Risk Prediction of Pneumonia in Maintenance Hemodialysis Patients with COVID-19: A Single-center Retrospective Study in China (preprint)

Objective:  The infection rate and mortality of COVID-19 in hemodialysis patients are extremely high. In this study, we analyzed the risk prediction of pneumonia in Chinese’s hemodialysis patients with COVID-19.  Method: We conducted a retrospective analysis of maintenance hemodialysis patients with COVID-19 admitted to Peking University Third Hospital from December 1, 2022 to January 31, 2023. We collected demographic data, underlying diseases, dialysis treatment data, and laboratory test results of these patients; logistic regression and ROC curve were used to analyze the risk factors of pneumonia.  Results:  A total of 209 hemodialysis patients with COVID-19 were enrolled in this study, of whom 80(38.3%) had pneumonia and 129(61.7%) normal. Multivariate logistic analysis revealed that older age (OR=1.030, 95%CI 1.002~1.059, p=0.036), lower hemoglobin (OR=0.968, 95%CI 0.942~0.995, p=0.019), lower albumin (OR=0.834, 95%CI 0.738-0.943, p=0.004) were risk factors for pneumonia. Patients with age >65 years old, hemoglobin <115g/L or albumin <36.8g/L had a higher risk of pneumonia, and we combined the three indexes to predict the risk of pneumonia (P= elogit(P)    / 1+  elogit(P) , logit(P)=9.593 +0.031×Age (years old) -0.038×Hemoglobin (g/L) -0.210×Albumin (g/L)), drew the ROC curve with the risk P value (AUC=0.756, 95% CI 0.687~0.825, p<0.001), when P=0.575 was selected as the cut-off value, the sensitivity and specificity of the three indexes combined to predict pneumonia were 44.0% and 94.5% respectively.  Conclusion: Older age, anemia and hypoalbuminemia were risk factors for pneumonia in MHD patients. We could reduce the incidence of pneumonia and improve the prognosis of MHD patients by correcting anemia and hypoalbuminemia.

Effects of novel Coronavirus pneumonia pandemic on the spread of multidrug-resistant Acinetobacter in ICU

OBJECTIVE: To investigate the effect of novel coronavirus pneumonia pandemic on multidrug-resistant Acinetobacter baumannii transmission in intensive care units(ICU) and to provide reference for the guidance of nosocomial infection prevention and control. METHODS: Data of multidrug-resistant A. baumannii in ICU1, ICU2 and neurosurgery ICU from Jan. 2019 to Aug. 2020 were collected. Contact times between healthcare workers and environmental surfaces, clearance rate of fluorescent marker in the culture of environment specimens before and after the novel coronavirus pneumonia outbreak, number of free colonies and number of MDR-AB were detected, and the correlation between MDR-AB detection rate of the environment and MDR-AB the infection rate were analyzed by using Pearson correlation analysis. RESULTS: The high-frequency contact surfaces in ICU were bed bars(43.59 times), quilts(39.58 times), treatment vehicles(30.83 times), vein tubes(27.46 times), nursing station table tops(27.20 times) and hand sterilized buttons(26.40 times). The clearance rate of fluorescent marker after novel coronavirus pneumonia outbreak was 81.35%, which was significantly higher than that before the new coronavirus-infected pneumonia epidemic outbreak(P<0.001), with the rate of 56.57%. The detection rate and infection rate of MDR-AB in the environment after new coronavirus-infected pneumonia epidemic were 5.40% and 1.80%, respectively, which were significantly lower than that before the epidemic(P<0.001). Pearson correlation analysis showed that the detection rate of MDR-AB in the ICU environment was positively correlated with the MDR-AB infection rate of patients(r=0.850, P=0.002). CONCLUSION: Methods of novel coronavirus pneumonia epidemic prevention promoted the implementation of environmental sanitation, disinfection and isolation measures, cut off the transmission route of multidrug-resistant A. baumannii, and played a positive role in the prevention and control of infection.