Kikuchi Kan, Nangaku Masaomi, Ryuzaki Munekazu, Yamakawa Tomoyuki, Hanafusa Norio, Sakai Ken, Kanno Yoshihiko, Ando Ryoichi, Shinoda Toshio, Nakamoto Hidetomo, Akizawa Tadao
Division of Nephrology, Shimoochiai Clinic, Tokyo, Japan.
Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Ther Apher Dial. 2020 Aug;24(4):361-365. doi: 10.1111/1744-9987.13531.
In Japan, the first case of COVID-19 in dialysis patients was reported on March 1, 2020. A total of 31 cases were reported by April 10, and it increased to 95 by May 15. Thereafter, with the rapid increase in the number of COVID-19 cases in the general population since late March, there was a not surprising increase in the number of COVID-19 cases in dialysis patients. The mortality rate is 16.2% (16/99 cases) in dialysis patients, which is higher than 5.3% (874/16 532 cases) in the general population. This higher mortality rate in dialysis patients with COVID-19 might be related to their age; the majority of COVID-19 cases are aged between 70 and 90 years old in dialysis patients, compared with between 20 and 60 years old in the general population. As COVID-19 presents with severe symptoms and is associated with a high mortality rate in dialysis patients, dialysis patients who have contracted severe acute respiratory syndrome coronavirus 2 infection confirmed by polymerase chain reaction testing are required to be hospitalized under Japanese government policy. In cases of COVID-19 hospitalizations, it is essential to prevent nosocomial infection. Therefore, patients must be sufficiently instructed in infection prevention and robust measures to prevent contraction and spread of the infection must be taken at dialysis facilities.
在日本,2020年3月1日报告了首例透析患者感染新冠病毒的病例。截至4月10日,共报告了31例,到5月15日增至95例。此后,自3月下旬以来普通人群中新冠病毒病例数迅速增加,透析患者中的新冠病毒病例数也不出所料地增加。透析患者的死亡率为16.2%(99例中有16例),高于普通人群的5.3%(16532例中有874例)。新冠病毒感染的透析患者死亡率较高可能与他们的年龄有关;透析患者中大多数新冠病毒病例年龄在70至90岁之间,而普通人群中为20至60岁。由于新冠病毒在透析患者中症状严重且死亡率高,根据日本政府政策,经聚合酶链反应检测确诊感染严重急性呼吸综合征冠状病毒2的透析患者必须住院治疗。在新冠病毒住院病例中,防止医院感染至关重要。因此,必须对患者进行充分的感染预防指导,并且透析机构必须采取有力措施防止感染的发生和传播。