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The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients
Introduction: The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. Mater...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408812/ https://www.ncbi.nlm.nih.gov/pubmed/32708750 http://dx.doi.org/10.3390/jcm9072264 |
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author | Stock da Cunha, Teresa Gomá-Garcés, Elena Avello, Alejandro Pereira-García, Mónica Mas-Fontao, Sebastian Ortiz, Alberto González-Parra, Emilio |
author_facet | Stock da Cunha, Teresa Gomá-Garcés, Elena Avello, Alejandro Pereira-García, Mónica Mas-Fontao, Sebastian Ortiz, Alberto González-Parra, Emilio |
author_sort | Stock da Cunha, Teresa |
collection | PubMed |
description | Introduction: The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. Material and Methods: Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units. Results: In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status. Conclusions: COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies. |
format | Online Article Text |
id | pubmed-7408812 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74088122020-08-13 The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients Stock da Cunha, Teresa Gomá-Garcés, Elena Avello, Alejandro Pereira-García, Mónica Mas-Fontao, Sebastian Ortiz, Alberto González-Parra, Emilio J Clin Med Article Introduction: The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. Material and Methods: Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units. Results: In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status. Conclusions: COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies. MDPI 2020-07-16 /pmc/articles/PMC7408812/ /pubmed/32708750 http://dx.doi.org/10.3390/jcm9072264 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Stock da Cunha, Teresa Gomá-Garcés, Elena Avello, Alejandro Pereira-García, Mónica Mas-Fontao, Sebastian Ortiz, Alberto González-Parra, Emilio The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients |
title | The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients |
title_full | The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients |
title_fullStr | The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients |
title_full_unstemmed | The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients |
title_short | The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients |
title_sort | spectrum of clinical and serological features of covid-19 in urban hemodialysis patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408812/ https://www.ncbi.nlm.nih.gov/pubmed/32708750 http://dx.doi.org/10.3390/jcm9072264 |
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