Sia Charmaine Si Min, Cheong Samantha Hui Ling, Ngoh Clara Lee Ying, Tan Yi Hern, Wong Weng Kin
Division of Nephrology, Department of Medicine, National University Hospital, Singapore, Singapore.
Department of Medicine, National University Hospital, Singapore, Singapore.
Case Rep Nephrol Dial. 2020 Jul 30;10(2):86-94. doi: 10.1159/000509792. eCollection 2020 May-Aug.
The coronavirus disease 2019 (COVID-19) pandemic has caused a catastrophic global health crisis. There is a lack of mitigation and clinical management strategies for COVID-19 in specific patient cohorts such as hemodialysis (HD) patients. We report our experience in treating the first case of COVID-19 in a HD patient in Singapore who had a severe clinical course including acute respiratory distress syndrome and propose a clinical management strategy. We propose a clinical workflow in managing such patients based on available evidence from literature review. We also highlight the importance of early recognition and intervention for disease control, dialysis support in an acute hospital isolation facility, deisolation protocol, and discharge planning due to prolonged viral shedding. The case highlights important points specific to a HD patient with a COVID-19 diagnosis, tailored interventions for each stage of the disease, and deisolation considerations in the recovery phase.
2019年冠状病毒病（COVID-19）大流行引发了一场灾难性的全球健康危机。在特定患者群体中，如血液透析（HD）患者，缺乏针对COVID-19的缓解和临床管理策略。我们报告了在新加坡治疗首例HD患者COVID-19的经验，该患者临床过程严重，包括急性呼吸窘迫综合征，并提出了一种临床管理策略。我们根据文献综述的现有证据，提出了管理此类患者的临床工作流程。我们还强调了早期识别和干预对疾病控制的重要性、急性医院隔离设施中的透析支持、解除隔离方案以及由于病毒长期脱落而进行的出院规划。该病例突出了HD患者COVID-19诊断的特定要点、针对疾病各阶段的量身定制干预措施以及恢复期的解除隔离考虑因素。
