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A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection.

Published on May 8, 2020in Kidney International8.306
· DOI :10.1016/J.KINT.2020.04.030
Federico Alberici17
Estimated H-index: 17
(University of Brescia),
Federico Alberici2
Estimated H-index: 2
(University of Brescia)
+ 28 AuthorsRoberta Cortinovis1
Estimated H-index: 1
Abstract
Abstract The SARS-CoV-2 epidemic is pressuring health care systems worldwide. Disease outcomes in certain subgroups of patients are still scarce, and data are needed. Therefore, we describe here the experience of four dialysis centers of the Brescia Renal COVID task force. During March 2020, within an overall population of 643 hemodialysis patients, SARS-CoV-2 RNA positivity was detected in 94 (15%). At disease diagnosis, 37 of the 94 (39%) patients (group 1) were managed on an outpatient basis whereas the remaining 57 (61%) (group 2) required hospitalization. Choices regarding management strategy were made based on disease severity. In group 1, 41% received antivirals and 76% hydroxychloroquine. Eight percent died and 5% developed acute respiratory distress syndrome (ARDS). In group 2, 79% received antivirals and 77% hydroxychloroquine. Forty two percent died and 79% developed ARDS. Overall mortality rate for the entire cohort was 29%. History of ischemic cardiac disease, fever, older age (over age 70) and dyspnea at presentation were associated with the risk of developing ARDS whereas fever, cough and a C-reactive protein higher than 50 mg/l at disease presentation were associated with the risk of death. Thus, in our population of hemodialysis patients with SARS-CoV-2 infection, we documented a wide range of disease severity. The risk of ARDS and death is significant for patients requiring hospital admission at disease diagnosis.
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References14
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#1Debasish Banerjee (St. George's University)H-Index: 17
#2Joyce Popoola (St George's, University of London)
Last. Mysore K. Phanish (St Helier Hospital)H-Index: 7
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Abstract By 21 March 2020 infections related to the novel coronavirus SARS-CoV-2 had affected people from 177 countries and caused 11,252 reported deaths worldwide. Little is known about risk, presentation and outcomes of SARS-CoV-2 (COVID-19) infection in kidney transplantation recipients, who may be at high-risk due to long-term immunosuppression, comorbidity and residual chronic kidney disease. Whilst COVID-19 is predominantly a respiratory disease, in severe cases it can cause kidney and mul...
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#1Anna Burgner (VUMC: Vanderbilt University Medical Center)H-Index: 2
#2T. Alp Ikizler (VUMC: Vanderbilt University Medical Center)H-Index: 67
Last. Jamie P. Dwyer (VUMC: Vanderbilt University Medical Center)H-Index: 22
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#1Xiaobo Yang (HUST: Huazhong University of Science and Technology)H-Index: 3
#2Yuan Yu (HUST: Huazhong University of Science and Technology)H-Index: 5
Last. Minghao Fang (HUST: Huazhong University of Science and Technology)H-Index: 2
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Summary Background An ongoing outbreak of pneumonia associated with the severe acute respiratory coronavirus 2 (SARS-CoV-2) started in December, 2019, in Wuhan, China. Information about critically ill patients with SARS-CoV-2 infection is scarce. We aimed to describe the clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia. Methods In this single-centered, retrospective, observational study, we enrolled 52 critically ill adult patients with SARS-CoV-2 pneumonia who w...
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#1Federico Alberici (University of Brescia)H-Index: 2
#1Federico Alberici (University of Brescia)H-Index: 17
Last. Marianna MoscatoH-Index: 2
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Abstract The outcome of SARS-CoV2 infection in patients who have received a kidney allograft and are being treated with immunosuppression is unclear. We describe 20 kidney transplant recipients (median age 59 years [inter quartile range 51-64 years], median age of transplant 13 years [9-20 years], baseline eGFR 36.5 [23-47.5]) with SARS-CoV2 induced pneumonia. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/day, all but one was commenced on antivira...
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#1Federico Alberici (University of Brescia)H-Index: 17
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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease (COVID-19) is a major pandemic challenging health care systems around the world. The optimal management of COVID-19 infected patients is still unclear, although the consensus is moving towards the need of a biphasic approach. During the first phase of the disease (from onset of the symptoms up to 7-10 days) viral-induced effects are prominent with the opportunity to institute antiviral therapy. In...
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#1Rui Wang (WHU: Wuhan University)H-Index: 1
#2Cong Liao (WHU: Wuhan University)H-Index: 1
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#1Chaomin Wu (Fudan University)H-Index: 3
#2Xiaoyan Chen (Fudan University)H-Index: 3
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Importance Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated. Objective To describe the clinical characteristics and outcomes in patients with COVID-19 pneumonia who developed acute respiratory distress syndrome (ARDS) or died. Design, Setting, and Participants Retrospective cohort study of 201 patients ...
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#1T. Alp Ikizler (Vandy: Vanderbilt University)H-Index: 67
Abstract The clinical presentation and mortality rate in maintenance hemodialysis (MHD) patients with COVID-19 are not well established. Recent data from Italy and Spain suggest that these patients present with wide range of symptoms, with a significant portion being asymptomatic. There is prolonged positivity of pharyngeal swabs in MHD patients. The mortality rates are very high, reaching almost 30%. These data highlight the importance of diligent oversight and care of MHD patients during COVID...
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