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Clinical outcomes of hemodialysis patients infected with severe acute respiratory syndrome coronavirus 2 and impact of proactive chest computed tomography scans.
Wang, Rui; He, Hong; Liao, Cong; Hu, Hongtao; Hu, Chun; Zhang, Juan; Gao, Ping; Wu, Xiaoyan; Cheng, Zhenshun; Liao, Meiyan; Shui, Hua.
  • Wang R; Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • He H; Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Liao C; Department of Laboratory Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Hu H; Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Hu C; Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Zhang J; Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Gao P; Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Wu X; Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Cheng Z; Department of Pulmonary Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Liao M; Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Shui H; Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Clin Kidney J ; 13(3): 328-333, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1109182
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

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Clin Kidney J Year: 2020 Document Type: Article Affiliation country: CKJ

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Clin Kidney J Year: 2020 Document Type: Article Affiliation country: CKJ