On July 4, a reporter from The Paper (www.thepaper.cn) learned from Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine that recently, a series of research results of the hospital’s nephrology team on the field of COVID-19 combined with kidney injury were published in multiple publications. The international authoritative medical journal provides high-quality evidence-based evidence for early identification and effective intervention of high-risk groups with acute and chronic kidney injury combined with new crown infection.
The above-mentioned research team pointed out that previous studies have confirmed that the anti-new coronavirus drug Paxlovid (Namatevir tablets/ritonavir tablets) can significantly reduce the hospitalization rate and death risk of non-hospitalized patients with new coronavirus infection in high-risk groups. Efficacy and safety in the population with renal impairment have not been established. To this end, the nephrology team of Renji Hospital conducted a series of studies on patients with renal impairment.
The team of Professor Mu Shan from the Department of Nephrology at the hospital included new crown patients who were treated at Renji Hospital, and found that patients with acute kidney injury (AKI) had a lower incidence of lung infection and shorter hospital stay after taking Paxlovid. In addition, patients with severe acute kidney injury who took Paxlovid had a lower risk of progressing to requiring dialysis. At different stages of acute kidney injury, patients taking Paxlovid had a faster decline in viral load and a significantly shorter time to viral clearance.
In order to prove the role of Paxlovid in patients with chronic kidney disease (CKD), the team further screened patients with chronic kidney disease and new crown infection, and found that this group had a heavy viral load and a poor prognosis. In patients with severe chronic kidney disease comorbidities, taking Paxlovid within 5 days after diagnosis, the all-cause mortality rate, mechanical ventilation rate and ICU rate were significantly reduced. independent risk factors.
In addition, the characteristics of lymphocyte subsets in patients with new coronary infection combined with kidney injury and their relationship with the prognosis of patients are still unclear. The team’s research suggests that the counts of lymphocyte subsets in patients with severe and critical new coronary pneumonia combined with kidney injury are the lowest, and among all lymphocytes Among the subgroups, the count of Th cells (helper T cells) is most closely related to the prognosis of patients, and the count of Th cells is independently correlated with poor prognosis of patients, which can be used as a potential predictor for early identification of high-risk patients.
Professor Gu Leyi and Mu Shan’s team from Renji Hospital’s Department of Nephrology conducted further research on patients with COVID-19 infection and moderate to severe renal injury (including hemodialysis), and found that the use of Paxlovid was independently associated with a lower risk of composite endpoints. The team also made an in-depth report on the application of Paxlovid in hemodialysis patients. The results of the study proved that the administration of appropriate doses of Paxlovid in hemodialysis patients can also quickly reduce the viral load and has high safety.
The research team stated that the above research results, as a series of studies on the full cycle of disease in patients with kidney disease (acute kidney injury, chronic kidney disease stages, and hemodialysis), support “early application of Paxlovid in high-risk groups with new coronary pneumonia combined with kidney injury to improve patient outcomes. “This point of view provides a new evidence-based basis for the application of Paxlovid in patients with kidney disease.