tetano
Editor, Senior Moderator
Clin Kidney J
. 2020 Jun 12;13(3):328-333.
doi: 10.1093/ckj/sfaa086. eCollection 2020 Jun.
Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans
Rui Wang[SUP] 1 [/SUP], Hong He[SUP] 1 [/SUP], Cong Liao[SUP] 2 [/SUP], Hongtao Hu[SUP] 3 [/SUP], Chun Hu[SUP] 1 [/SUP], Juan Zhang[SUP] 1 [/SUP], Ping Gao[SUP] 1 [/SUP], Xiaoyan Wu[SUP] 1 [/SUP], Zhenshun Cheng[SUP] 4 [/SUP], Meiyan Liao[SUP] 5 [/SUP], Hua Shui[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in humans in Wuhan, Hubei Province, China, in December 2019, and has subsequently spread worldwide.
Methods: We conducted a retrospective, single-center case series of the seven maintenance hemodialysis (HD) patients infected with COVID-19 at Zhongnan Hospital of Wuhan University from 13 January to 7 April 2020 and a proactive search of potential cases by chest computed tomography (CT) scans.
Results: Of 202 HD patients, 7 (3.5%) were diagnosed with COVID-19. Five were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) because of compatible symptoms, while two were diagnosed by RT-PCR as a result of screening 197 HD patients without respiratory symptoms by chest CT. Thirteen of 197 patients had positive chest CT features and, of these, 2 (15%) were confirmed to have COVID-19. In COVID-19 patients, the most common features at admission were fatigue, fever and diarrhea [5/7 (71%) had all these]. Common laboratory features included lymphocytopenia [6/7 (86%)], elevated lactate dehydrogenase [3/4 (75%)], D-dimer [5/6 (83%)], high-sensitivity C-reactive protein [4/4 (100%)] and procalcitonin [5/5 (100%)]. Chest CT showed bilateral patchy shadows or ground-glass opacity in the lungs of all patients. Four of seven (57%) received oxygen therapy, one (14%) received noninvasive and invasive mechanical ventilation, five (71%) received antiviral and antibacterial drugs, three (43%) recieved glucocorticoid therapy and one (14%) received continuous renal replacement therapy. As the last follow-up, four of the seven patients (57%) had been discharged and three patients were dead.
Conclusions: Chest CT may identify COVID-19 patients without clear symptoms, but the specificity is low. The mortality of COVID-19 patients on HD was high.
Keywords: COVID-19; SARS-CoV-2; chronic renal failure; clinical outcome; hemodialysis.
. 2020 Jun 12;13(3):328-333.
doi: 10.1093/ckj/sfaa086. eCollection 2020 Jun.
Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans
Rui Wang[SUP] 1 [/SUP], Hong He[SUP] 1 [/SUP], Cong Liao[SUP] 2 [/SUP], Hongtao Hu[SUP] 3 [/SUP], Chun Hu[SUP] 1 [/SUP], Juan Zhang[SUP] 1 [/SUP], Ping Gao[SUP] 1 [/SUP], Xiaoyan Wu[SUP] 1 [/SUP], Zhenshun Cheng[SUP] 4 [/SUP], Meiyan Liao[SUP] 5 [/SUP], Hua Shui[SUP] 1 [/SUP]
Affiliations
- PMID: 32695322
- PMCID: PMC7314250
- DOI: 10.1093/ckj/sfaa086
Abstract
Background: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that first manifested in humans in Wuhan, Hubei Province, China, in December 2019, and has subsequently spread worldwide.
Methods: We conducted a retrospective, single-center case series of the seven maintenance hemodialysis (HD) patients infected with COVID-19 at Zhongnan Hospital of Wuhan University from 13 January to 7 April 2020 and a proactive search of potential cases by chest computed tomography (CT) scans.
Results: Of 202 HD patients, 7 (3.5%) were diagnosed with COVID-19. Five were diagnosed by reverse transcription polymerase chain reaction (RT-PCR) because of compatible symptoms, while two were diagnosed by RT-PCR as a result of screening 197 HD patients without respiratory symptoms by chest CT. Thirteen of 197 patients had positive chest CT features and, of these, 2 (15%) were confirmed to have COVID-19. In COVID-19 patients, the most common features at admission were fatigue, fever and diarrhea [5/7 (71%) had all these]. Common laboratory features included lymphocytopenia [6/7 (86%)], elevated lactate dehydrogenase [3/4 (75%)], D-dimer [5/6 (83%)], high-sensitivity C-reactive protein [4/4 (100%)] and procalcitonin [5/5 (100%)]. Chest CT showed bilateral patchy shadows or ground-glass opacity in the lungs of all patients. Four of seven (57%) received oxygen therapy, one (14%) received noninvasive and invasive mechanical ventilation, five (71%) received antiviral and antibacterial drugs, three (43%) recieved glucocorticoid therapy and one (14%) received continuous renal replacement therapy. As the last follow-up, four of the seven patients (57%) had been discharged and three patients were dead.
Conclusions: Chest CT may identify COVID-19 patients without clear symptoms, but the specificity is low. The mortality of COVID-19 patients on HD was high.
Keywords: COVID-19; SARS-CoV-2; chronic renal failure; clinical outcome; hemodialysis.