Management of Hemodialysis Patients with Suspected or Confirmed COVID-19 Infection: Perspective from the Spanish Nephrology.
COVID-19
Spain
dialysis
hemodialysis
pandemic
renal dialysis
Journal
Kidney360
ISSN: 2641-7650
Titre abrégé: Kidney360
Pays: United States
ID NLM: 101766381
Informations de publication
Date de publication:
25 11 2020
25 11 2020
Historique:
received:
30
04
2020
accepted:
09
09
2020
entrez:
4
4
2022
pubmed:
11
9
2020
medline:
8
4
2022
Statut:
epublish
Résumé
The recent SARS-CoV-2 coronavirus pandemic has signified a significant effect on the health of the population worldwide. Patients on chronic RRT have been affected by the virus, and they are at higher risk due to the frequent comorbid conditions. Here, we show the results of the COVID-19 Registry of the Spanish Society of Nephrology during the first 6 weeks of the outbreak. This study is an analysis of the data recorded on a registry of patients with ESKD on RRT who tested positive for COVID-19. The aim was to evaluate clinical conditions, therapeutic management, and consequences, including outcome. The registry began on March 18th, 2020. It includes epidemiologic data, cause of CKD, signs and symptoms of the infection, treatments, and outcomes. Patients were diagnosed with SARS-CoV-2 infection on the basis of the results of PCR of the virus obtained from nasopharyngeal/oropharyngeal swabs. The tests were performed on symptomatic patients and on those who mentioned contact with infected patients. As of May 2, the registry included data on 1397 patients (in-center hemodialysis [IC-HD], 63%; kidney transplant [Tx], 34%; peritoneal dialysis [PD], 3%; and home hemodialysis, 0.3%). The mean age was 67±15 years, and two-thirds were men. Dialysis vintage was 46±41 months, and the time after transplantation was 59±54 months. Eighty-five percent of the patients required hospital admission, and 8% had to be transferred to intensive care units. Overall mortality was 25% (IC-HD, 27%; Tx, 23%; and PD, 15%), and significant proportions of deceased patients have advanced age, are on IC-HD, and presented pneumonia. Age and pneumonia were independently associated with the risk of death. SARS-CoV-2 infection affected a significant number of Spanish patients on RRT, mainly those on IC-HD. Hospitalization rates and mortality were high. The factors more closely related to mortality were age and pneumonia.
Sections du résumé
Background
The recent SARS-CoV-2 coronavirus pandemic has signified a significant effect on the health of the population worldwide. Patients on chronic RRT have been affected by the virus, and they are at higher risk due to the frequent comorbid conditions. Here, we show the results of the COVID-19 Registry of the Spanish Society of Nephrology during the first 6 weeks of the outbreak.
Methods
This study is an analysis of the data recorded on a registry of patients with ESKD on RRT who tested positive for COVID-19. The aim was to evaluate clinical conditions, therapeutic management, and consequences, including outcome. The registry began on March 18th, 2020. It includes epidemiologic data, cause of CKD, signs and symptoms of the infection, treatments, and outcomes. Patients were diagnosed with SARS-CoV-2 infection on the basis of the results of PCR of the virus obtained from nasopharyngeal/oropharyngeal swabs. The tests were performed on symptomatic patients and on those who mentioned contact with infected patients.
Results
As of May 2, the registry included data on 1397 patients (in-center hemodialysis [IC-HD], 63%; kidney transplant [Tx], 34%; peritoneal dialysis [PD], 3%; and home hemodialysis, 0.3%). The mean age was 67±15 years, and two-thirds were men. Dialysis vintage was 46±41 months, and the time after transplantation was 59±54 months. Eighty-five percent of the patients required hospital admission, and 8% had to be transferred to intensive care units. Overall mortality was 25% (IC-HD, 27%; Tx, 23%; and PD, 15%), and significant proportions of deceased patients have advanced age, are on IC-HD, and presented pneumonia. Age and pneumonia were independently associated with the risk of death.
Conclusions
SARS-CoV-2 infection affected a significant number of Spanish patients on RRT, mainly those on IC-HD. Hospitalization rates and mortality were high. The factors more closely related to mortality were age and pneumonia.
Identifiants
pubmed: 35372874
doi: 10.34067/KID.0002602020
pii: K3602020000260C
pmc: PMC8815506
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1254-1258Informations de copyright
Copyright © 2020 by the American Society of Nephrology.
Déclaration de conflit d'intérêts
All authors have nothing to disclose.
Références
J Ren Nutr. 2012 Jan;22(1):149-56
pubmed: 22200433
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):215-219
pubmed: 32391667
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
BMJ. 2020 Feb 28;368:m810
pubmed: 32111649
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
Int J Antimicrob Agents. 2020 Jul;56(1):105949
pubmed: 32205204
MMWR Morb Mortal Wkly Rep. 2020 Apr 17;69(15):458-464
pubmed: 32298251
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Am J Transplant. 2020 Jul;20(7):1859-1863
pubmed: 32181990
Int Urol Nephrol. 2020 Jun;52(6):1193-1194
pubmed: 32222883