High prevalence of asymptomatic COVID-19 in haemodialysis: learning day by day in the first month of the COVID-19 pandemic
High prevalence of asymptomatic COVID-19 in haemodialysis: learning day by day in the first month of the COVID-19 pandemic
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DOI：
10.1016/j.nefro.2020.04.005
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发表时间：
2020-05-01
期刊：
影响因子：
2.6
通讯作者：
de Sequera, Patricia
中科院分区：
文献类型：
--
作者：
Albalate, Marta;Arribas, Patricia;de Sequera, Patricia
透析患者是SARS-CoV-2感染和可能进一步并发症的风险群体，但我们知之甚少。本文的目的是描述SARS-CoV-2大流行第一个月在马德里地区的医院血液透析（HD）部门的经历，该地区的COVID-19发病率第二高（100,000小时内几乎有1,000名患者）。我们以日记的形式记录了所采取的行动、患者和医护人员的COVID-19发病率、一些临床特征以及对该单位所有患者的筛查结果。我们从90名HD患者开始：37名（41.1%）患有COVID-19，其中17名（45.9%）是通过分诊或治疗期间检测到的症状诊断出来的，15名（40.5%）是通过随后对未接受SARS-CoV-2 PCR检测的患者进行筛查而诊断出来的。发热是最常见的症状，50%有淋巴细胞减少，18.4% O-2饱和度< 95%。住院16例（43.2%），死亡6例（16.2%）。我们发现每个班次和乘坐公共交通工具的人都有感染。就工作人员而言，在涉及的44人中，15人（34%）有相似的症状，4人（9%）被职业卫生确认为SARS-CoV-2 PCR病例，9人（20%）需要一段时间的病假，暂时无法工作（ILT）， 5人被认为是可能的病例。结论：我们检测到COVID-19的高流行率，筛查检出率高；因此，需要主动诊断以阻止大流行。大多数病例作为门诊病人处理，但也出现严重症状，迄今死亡率为16.2%。在工作人员方面，20%的人因COVID-19请了病假。(C) 2020西班牙神经科学学会。Elsevier Espana， S.L.U.出版
Dialysis patients are a risk group for SARS-CoV-2 infection and possibly further complications, but we have little information. The aim of this paper is to describe the experience of the first month of the SARS-CoV-2 pandemic in a hospital haemodialysis (HD) unit serving the district of Madrid with the second highest incidence of COVID-19 (almost 1,000 patients in 100,000 h). In the form of a diary, we present the actions undertaken, the incidence of COVID-19 in patients and health staff, some clinical characteristics and the results of screening all the patients in the unit.We started with 90 patients on HD: 37 (41.1%) had COVID-19, of whom 17 (45.9%) were diagnosed through symptoms detected in triage or during the session, and 15 (40.5%) through subsequent screening of those who, until that time, had not undergone SARS-CoV-2 PCR testing. Fever was the most frequent symptom, 50% had lymphopenia and 18.4% < 95% O-2 saturation. Sixteen (43.2%) patients required hospital admission and 6 (16.2%) died. We found a cluster of infection per shift and also among those using public transport. In terms of staff, of the 44 people involved, 15 (34%) had compatible symptoms, 4 (9%) were confirmed as SARS-CoV-2 PCR cases by occupational health, 9 (20%) required some period of sick leave, temporary disability to work (ILT), and 5 were considered likely cases.Conclusions: We detected a high prevalence of COVID-19 with a high percentage detected by screening; hence the need for proactive diagnosis to stop the pandemic. Most cases are managed as outpatients, however severe symptoms are also appearing and mortality to date is 16.2%. In terms of staff, 20% have required sick leave in relation to COVID-19. (C) 2020 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.