Analysis of the Clinical and Epidemiological Meaning of Screening Test for SARS-CoV-2: Considerations in the Chronic Kidney Disease Patients during the COVID-19 Pandemic.

ABSTRACT

The COronaVIrus Disease 19 (COVID-19) pandemic is an emerging reality in nephrology. In a continuously changing scenario, we need to assess our patients' additional risk in terms of attending hemodialysis treatments, follow-up peritoneal dialysis, and kidney transplant visits. The prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-20 infection in the general population plays a pivotal role in estimating the additional COVID-19 risk in chronic kidney disease (CKD) patients. Unfortunately, local prevalence is often obscure, and when we have an estimation, we neglect the number of asymptomatic subjects in the same area and, consequently, the risk of infection in CKD patients. Furthermore, we still have the problem of managing COVID-19 diagnosis and the test's accuracy. Currently, the gold standard for SARS-CoV-2 detection is a real-time reverse transcription-polymerase chain reaction (rRT-PCR) on respiratory tract samples. rRT-PCR presents some vulnerability related to pre-analytic and analytic problems and could impact strongly on its diagnostic accuracy. Specifically, the operative proceedings to obtain the samples and the different types of diagnostic assay could affect the results of the test. In this scenario, knowing the local prevalence and the local screening test accuracy helps the clinician to perform preventive measures to limit the diffusion of COVID-19 in the CKD population.