Can patients with COVID-19 infection and kidney injury take antiviral drugs? The Renji team has published relevant results, which damage | patients | disease resistance
Recently, a series of research results on COVID-19 combined with renal injury by the Renal Department of Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine were published in several international authoritative medical journals, providing high-quality evidence-based evidence for early identification and effective intervention of high-risk groups with acute and chronic renal injury combined with COVID-19 infection.
Previous studies have confirmed that Paxlovid, an anti COVID-19 drug, can significantly reduce the hospitalization rate and death risk of non hospitalized patients with COVID-19 infection in high-risk groups. However, the effectiveness and safety of Paxlovid in people with kidney injury are still unclear. To this end, the nephrology team of Renji Hospital conducted a series of studies on patients with kidney injury.
The research of Professor Ke Moushan's team of Kidney included COVID-19 patients who visited Renji Hospital. It was found that after taking Paxlovid, patients with acute renal injury had lower incidence of lung infection and shorter hospital stay. In addition, patients with severe acute kidney injury who take Paxlovid have a lower risk of progression to requiring dialysis treatment. At different stages of acute kidney injury, patients taking Paxlovid experience a faster decrease in virus load and significantly shorter virus clearance time. In order to prove the role of Paxlovid in patients with chronic kidney disease, the team further screened patients with chronic kidney disease combined with COVID-19 infection, and found that this population has a heavy viral load and poor prognosis. Among patients with severe complications of chronic kidney disease, taking Paxlovid within 5 days after diagnosis significantly reduced their all-cause mortality, mechanical ventilation rate and ICU admission rate. Whether taking Paxlovid or not is an independent risk factor for all-cause mortality of patients with COVID-19 infection and chronic kidney disease. In addition, the characteristics of lymphocyte subsets in patients with COVID-19 infection combined with renal injury and their relationship with the prognosis of patients are still unclear. The team's research suggests that the lymphocyte subsets in patients with severe/critical COVID-19 infection combined with renal injury are the lowest. Among all lymphocyte subsets, Th cell count is the most closely related to the prognosis of patients. Th cell count is independently related to the poor prognosis of patients, which can be used as a potential predictor for early identification of high-risk patients.
Professor Gu Leyi and Professor Mou Shan from the Nephrology Department carried out further research on patients with COVID-19 infection complicated with moderate and severe renal injury, and found that the use of Paxlovid was independently related to the reduced risk of the composite endpoint. The team also extensively reported on the application of Paxlovid in hemodialysis patients, and the research results showed that administering an appropriate dose of Paxlovid in hemodialysis patients can also quickly reduce viral load and has high safety.
As a series of studies on the whole disease cycle of patients with kidney disease, the above research results support the idea of "early application of Paxlovid to improve the prognosis of patients in high-risk groups of COVID-19 with kidney injury", and provide a new evidence-based basis for the application of Paxlovid in patients with kidney disease.