ABSTRACT
Introduction: Since the rapid spread of the COVID 19 pandemic, it is crucial to identify possible sources of transmission of the SARS-COV-2 virus in order to perform procedures safely. There has been interest to identify the presence of SARS-CoV-2 in different compartments including peritoneal compartment. SARS-CoV-2 was detected by reverse transcriptase-polymerase chain reaction (RT-PCR) in dialysis effluent on a few single cases while other authors have reported negative results. Peritoneal membrane pores have a diameter of 20-40 nm while the SARS-CoV-2 virion diameter is between 60 to 140 nm, theoretically the virion could reach the peritoneal cavity by hematogenous diffusion or through the dialysis catheter after contact contamination. Case Description: We report dialysis effluent findings of four patients, two women and two men, with an age range of 35 to 64 years and different comorbidities including: diabetes mellitus, hypertension and obesity. They were diagnosed with COVID-19 using RT-PCR assay on nasopharyngeal samples or by tomography findings. RT-PCR samples of peritoneal effluent were obtained with a length of stay on peritoneal cavity of 6 hours, without centrifugation of the sample. Three patients were positive for presence of SARSCoV-2 on nasopharyngeal sample and dialysis effluent, while the fourth patient was negative in both samples despite having tomography findings suggestive of COVID-19 infection. It should be noted that in the 3 patients that had a positive RT-PCR on both nasopharyngeal and peritoneal effluent, samples were obtained within the first 7 days following the onset of symptoms associated with COVID-19 and on the fourth patient the peritoneal effluent sample was obtained 12 days after initial symptoms. All patients presented with acellular peritoneal fluid. No abdominal symptoms were reported. Discussion: Presence of SARS-CoV-2 on peritoneal fluid continues to be a subject of debate. Peritoneal effluent sample-drawing procedure has not been standardized, which may explain the inconsistent results noted by different authors. The positive results of the RT-PCR for SARS-CoV2 on peritoneal effluent must be confirmed on a larger sample. Although based on a small group, these findings should prompt to consider these fluids as potentially infective.