1.0 feem pua -3.7 feem pua ) thiab 1.4 feem pua ntawm cov neeg nyob nrog kev ua haujlwm tsis zoo (lub teb chaws thaj tsam 1.3 feem pua -1.6 feem pua) (Cov Lus Qhia Ntxiv S1). Piv nrog rau kev lim ntshav thiab hloov cov neeg mob uas tsis muaj COVID-19, cov neeg uas muaj COVID{17}} yog 2–3 xyoos. Qhov feem pua ntawm cov txiv neej cov neeg mob tau nce me ntsis, nrog 2.0 feem pua ntawm cov txiv neej ntawm cov neeg mob lim ntshav, thiab 3.0 feem pua ntawm cov txiv neej ntau dua ntawm cov neeg tau txais kev hloov pauv (Sab Ntxiv Table S2). Hauv ob qho tib si lim ntshav thiab hloov cov neeg mob nrog COVID-19, muaj ntau tus neeg mob ntshav qab zib mellitus li PRD (4.7 feem pua thiab 3.9 feem pua, raws li).
Crude tuag
Nees nkaum yim hnub tom qab kev kuaj mob COVID-19, 628 ntawm 3160 cov neeg mob hemodialysis thiab 30 ntawm 125 tus neeg mob ntawm lub plab zom mov tau tuag. Daim duab 1 qhia tau hais tias nyob rau hauv pab pawg neeg lim ntshav tag nrho, 21.2 feem pua tau tuag 28 hnub tom qab kuaj mob, nrog rau 0.3 feem pua ntawm cov neeg tuag tshwm sim rau hnub kuaj. Hauv cov neeg tau txais kev hloov pauv, 191 ntawm 1013 tau tuag tom qab 28 hnub. Lawv crude 28-hnub qhov tshwm sim ntawm kev tuag ntawm 20.2 feem pua zoo ib yam li cov hauv kev lim ntshav (Daim duab 1), nrog rau 3.3 feem pua ntawm cov neeg tuag nyob rau hnub kuaj mob. Thaum 28 hnub, txoj kev ciaj sia tau pib tawm mus, uas qhia tias feem ntau ntawm cov neeg tuag vim yog COVID-19 tau tshwm sim nyob rau lub sijhawm no.
Daim duab 1|Qhov tshwm sim ntawm kev tuag ntawm cov neeg mob lim ntshav (sab laug vaj huam sib luag) thiab cov neeg mob hloov pauv (txoj cai vaj huam sib luag) nrog tus kab mob coronavirus 2019 (COVID-19) thiab pawg tswj hwm tus qhab nia sib luag yam tsis muaj COVID-19 ( ciaj sia nyob, thiab ua raws los ntawm Lub Peb Hlis 15, 2017). CI, kev ntseeg siab luv.
COVID-19 kev tuag uas tshwm sim
Piv nrog rau qhov xav tau 1.2 feem pua ntawm cov neeg tuag nyob rau hauv pawg tswj hwm ntawm cov neeg mob lim ntshav tsis muaj COVID-19, COVID-19 cov neeg tuag tau yog 200 feem pua thiab kev pheej hmoo tuag yog 21.1 (95 feem pua kev ntseeg siab ncua sij hawm [CI] 18.6–23.9) lub sij hawm siab dua hauv cov neeg mob lim ntshav kuaj pom tus kab mob COVID-19 (Daim duab 1; Cov lus ntxiv S3). Hauv cov neeg tau txais kev hloov pauv tau kuaj pom tias muaj COVID-19, qhov kev tuag tshwm sim yog 19.9 feem pua ntawm qhov xav tau 0.2 feem pua kev tuag hauv pawg tswj hwm. Vim tias kev tuag feem ntau qis dua nyob rau hauv cov neeg mob hloov pauv piv nrog cov neeg mob lim ntshav, lawv txoj kev pheej hmoo tuag yog 92.7 (95 feem pua CI 61.0–140.7) lub sij hawm siab dua piv nrog lawv cov neeg tsis yog-COVID-19 sib tw tswj cov neeg mob (Daim duab 1).
Kev pheej hmoo tuag hauv cov neeg tau txais kev hloov pauv piv rau cov neeg mob lim ntshav
Ntxiv daim duab S1 qhia tau hais tias qhov kev pheej hmoo tuag ntawm cov neeg tau txais kev hloov pauv nrog COVID-19 yog 28 feem pua siab dua (kev phom sij 1.28, 95 feem pua CI 1.02–1.60) piv nrog rau pawg xaiv ntawm cov neeg mob lim ntshav uas tuaj yeem sib phim (Table Ntxiv S4 ).
Figure 2 | Probability of death 28 days after diagnosis of coronavirus disease 2019 and number at risk for dialysis patients (top) and transplant patients (bottom), by age at diagnosis. Axis scales differ for dialysis and transplant graphs. Two transplant patients >90 xyoo ntawm kev kuaj mob tau suav nrog hauv pawg hnub nyoog 80þ.
Kev pheej hmoo tuag taus hauv cov neeg mob lim ntshav kuaj pom tias muaj COVID-19
Hauv cov neeg mob dialysis, kev soj ntsuam ntawm cov neeg tuag crude los ntawm qeb hnub nyoog tau qhia qhov sib txawv ntawm cov hnub nyoog sib txawv, nrog {{0}}hnub tuag rau cov neeg mob hnub nyoog $ 75 xyoo siab txog 31.4 feem pua (Table 2; Daim duab 2). Qhov kev pheej hmoo ntawm kev tuag ntawm cov txiv neej yog 22.5 feem pua ntawm 19. 0 feem pua ntawm cov poj niam. Dialysis cov neeg mob ntshav siab / RVD raws li PRD muaj qhov muaj feem yuav tuag ntau tshaj plaws (24.3 feem pua), tom qab ntawd yog ntshav qab zib mellitus (20.6 feem pua) thiab glomerulonephritis (16.7 feem pua). Lub sijhawm 28-hnub qhov tshwm sim ntawm kev tuag yog 25.0 feem pua ntawm cov neeg kho nrog peritoneal dialysis thiab 23.8 feem pua hauv cov neeg mob hemodialysis. Muaj qhov sib txawv ntawm cov neeg tuag thoob plaws 7 lub teb chaws koom; nws yog qhov siab tshaj plaws hauv Netherlands (29.7 feem pua) thiab qis tshaj hauv Romania (8.5 feem pua) (Daim duab 3). Kev txheeb xyuas ntau yam sib txawv tau txheeb xyuas cov hnub nyoog siab dua thiab txiv neej pw ua ke uas muaj feem cuam tshuam rau 28-hnub tuag hauv COVID-19 cov neeg mob lim ntshav (Table 2). Tom qab kev hloov kho rau txhua tus neeg muaj kev tsis sib haum xeeb, cov neeg mob lim ntshav hauv Romania thiab Fabkis tau muaj kev pheej hmoo tuag tsawg dua li cov neeg nyob hauv Switzerland. Qhov tshwm sim ntawm kev tuag los ntawm pab pawg hnub nyoog, poj niam txiv neej, thiab PRD muaj nyob rau hauv Cov Duab Ntxiv S2–S4 thiab COVID-19– cov neeg tuag uas muaj feem cuam tshuam tau muab rau hauv Cov Lus Ntxiv S5.
Daim duab 3|Qhov tshwm sim ntawm kev tuag ntawm cov neeg mob lim ntshav (sab laug) thiab cov neeg hloov pauv (txoj cai) nrog tus kab mob coronavirus 2019 (COVID-19), los ntawm lub tebchaws. CI, kev ntseeg siab luv.
Kev pheej hmoo tuag taus hauv cov neeg tau txais kev hloov pauv tau kuaj pom tias muaj COVID-19
Hauv cov neeg tau txais kev hloov hauv lub raum, kev soj ntsuam ntawm kev tuag tsis zoo los ntawm pawg hnub nyoog pom tau tias muaj 44.3 feem pua qhov yuav tuag ntawm cov hnub nyoog $ 75 xyoo, uas suav txog yuav luag ib nrab ntawm cov neeg mob (Table 3). Qhov tshwm sim ntawm kev tuag yog 19.1 feem pua ntawm cov txiv neej thiab 22.2 feem pua ntawm cov poj niam, thiab siab tshaj plaws ntawm cov neeg mob ntshav qab zib mellitus raws li PRD (30.6 feem pua), tom qab ntawd kub siab / RVD (27.9 feem pua), thiab qis tshaj ntawm cov neeg mob glomerulonephritis (16.4 feem pua) . Qhov tshwm sim ntawm kev tuag yog siab dua hauv Spain (23.3 feem pua) dua li hauv Fabkis (16.8 feem pua) (Daim duab 3). Hauv kev txheeb xyuas ntau yam sib txawv, tsuas yog muaj hnub nyoog siab dua tau pom tias yog qhov muaj feem pheej hmoo rau 28-hnub tuag (Table 3). Qhov tshwm sim ntawm kev tuag los ntawm pab pawg hnub nyoog, poj niam txiv neej, thiab PRD muaj nyob rau hauv Cov Duab Ntxiv S2–S4, thiab COVID-19– cov neeg tuag uas muaj feem cuam tshuam tau muab rau hauv Cov Lus Ntxiv S5.
Cistanche ntxiv: txhim kho kev tiv thaiv
Kev sib tham
Hauv tsab xov xwm no, peb nthuav qhia cov ntaub ntawv ua tiav cov pej xeem ntawm ntau dua 4000 KRT cov neeg mob cuam tshuam los ntawm COVID-19 sau los ntawm cov npe hauv tebchaws thiab cheeb tsam hauv lub raum hauv Tebchaws Europe. Peb tshaj tawm qhov tshwm sim ntawm kev tuag ntawm 28 hnub tom qab kuaj pom thiab muaj feem cuam tshuam rau cov neeg mob lim ntshav los ntawm7 Cov teb chaws Europe thiab hauv cov neeg tau txais kev hloov pauv los ntawm 2 European lub teb chaws. Hauv ob qhov kev lim ntshav thiab cov neeg tau txais kev hloov pauv, ib feem tsib ntawm cov neeg mob tau tuag los ntawm 28 hnub tom qab kuaj mob. Kev sib piv ntawm lub taub hau-rau-lub taub hau tau pom tias cov neeg tau txais kev hloov pauv tau muaj 28 feem pua ntawm kev pheej hmoo ntawm kev tuag ntau dua piv nrog lawv cov neeg lim ntshav. Kev soj ntsuam ntxiv hauv cov neeg mob lim ntshav tau qhia tias muaj hnub nyoog ntau dua, txiv neej poj niam txiv neej, thiab lub teb chaws yog qhov muaj feem cuam tshuam, thaum cov neeg tau txais kev hloov pauv tsuas yog hnub nyoog siab dua tau cuam tshuam nrog kev pheej hmoo ntawm kev tuag. Cov ntaub ntawv qhia tias qhov tshwm sim ntawm kev kuaj mob COVID-19 hauv cov pej xeem KRT tsawg. Txawm li cas los xij, raws li 2.9 feem pua ntawm cov neeg mob ntshav lim ntshav ntau thiab 1.4 feem pua ntawm cov neeg nyob hauv kev ua haujlwm tsis zoo tau cuam tshuam los ntawm COVID-19, tus kab mob no zoo li tau muaj kev cuam tshuam ntau dua rau cov pej xeem KRT piv rau cov pej xeem, 1 uas tej zaum yuav yog vim lawv lub hnub nyoog laus, lossis tej zaum qhov tshwm sim ntawm kev sim ntau zaus.
Txawm hais tias peb cov neeg mob COVID-19 tau los ntawm cov neeg sau npe, lawv tsis tuaj yeem sawv cev rau txhua tus neeg mob KRT nrog COVID-19. Feem ntau ntawm cov kab mob yog asymptomatic lossis mob me thiab tsis tas yuav mus pw hauv tsev kho mob, tej zaum tsis muaj kev sab laj ntawm tus kws kho mob lossis kws kho mob nephrologist. Cov neeg mob no yuav tsis tau kuaj thiab yog li ntawd tseem tsis tau kuaj pom. Raws li kev ntsuam xyuas hauv cov chaw lim ntshav tau dhau los ua ntau dua, txawm tias tus qauv, thaum muaj kev sib kis thoob qhov txhia chaw, qhov no tsis tshua muaj rau cov neeg mob hemodialysis uas tuaj xyuas lawv lub chaw lim ntshav ob peb zaug hauv ib lub lis piam. Kev faib ua feem ntawm cov neeg mob nrog COVID-19 tau qis dua hauv cov neeg mob ntawm kev lim ntshav peritoneal thiab hauv cov neeg tau txais kev hloov pauv. Peb xav tias nyob rau hauv cov pab pawg no, kev sim yuav raug txwv rau cov tsos mob thiab mob hnyav dua, thiab yog li ntawd peb cov ntaub ntawv rau cov neeg no yuav sawv cev rau ib pab pawg neeg mob. Qhov no tau txais kev txhawb nqa los ntawm cov neeg tau txais kev hloov pauv siab heev uas tau tuag rau hnub kuaj mob (3.3 feem pua). Qhov kev coj tsis ncaj no tuaj yeem piav qhia peb qhov kev tshawb pom tias cov neeg mob hloov pauv tau muaj kev pheej hmoo siab tuag ntau dua li cov neeg mob lim ntshav ntawm cov qhab nia zoo sib xws. Ntawm qhov tod tes, kev txhaj tshuaj tiv thaiv kab mob kuj tseem yuav muaj qhov tsis zoo thaum tiv thaiv tus kab mob ntau dua li qhov kom zoo dua los ntawm kev txo cov cua daj cua dub cytokine.6,7
Txawm hais tias qhov txaus ntshai ntawm kev cog lus COVID-19 tsawg hauv KRT cov neeg mob, 28-hnub tuag hauv COVID-19 cov neeg mob tau dhau qhov kev tuag uas yuav xav tau rau cov neeg mob KRT ntawm cov qhab nia zoo sib xws raws li cov ntaub ntawv tswj keeb kwm. Cov ntaub ntawv hais txog 28-hnub qhov tshwm sim ntawm kev tuag vim yog COVID-19 los ntawm qeb hnub nyoog hauv cov pej xeem tsis muaj. Txawm li cas los xij, cov ntaub ntawv hais txog tus neeg mob tuag nyob rau hauv cov neeg Italian feem ntau muaj li 3.5 feem pua hauv 60–69-cov hnub nyoog thiab rau 12.8 feem pua rau cov hnub nyoog 70–79 xyoo.18 Cov ntaub ntawv zoo sib xws los ntawm Spain qhia me ntsis siab dua feem pua: 5.2 feem pua thiab 14.6 feem pua.19 Qhov no yuav qhia tau tias kev tuag los ntawm COVID-19 hauv cov neeg lim ntshav (hnub nyoog nruab nrab 71.7 xyoo) yog w2 npaug siab dua thiab hauv cov neeg mob hloov pauv (hnub nyoog nruab nrab 60.9 xyoo) $ 6 npaug siab dua, piv nrog cov neeg mob uas tsis yog KRT nrog COVID{{ 8}} muaj hnub nyoog zoo sib xws. Undoubtedly, multimorbidity hauv kev lim ntshav thiab hloov cov neeg mob yuav tau ua lub luag haujlwm tseem ceeb hauv kev piav qhia txog kev tuag ntau heev, tab sis hmoov tsis zoo, peb cov ntaub ntawv tsis tso cai rau kev tshawb nrhiav ntxiv ntawm cov ncauj lus no. Txawm li cas los xij, peb yuav tsum nco ntsoov tias nyob rau hauv ob qho tib si kev lim ntshav thiab cov pab pawg hloov pauv yuav luag 80 feem pua ntawm cov neeg mob muaj sia nyob COVID-19 tsawg kawg txog 28 hnub tom qab kuaj mob, txawm tias muaj ntau ntawm lawv yuav tsis muaj. tau txais mus rau hauv chav saib xyuas mob hnyav vim lawv qhov kev pheej hmoo siab ntawm kev tuag.
Hauv ob qho tib si lim ntshav thiab hloov cov neeg mob nrog COVID-19, hnub nyoog siab dua tseem yog qhov tseem ceeb tshaj plaws rau kev tuag hauv peb qhov kev txheeb xyuas ntau yam sib txawv. Qhov kev tshawb pom tias txiv neej pw ua ke yog qhov muaj feem cuam tshuam rau cov neeg mob lim ntshav nrog COVID-19 yog qhov txaus siab. Nws tau lees paub qhov kev tshawb pom yav dhau los hauv cov pej xeem thiab tseem muaj kev tuag ntawm cov hlab plawv me ntsis pom hauv cov txiv neej laus piv nrog cov poj niam ntawm kev lim ntshav yam tsis muaj COVID-19.20 Cov kev tshawb fawb yav dhau los pom muaj kab mob plawv ua ntej yuav muaj feem cuam tshuam rau cov neeg mob lim ntshav.10Peb tsis muaj kev nkag mus rau cov ntaub ntawv comorbidity, tab sis PRD tuaj yeem suav tias yog tus neeg sawv cev rau kev sib kis. Hauv peb txoj kev tshawb fawb, cov ntsiab lus kwv yees ntawm qhov kev pheej hmoo ntxiv tshwm sim los ntawm ntshav qab zib mellitus thiab kub siab / RVD tau qhia tias muaj kev tuag ntau ntxiv. Txawm li cas los xij, qhov kev ywj pheej ntxiv ntawm PRD nyob rau sab saum toj ntawm lub hnub nyoog tsis tuaj yeem kuaj pom, tej zaum yuav yog qhov tshwm sim ntawm lub zog tsis txaus. Hauv kev lim ntshav cov neeg mob nrog COVID-19, peb pom tias qhov tshwm sim ntawm kev tuag txawv nyob thoob plaws lub tebchaws. Txawm hais tias nws yog qhov txaus nyiam, peb tsis xav kos ib qho kev txiav txim siab los ntawm qhov kev tshawb pom, vim tias ntau qhov kev hloov pauv tuaj yeem raug ntaus nqi los ntawm qhov sib txawv ntawm qhov kev txheeb xyuas ntawm COVID-19 cov xwm txheej (raws li qhov sib txawv ntawm cov tswv yim sim), qhov sib txawv ntawm qhov mob hnyav, thiab tsis muaj peev xwm kho tau rau lub teb chaws tsis muaj kev ntsuas- thiab cov neeg mob-theem confounders.
Cistanche ntxiv: txhim kho kev tiv thaiv
Muaj zog thiab kev txwv
Txoj kev tshawb no qhia txog cov ntaub ntawv los ntawm lub raum kev sau npe uas lub hom phiaj suav nrog cov ntaub ntawv tiav nrog rau tag nrho lub tebchaws, tshem tawm cov qauv kev tsis ncaj ncees uas pom hauv cov kev tshawb fawb me me thiab tsis yog pej xeem. Txawm li cas los xij no lub zog tshwj xeeb, thaum nws
los ntawm kev tshaj tawm txog cov neeg mob nrog COVID-19, kev sau npe rau lub raum, ib yam nkaus, tsis tuaj yeem zam qhov cuam tshuam ntawm cov tswv yim kev sim tsis zoo uas tshwm sim los ntawm cov khoom siv kuaj tsis txaus. Kev tshaj tawm txog cov xwm txheej, tsis hais seb yog vim li cas (tsis muaj tsos mob, tsis muaj kev saib xyuas tus cwj pwm, tsis muaj kev sim, lossis tsis qhia rau KRT qhov chaw kho mob), yuav ua rau muaj kev kwv yees ntau dhau ntawm kev tuag. Qhov overestimation no zoo li me me rau cov neeg mob hemodialysis, tab sis nws yuav yog qhov tseem ceeb dua rau cov neeg mob ntshav qab zib hauv lub cev thiab cov neeg tau txais kev hloov pauv, qhov twg tuaj yeem muaj mob hnyav dua. Qhov twg ntawm qhov kev coj ua piv txwv no, ua rau muaj kev sib txawv ntawm cov tswv yim sim, tej zaum yuav txawv ntawm cov teb chaws thiab cov chaw. Tsis tas li ntawd, siv cov ntaub ntawv sau npe ua qhov chaw, peb tsis muaj kev nkag mus rau cov ntaub ntawv ntxiv ntawm tus neeg mob thiab cov yam ntxwv kho mob uas tuaj yeem yog qhov tseem ceeb rau qhov tshwm sim ntawm COVID-19 cov neeg mob ntawm KRT. Thaum kawg, txawm tias txoj kev tshawb fawb no suav nrog cov neeg mob ntau tshaj plaws ntawm COVID-19 ntawm KRT los txog rau niaj hnub no, nws tseem yuav raug kev txom nyem los ntawm cov teeb meem ntawm lub zog suav, uas ua rau tsis muaj peev xwm txheeb xyuas cov koom haum tiag tiag.
Xaus
COVID-19 tus kab mob kis thoob qhov txhia chaw tau muaj kev cuam tshuam loj heev rau kev tuag hauv txhua pawg ntawm cov neeg mob KRT cuam tshuam los ntawm tus kab mob, ua rau cov neeg laus KRT cov neeg laus thiab cov neeg tau txais kev hloov pauv. Nws pom tau tias thaum ntxov ntawm kev sib kis, cov chaw kho mob hemodialysis tuaj yeem ua haujlwm tseem ceeb ntawm kev kis kab mob. Nws yog ib qho tseem ceeb heev uas nyob rau yav tom ntej muaj kev sib kis thoob ntiaj teb cov zej zog nephrology muaj kev tswj hwm kev kub ntxhov thiab tswj cov txheej txheem nyob rau hauv qhov chaw thiab muaj peev xwm ua tau nrawm kom muaj kev nyab xeeb ntawm lawv cov neeg mob thiab txo kev puas tsuaj rau lawv txoj kev noj qab haus huv ntau li ntau tau. Cov lus pom zoo hauv cov lus qhia no tau tshaj tawm, thiab ntau qhov kev tshawb fawb txog kev tiv thaiv COVID-19 hauv KRT cov neeg mob tseem tab tom ua.
Cistanche txiaj ntsig: anti-bacterial
Cov neeg mob thiab cov txheej txheem
Kev sau cov ntaub ntawv thiab cov neeg koom
European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry sau cov ntaub ntawv txhua xyoo ntawm cov neeg mob pib KRT los ntawm lub teb chaws thiab cheeb tsam lub raum sau npe hauv Tebchaws Europe. Thaum tus kab mob COVID-19 kis tau mus txog peb lub teb chaws, cov ntawv sau npe muab cov ntaub ntawv tus neeg mob qib ib tus neeg mob ntawm KRT cov neeg mob tau hais kom muab cov ntaub ntawv ntxiv ntawm txhua tus neeg mob KRT nrog kev kuaj mob ntawm COVID-19, tsis yog kuaj mob lossis ib qho pov thawj los ntawm kev sim. Cov ntaub ntawv suav nrog tus neeg mob thiab KRT tus yam ntxwv kho mob (hli thiab xyoo yug, poj niam txiv neej, PRD, xyoo pib ntawm KRT, kev kho tam sim no), ntxiv nrog rau hnub kuaj mob COVID-19, thiab hnub tuag. Cov ntaub ntawv los ntawm 7 lub raum sau npe nrog tsawg kawg 25 tus neeg mob ntawm kev lim ntshav lossis 25 tus neeg mob nyob nrog lub raum hloov pauv nrog COVID-19 kev kuaj mob tau suav nrog hauv txoj kev tshawb no (Austria, Fabkis hais lus Belgium, Fabkis, Romania, Spain, Switzerland, thiab Netherlands). Lub xyoo ntawm KRT pib tsis muaj rau Spain; Hloov chaw, xyoo pib ntawm kev kho mob tam sim no tau muab. PRD tau muab faib ua 4 pawg: glomerulonephritis, ntshav qab zib mellitus, kub siab / RVD, thiab lwm yam PRDs. Cov neeg mob uas ploj lawm xyoo ntawm kev tuag (n ¼ 2) thiab kev kho mob (n ¼ 8) raug tshem tawm los ntawm kev tshuaj xyuas. PRD ploj lawm (n ¼ 5) tau suav nrog "lwm" PRD qeb. Kev sib deev thiab hnub kuaj tau tiav rau txhua tus neeg mob. Txhua lub teb chaws thiab cheeb tsam rau lub raum sau npe koom nrog cov ntaub ntawv rau txoj kev tshawb no ua raws li kev cai lij choj hauv tebchaws thiab European thiab cov cai hauv tebchaws rau kev tiv thaiv cov ntaub ntawv.
Kawm cov txiaj ntsig thiab kev txheeb xyuas kev txheeb xyuas
Cov ntsiab lus kawg tau kawm yog tag nrho-ua rau kev tuag nyob rau hauv 28 hnub tom qab kuaj pom tus kab mob COVID-19. Cov kev hloov pauv tsis tu ncua tau muab raws li qhov nruab nrab (SD) lossis nruab nrab (IQR) thiab tau muab piv nrog cov pab pawg nrog kev siv (paired) t-test lossis Wilcoxon rank sums test. Categoric variables tau nthuav tawm raws li qhov zaus thiab feem pua thiab tau muab piv los ntawm kev xeem Fisher tseeb. Qhov feem pua ntawm cov neeg mob lim ntshav thiab hloov pauv cov neeg mob uas kuaj pom muaj tus kab mob COVID-19 tau kwv yees los ntawm kev faib cov neeg mob los ntawm cov neeg mob uas muaj nyob rau lub Kaum Ob Hlis 31, 2017, muab faib ua 100.
Txhawm rau sib piv qhov tshwm sim ntawm kev tuag ntawm cov neeg mob nrog COVID-19 thiab cov uas tsis muaj COVID-19 ntawm cov neeg mob lim ntshav thiab hloov pauv cov neeg mob, peb tau xaiv cov neeg mob tswj keeb kwm los ntawm ERA-EDTA Registry database uas tau muaj sia nyob thiab lim ntshav lossis nyob. nrog rau kev hloov pauv ua haujlwm thaum Lub Peb Hlis 15, 2017. Cov neeg mob COVID-19 tau sib phim rau 10
cov neeg mob uas tsis yog-COVID-19 raws li lawv cov qhab nia kwv yees. Cov qhab nia zoo li no tau suav nrog siv logistic regression suav nrog COVID-19 raws li qhov sib txawv ntawm qhov sib txawv thiab cov kev hloov pauv ywj pheej hauv qab no: kev hloov pauv (xws li lim ntshav lossis hloov pauv, 100 feem pua tsim yuav tsum tau), hnub nyoog, poj niam txiv neej, PRD (4 pawg), lub sijhawm txij li pib ntawm KRT (los yog txij li qhov kawg kev kho mob hloov pauv rau Spain), thiab lub teb chaws.
Survival analytics tau siv los xam qhov tshwm sim ntawm kev tuag. Rau cov neeg mob uas muaj tus kab mob COVID-19, hnub kuaj tau raug coj los ua qhov chaw pib thiab txhua qhov kev tuag yog qhov tshwm sim tau kawm. Lub sijhawm taug qab tau raug censored tom qab 28 hnub ntawm kev taug qab lossis lub Tsib Hlis 1, 2020, qhov twg tshwm sim thawj zaug. Rau cov neeg mob lim ntshav thiab hloov pauv cov neeg mob yam tsis muaj COVID-19 kev tshuaj xyuas tau pib thaum Lub Peb Hlis 15, 2017, thiab xaus rau ntawm kev tuag lossis ntawm 28 hnub tom qab Lub Peb Hlis 15, 2017. Txoj kev Kaplan-Meier tau siv los suav cov kev pheej hmoo ntawm kev tuag uas tsis tau kho. rau cov neeg mob lim ntshav thiab hloov cov neeg mob nrog COVID-19 thiab lawv cov kev tswj hwm keeb kwm zoo sib xws uas tsis muaj COVID{16}}, tso cai rau kev soj ntsuam censored. Qhov ntsuas ntsuas ntsuas tau siv los sib piv qhov faib lub sijhawm rau kev tuag ntawm pawg. Tus kab mob COVID{18}}– cov neeg tuag uas muaj feem cuam tshuam tau txhais tau tias yog qhov tshwm sim ntawm kev tuag hauv COVID{19}} cov neeg mob tshem tawm qhov tshwm sim ntawm kev tuag hauv cov neeg mob uas tsis yog-COVID-19 cov neeg mob (piv txwv li, keeb kwm tswj cov neeg mob ). Kev tuag muaj peev xwm ntsuas qhov feem ntawm qhov tshwm sim ntawm kev tuag hauv COVID-19 cov pej xeem uas tuaj yeem raug ntaus nqi los ntawm COVID-19.
Kev sib piv ntawm kev tuag hauv kev lim ntshav thiab hloov cov neeg mob nrog KEVID-19 kuj tau siv cov qhab nia zoo sib xws raws li txoj hauv kev los tswj kom tsis meej pem. Cov neeg mob los ntawm cov pab pawg no tau sib tw 1 txog 1, thiab cov qhab nia zoo raws li hnub nyoog, poj niam txiv neej, PRD (4 pawg), lub sijhawm txij li pib ntawm KRT (lossis txij li qhov kev kho mob kawg hloov pauv rau Spain), thiab lub tebchaws. Cov neeg mob uas tsis tuaj yeem sib tw tau raug tshem tawm ntawm qhov kev tshuaj ntsuam. Ib zaug ntxiv, txoj kev Kaplan-Meier tau siv los sib piv qhov tshwm sim ntawm kev tuag rau cov neeg mob nrog COVID-19 ntawm kev lim ntshav thiab lawv cov neeg mob tswj tau sib luag nyob rau hauv kev hloov pauv ua haujlwm. Peb tau ua qhov kev soj ntsuam rhiab heev ntawm cov txiaj ntsig tseem ceeb kom paub tseeb qhov tseeb ntawm qhov kev xav tau nrog kev siv ntau yam ntawm Cox regression (hloov rau hnub nyoog, poj niam txiv neej, xyoo pib ntawm KRT, PRD, thiab lub teb chaws). Cov txiaj ntsig tau los ntawm qhov kev tshuaj ntsuam no tsis txawv ntawm qhov txiaj ntsig tseem ceeb.
Hauv kev lim ntshav thiab hloov cov neeg mob nrog KEVID-19, qhov tshwm sim tsis zoo thiab hloov kho qhov tshwm sim ntawm kev tuag tau raug kawm rau cov hnub nyoog (<65 years,="" 65–74="" years,="" and="" $75="" years),="" for="" men="" and="" women,="" by="" prd="" category,="" by="" treatment="" modality="" (dialysis="" vs.="" transplantation),="" and="" by="" country.="" we="" used="" cox="" regression="" analysis="" to="" investigate="" the="" association="" of="" covid-19="" with="" the="" probability="" of="" death.="" in="" covid-19="" patients,="" we="" applied="" cox="" regression="" to="" adjust="" for="" age,="" sex,="" prd,="" year="" of="" the="" start="" of="" krt="" or="" year="" of="" transplant,="" treatment="" modality,="" and="" country,="" where="" appropriate.="" all="" analyses="" were="" performed="" with="" sas="" software="" version="">
Cistanche txiaj ntsig: anti-inflammatory
REFERENCES
1. European Center for Disease Prevention and Control. COVID-19 cov xwm txheej hloov tshiab rau EU/EEA thiab UK. Available at:https://www.ecdc.europa.eu/en/cases-2019-ncov-eueea. Tau txais los ntawm Lub Rau Hli 9, 2020.
2. Wu Z, McGoogan JM. Cov yam ntxwv ntawm thiab cov lus qhia tseem ceeb los ntawm tus kab mob coronavirus 2019 (COVID-19) tshwm sim hauv Suav teb: cov ntsiab lus ntawm 72314 tus neeg mob los ntawm Tuam Tsev Saib Xyuas Kab Mob thiab Tiv Thaiv Suav. JAMA. 2020; 323: 1239–1242.
3. Docherty AB, Harrison EM, Green CA, et al. Cov yam ntxwv ntawm 16,749 tus neeg mob hauv tsev kho mob UK nrog COVID-19 siv ISARIC WHO Clinical Characterization Protocol. medRxiv. 2020; 04(23): 20076042.
4. de Jager DJ, Grootendorst DC, Jager KJ, et al. Kev tuag ntawm cov hlab plawv thiab cov hlab plawv tsis ua haujlwm ntawm cov neeg mob pib lim ntshav. JAMA. 2009; 302: 1782–1789.
5. ERA-EDTA Registry. ERA-EDTA Registry Annual Report 2017. 2019. Muaj nyob ntawm: https://www.era-edta.org/en/registry/publications/annualreports/# 2017.
6. Coates PT, Wong G, Drueke T, et al. Kev paub ntxov ntxov nrog COVID-19 hauv kev hloov raum. Raum Int. 2020; 97:1074–1075.
7. Tay MZ, Poh CM, Rénia L, et al. Lub trinity ntawm COVID-19: kev tiv thaiv, kev mob, thiab kev cuam tshuam. Nat Rev Immunol. 2020; 20:363–374.
8. Wang R, Liao C, He H, et al. COVID-19 hauv cov neeg mob hemodialysis: daim ntawv qhia txog 5 tus neeg mob. Am J Raum Dis. 2020; 76:141–143.
9. Scarpioni R, Manini A, Valsania T, et al. Covid-19 thiab nws qhov cuam tshuam rau cov neeg mob nephropathic: qhov kev paub ntawm Ospedale "Guglielmo da Saliceto" hauv Piacenza. G Ital Nefrol. 2020; 37(2):4.
10. Alberici F, Delbarba E, Manenti C, thiab al. Ib tsab ntawv ceeb toom los ntawm Brescia Renal COVID Task Force ntawm cov yam ntxwv kho mob thiab cov txiaj ntsig luv luv ntawm cov neeg mob hemodialysis nrog SARS-CoV-2 kev kis tus kab mob. Raum Int. 2020; 98:20–26.
11. Goicoechea M, Sánchez Cámara LA, Macías N, et al. COVID-19: chav kho mob thiab cov txiaj ntsig ntawm 36 tus neeg mob kho hemodialysis los ntawm ib lub chaw hauv Spain. Raum Int. 2020; 98:27–34.
12. Valeri AM, Robbins-Juarez SY, Stevens JS, et al. Kev nthuav qhia thiab cov txiaj ntsig ntawm cov neeg mob ESKD thiab COVID-19. J Am Soc Nephrol. 2020; 31:1409–1415.
13. Mohan S. Cov lus piav qhia ntxov ntawm tus kab mob coronavirus 2019 hauv cov neeg tau txais kev hloov lub raum hauv New York. J Am Soc Nephrol. 2020; 31:1150–1156.
14. Banerjee D, Popoola J, Shah S, et al. Tus kab mob COVID-19 nyob rau hauv cov neeg tau txais kev hloov lub raum. Raum Int. 2020; 97:1076–1082.
15. Alberici F, Delbarba E, Manenti C, et al. Ib qho kev soj ntsuam ntawm ib lub chaw soj ntsuam ntawm cov yam ntxwv kho mob thiab cov txiaj ntsig luv luv ntawm 20 tus neeg mob raum hloov pauv tau txais rau SARS-CoV2 mob ntsws. Raum Int. 2020; 97:1083–1088.
16. Sánchez-Álvarez JE, Fontán MP, Martín CJ, et al. Status of SARS-CoV-2 infection in patient on renal replacement therapy. Daim ntawv tshaj tawm ntawm COVID- 19 Kev Sau Npe ntawm Spanish Society of Nephrology (SEN). Nefrology. 2020; 40:272–278.
17. Natale F, Ghio D, Tarchi D, Goujon A, Conte A. COVID-19 tus neeg mob thiab tus neeg mob tuag los ntawm hnub nyoog. Muaj nyob ntawm: https://ec.europa.eu/knowledge4policy/ publication/covid-19-cases-case-fatality-rate-age_en. Tau txais los ntawm Lub Rau Hli 9, 2020.
18. Onder G, Rezza G, Brusaferro S. Case-fatality rate thiab tus yam ntxwv ntawm cov neeg mob tuag nyob rau hauv kev cuam tshuam nrog COVID-19 hauv Ltalis. JAMA. 2020; 323: 1775–1776.
19. Equipo COVID-19, Red Nacional de Vigiancia Epidemiológica; Centro Nacional de Epidemiología; Centro Nacional de Microbiología, Instituto de Salud Carlos III.
