Alfano Gaetano, Perrone Rossella, Fontana Francesco, Mori Giacomo, Lucchi Leonardo, Guaraldi Giovanni, Magistroni Riccardo, Cappelli Gianni
Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Modena, Italy.
Nephrology Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy.
Hemodial Int. 2020 Oct;24(4):E50-E54. doi: 10.1111/hdi.12859. Epub 2020 Aug 2.
Coronavirus infectious disease (COVID-19) is a novel respiratory infection highly associated with severe complications in elderly subjects affected by cardiovascular disease. Patients on maintenance dialysis are exceptionally vulnerable because most of them are old and have multiple comorbidities. We report the complex clinical course of SARS-CoV-2 infection in a patient on maintenance dialysis who presented with fever and lung edema. After 41 days from the primary infection, the clinically recovered patient experienced symptomatic reactivation of SARS-COV-2 infection documented by positive polymerase chain reaction (PCR) result on nasal/oropharyngeal swab along with immunoglobulin M seroconversion. The recurrence of PCR positivity forced us to perform hemodialysis in a separate isolation room for a prolonged period of time. Close monitoring of previously infected patients and restructuring of dialysis facilities are necessary to avoid new outbreaks of this concerning disease.
冠状病毒感染疾病（COVID-19）是一种新型呼吸道感染疾病，与患有心血管疾病的老年患者的严重并发症高度相关。维持性透析患者格外脆弱，因为他们大多数年龄较大且患有多种合并症。我们报告了一名维持性透析患者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的复杂临床过程，该患者出现发热和肺水肿。在初次感染41天后，临床康复的患者经鼻腔/口咽拭子聚合酶链反应（PCR）结果呈阳性以及免疫球蛋白M血清学转换证实，出现了SARS-CoV-2感染的症状性复发。PCR阳性的复发迫使我们在单独的隔离病房长时间进行血液透析。密切监测先前感染的患者并重新规划透析设施对于避免这种令人担忧的疾病再次爆发是必要的。
