ABSTRACT
OBJECTIVE: To analyze the clinical characteristics of critically ill patients during the prevention and control of new coronavirus pneumonia and to improve the diagnosis and treatment of critically ill patients with fever. METHODS: A retrospective case analysis method was used to collect clinical data of 80 patients admitted to the critically ill area of fever clinic in the first medical center of PLA general hospital from February to March,2020. Pharyngeal swab specimens were collected from all patients at 24 h intervals and tested for new coronavirus nucleic acid twice.At the same time, a combination of influenza A and B virus nucleic acid were determined, and lung computer tomography scan examination were performed. The differences in clinical data of patients with different blood leukocyte count groups were compared. RESULTS: All patients had negative results for new coronavirus nucleic acid tests, and 2 patients had a positive test for influnenza A virus nucleic acid. One patient was tested positive for hepatitis B virus nucleic acid. There were 60 patients(75.00%) with age over 65 years, 47 patients(58.75%) with more than two basic medical diseases, 70 patients(87.50%) with lung CT indicating lesions, 30 patients(37.50%) with acute kidney injury. Compared with patients with while blood cell count <1010~9/L, patients with WBC>=1010~9/L had higher incidence of diabetes mellitus WBC(P=0.024). There was no significant difference in retention time, body temperature, oxygenation index, and incidence of acute kidney injury between two groups of patients. CONCLUSION: The critically ill patients diagnosed in hospital had the characteristics of old age, many chronic diseases, widespread lung disease, and prone to acute kidney injury during screening. Nucleic acid detection is the most important differential diagnosis basis for the screening of new coronavirus infection.
ABSTRACT
Coronavirus disease 2019 (COVID-19) not only causes pulmonary inflammation but also causes multiple organ damages, including the kidney. ACE2, as one of the receptors for SARS-CoV-2 intrusion, is widely distributed in kidney tissues. Currently, the diagnosis and treatment of SARS-CoV-2 infection in patients with chronic kidney disease (CKD) are still unclear. Here, we review the recent findings of characteristics of COVID-19 in CKD patients and highlight the possible mechanisms of kidney injury caused by SARS-CoV-2 infection. We then discuss the emerging therapeutic approaches aimed at reducing kidney damage and protecting kidney function including virus removal, immunotherapy, supporting treatment, special blood purification therapy, etc. Problems unresolved and challenges ahead are also discussed.