SARS-CoV-2 Infection in a Spanish Cohort of CKD-5D Patients: Prevalence, Clinical Presentation, Outcomes, and De-Isolation Results
SARS-CoV-2 Infection in a Spanish Cohort of CKD-5D Patients: Prevalence, Clinical Presentation, Outcomes, and De-Isolation Results
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DOI：
10.1159/000510557
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发表时间：
2020-12-22
影响因子：
3
通讯作者：
Maduell, Francisco
中科院分区：
文献类型：
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作者：
Broseta, Jose Jesus;Rodriguez-Espinosa, Diana;Maduell, Francisco
简介：COVID-19 是一种高度传染性疾病，很容易在全球范围内传播。门诊维持性血液透析似乎会增加传染风险，之前的报告显示该人群的死亡率增加。方法：我们回顾性分析了我们卫生区感染 SARS-CoV-2 的 CKD-5D 患者出院后的临床和实验室参数、结果和管理。结果：在 429 名 CKD-5D 人群中，36 人被诊断患有 SARS-CoV-2 感染（8%）：34 人接受中心血液透析，2 人接受腹膜透析。五人无症状。最常见的症状是发烧（70%），其次是呼吸困难和咳嗽。心血管疾病史以及入院期间 LDH 和 C 反应蛋白升高与较高的死亡率相关。 13 名患者死亡（36%），8 名患者住进 ICU，后者的生存率较低（38%）。平均死亡时间为 12 天。大多数出院患者在诊断后 26 天内鼻咽拭子 rRT-PCR 呈阴性。然而，有一部分治愈的患者甚至在初次就诊后 2 个多月后仍继续出现阳性结果。结论：如果感染 SARS-CoV-2，透析患者的死亡风险会增加。事实证明，预防措施是有用的。因此，需要推广适当的措施，例如对人群进行普遍筛查和在需要时进行隔离。为了确保公共卫生资源的适当使用，需要更好的解除隔离标准。
Introduction: COVID-19 is a highly contagious disease that has easily spread worldwide. Outpatient maintenance hemodialysis seems to entail an increased risk of contagion, and previous reports inform of increased mortality among this population. Methods: We retrospectively analyzed clinical and laboratory parameters, outcomes, and management once discharged of CKD-5D patients infected with SARS-CoV-2 from our health area. Results: Out of the 429 CKD-5D population, 36 were diagnosed with SARS-CoV-2 infection (8%): 34 on in-center hemodialysis and 2 on peritoneal dialysis. Five were asymptomatic. The most common symptom was fever (70%), followed by dyspnea and cough. History of cardiovascular disease and elevation of LDH and C-reactive protein during admission were associated with higher mortality. Thirteen patients died (36%), 8 patients were admitted to an ICU, and survival was low (38%) among the latter. The mean time to death was 12 days. Most discharged patients got negative rRT-PCR in nasopharyngeal swabs within 26 days of diagnosis. However, there is a portion of cured patients that continue to have positive results even more than 2 months after the initial presentation. Conclusions: Patients on dialysis have an increased mortality risk if infected with SARS-CoV-2. Preventive measures have proven useful. Thus, proper ones, such as universal screening of the population and isolation when required, need to be generalized. Better de-isolation criteria are necessary to ensure an appropriate use of public health resources.