Division of Nephrology, Miulli General Hospital, Acquaviva delle Fonti, Italy.
Associazione Nefrologica Gabriella Sebastio, Martina Franca, Italy.
Nephrol Dial Transplant. 2020 May 1;35(5):737-741. doi: 10.1093/ndt/gfaa069.
COVID-19, a disease caused by a novel coronavirus, is a major global human threat that has turned into a pandemic. This novel coronavirus has specifically high morbidity in the elderly and in comorbid populations. Uraemic patients on dialysis combine an intrinsic fragility and a very frequent burden of comorbidities with a specific setting in which many patients are repeatedly treated in the same area (haemodialysis centres). Moreover, if infected, the intensity of dialysis requiring specialized resources and staff is further complicated by requirements for isolation, control and prevention, putting healthcare systems under exceptional additional strain. Therefore, all measures to slow if not to eradicate the pandemic and to control unmanageably high incidence rates must be taken very seriously. The aim of the present review of the European Dialysis (EUDIAL) Working Group of ERA-EDTA is to provide recommendations for the prevention, mitigation and containment in haemodialysis centres of the emerging COVID-19 pandemic. The management of patients on dialysis affected by COVID-19 must be carried out according to strict protocols to minimize the risk for other patients and personnel taking care of these patients. Measures of prevention, protection, screening, isolation and distribution have been shown to be efficient in similar settings. They are essential in the management of the pandemic and should be taken in the early stages of the disease.
新型冠状病毒(SARS-CoV-2)引发的 COVID-19 是对全球人类的重大威胁,目前已发展成全球性大流行疾病。这种新型冠状病毒在老年人和合并症患者中发病率极高。接受透析治疗的尿毒症患者自身存在脆弱性,且常合并多种合并症,同时处于一种特殊环境中,许多患者在同一区域(血液透析中心)反复接受治疗。此外,如果感染,需要专门资源和人员进行强化透析治疗,同时需要隔离、控制和预防,这给医疗系统带来了巨大压力。因此,必须认真对待所有减缓(甚至消除)大流行和控制高发病率的措施。本综述由欧洲透析(EUDIAL)工作组的 ERA-EDTA 撰写,旨在为血液透析中心预防、减轻和控制新兴的 COVID-19 大流行提供建议。受 COVID-19 影响的透析患者的管理必须根据严格的方案进行,以尽量减少对其他患者和护理这些患者的人员的风险。在类似环境中,已经证明预防、保护、筛查、隔离和分配措施是有效的。这些措施在大流行管理中必不可少,应在疾病早期实施。