Detection of SARS-CoV-2 in peritoneal fluid from patients with kidney disease and COVID-19: report of two cases (preprint)

ABSTRACT

Background: Coronavirus disease-2019 (COVID-19) has a broad clinical presentation, involving multiple organs besides the respiratory system. Currently, there is little evidence available on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in peritoneal fluid (PF). In this study, we describe the detection of SARS-CoV-2 in the PF of two patients with COVID 19 and kidney disease.Case presentation Case 1 A 71-year-old woman with a history of end-stage kidney disease who presented with a 15-day evolution of progressive dyspnea, accompanied by dry cough and fever; IgM antibodies to SARS-CoV-2 were detected on admission. Real-time SARS-CoV-2 polymerase chain reaction (qRT-PCR) in the PF was positive. Three days after admission the patient's respiratory distress improved and she was discharged after 8 days of hospitalization.Case 2 A 78-year-old woman, with type 2 diabetes, hypertension, a 15-day history of polypnea, and a 5-day onset of fever and dyspnea. IgM and IgG antibodies to SARS-CoV-2 were detected on admission, as well as a positive nasopharyngeal qRT-PCR test for SARS-CoV-2. During hospitalization she developed acute kidney injury, requiring peritoneal dialysis, SARS-CoV-2 was confirmed in PF by qRT-PCRConclusions: These two cases highlights the importance of increasing the level of awareness for the presence and possible SARS-CoV-2 transmission through non-respiratory routes, like peritoneal fluid.Emphasis should be given to appropriate preventive strategies for minimizing the risk of transmission of COVID-19 from patients on peritoneal dialysis in both inpatient and outpatient settings.