ABSTRACT
ImportanceThe outbreak of highly contagious COVID-19 has posed a serious threat to human health, especially for those with underlying diseases. However, Impacts of COVID-19 epidemic on HD center and HD patients have not been reported. ObjectiveTo summery an outbreak of COVID-19 epidemic in HD center. Design, Setting, and ParticipantsWe reviewed the epidemic course from the first laboratory-confirmed case of COVID-19 infection on January 14 to the control of the epidemic on March 12 in the HD center of Renmin Hospital of Wuhan University. Total 230 HD patients and 33 medical staff were included in this study ExposuresCOVID-19. Main Outcomes and MeasuresEpidemiological, clinical, laboratory, and radiological characteristics and outcomes data were collected and analyzed. 19 COVID-19 HD patients, 19 non-COVID-19 HD patients and 19 healthy volunteers were enrolled for further study about the effect of SARS-CoV-2 infection on host immune responses. Results42 out of 230 HD patients (18.26%) and 4 out of 33 medical staffs (12.12%) were diagnosed with COVID-19 from the outbreak to March 12, 2020. 13 HD patients (5.65%), including 10 COVID-19 diagnosed, died during the epidemic. Only 2 deaths of the COVID-19 HD patients were associated with pneumonia/lung failure. Except 3 patients were admitted to ICU for severe condition (8.11%), including 2 dead, most COVID-19 diagnosed patients presented mild or none-respiratory symptoms. Multiple lymphocyte populations in HD patients were significantly decreased. HD patients with COVID-19 even displayed more remarkable reduction of serum inflammatory cytokines than other COVID-19 patients. Conclusions and RelevanceHD patients are the highly susceptible population and HD centers are high risk area during the outbreak of COVID-19 epidemic. HD Patients with COVID-19 are mostly clinical mild and unlikely progress to severe pneumonia due to the impaired cellular immune function and incapability of mounting cytokines storm. More attention should be paid to prevent cardiovascular events, which may be the collateral impacts of COVID-19 epidemic on HD patients.
ABSTRACT
Objective To appraise the treatment of percutaneous ethanol injection (PEI) on Graves′ disease in case selecting, puncture locating and treat evaluation. Methods With high frequency color Doppler ultrasonographic examination, 32 cases with Graves′ disease underwent PEI treatment. Twenty four weeks later the patients were reassessed. Results All the patients can endure PEI treatment.Thirteen cases(41%) showed no hyperthyroid symptoms and their relative steriods and antibodies recovered normal.They stopped the drug,then four cases(13%) recurred.The other nineteen cases(59%) showed less symptoms or disappearance,their relative steriods and antibodies basically returned to normal,low dosage of the drug was administered.Conclusions A good outcome can be achieved with PEI treatment. Ultrasonography has important roles in case selecting, puncture locating and treat evaluation.
