Albalate Marta, Arribas Patricia, Torres Esther, Cintra Melissa, Alcázar Roberto, Puerta Marta, Ortega Mayra, Procaccini Fabio, Martin Juan, Jiménez Eva, Fernandez Inés, de Sequera Patricia
Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España.
Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España.
Nefrologia (Engl Ed). 2020 May-Jun;40(3):279-286. doi: 10.1016/j.nefro.2020.04.005. Epub 2020 Apr 30.
Dialysis patients are a risk group for SARS-CoV-2 infection and possibly further complications, but we have little information. The aim of this paper is to describe the experience of the first month of the SARS-CoV-2 pandemic in a hospital haemodialysis (HD) unit serving the district of Madrid with the second highest incidence of COVID-19 (almost 1,000 patients in 100,000h). In the form of a diary, we present the actions undertaken, the incidence of COVID-19 in patients and health staff, some clinical characteristics and the results of screening all the patients in the unit. We started with 90 patients on HD: 37 (41.1%) had COVID-19, of whom 17 (45.9%) were diagnosed through symptoms detected in triage or during the session, and 15 (40.5%) through subsequent screening of those who, until that time, had not undergone SARS-CoV-2 PCR testing. Fever was the most frequent symptom, 50% had lymphopenia and 18.4% <95% O saturation. Sixteen (43.2%) patients required hospital admission and 6 (16.2%) died. We found a cluster of infection per shift and also among those using public transport. In terms of staff, of the 44 people involved, 15 (34%) had compatible symptoms, 4 (9%) were confirmed as SARS-CoV-2 PCR cases by occupational health, 9 (20%) required some period of sick leave, temporary disability to work (ILT), and 5 were considered likely cases. CONCLUSIONS: We detected a high prevalence of COVID-19 with a high percentage detected by screening; hence the need for proactive diagnosis to stop the pandemic. Most cases are managed as outpatients, however severe symptoms are also appearing and mortality to date is 16.2%. In terms of staff, 20% have required sick leave in relation to COVID-19.
透析患者是感染新型冠状病毒2（SARS-CoV-2）及可能出现进一步并发症的风险群体，但我们掌握的信息很少。本文旨在描述在为马德里地区服务且新冠病毒疾病（COVID-19）发病率第二高（每100,000小时近1000例患者）的医院血液透析（HD）单元中，SARS-CoV-2大流行首月的情况。我们以日记形式呈现所采取的行动、患者及医护人员中COVID-19的发病率、一些临床特征以及对该单元所有患者进行筛查的结果。我们最初有90例接受血液透析的患者：37例（41.1%）感染了COVID-19，其中17例（45.9%）通过分诊时或透析过程中检测到的症状确诊，15例（40.5%）通过对当时尚未进行SARS-CoV-2聚合酶链反应（PCR）检测的患者进行后续筛查确诊。发热是最常见的症状，50%的患者有淋巴细胞减少，18.4%的患者氧饱和度<95%。16例（43.2%）患者需要住院治疗，6例（16.2%）死亡。我们发现每个班次以及乘坐公共交通工具的患者中都有感染聚集情况。在工作人员方面，44名相关人员中，15名（34%）有相符症状，4名（9%）经职业健康部门确认为SARS-CoV-2 PCR病例，9名（20%）需要一段时间的病假、暂时无法工作（ILT），5名被认为可能感染。结论：我们检测到COVID-19的高流行率，通过筛查检测到的比例很高；因此需要进行主动诊断以阻止大流行。大多数病例作为门诊患者处理，但也出现了严重症状，迄今为止死亡率为16.2%。在工作人员方面，20%因COVID-19需要病假。
