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血液透析病房中新冠病毒病筛查的作用:一项单中心研究结果

Role of Screening for COVID-19 in Hemodialysis Wards, Results of a Single Center Study.

作者信息

Ossareh Shahrzad, Bagheri Morteza, Abbasi Mohsen, Abolfathi Sara, Bohlooli Azam

机构信息

Nephrology Section, Hasheminejad Kidney Centre, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Kidney Dis. 2020 Sep;14(5):389-398.

Abstract

INTRODUCTION

Seven months after the emergence of SARS-COV-2 virus, there is paucity of data regarding the epidemiology of the virus in hemodialysis patients. We aim to present the results of the screening program implied after outbreak of COVID-19 in a referral hemodialysis ward.

METHODS

We started clinical screening and obligatory mask wearing for dialysis patients and personnel on 20-Feb-2020. However 11 symptomatic COVID-19 patients emerged till day +36. On days +39 and +40 a screening program was implied including measurement of SARS-COV-2 PCR and immunoglobulin G and M (IgG/IgM) and chest computerized tomography (CCT) scan. The results of CCT scan, classified according to the coronavirus disease 2019 (COVID-19) Reporting and Data System (CO-RADS) classification; as with very low (grade 1-normal), low, indeterminate, high, and very high likelihood of COVID-19 (grades 2, 3, 4, and 5; respectively), were used for compartmentalization of patients.

RESULTS

Among 178 patients (68.2% male, mean age = 58.7 ± 16.6 years), 11 got COVID-19 before screening, two of whom died. CCT scans were normal in 71.3% and grade 2, 3, 4, and 5 in 7.9%, 4.5%, 5.6%, and 10.7%; respectively. PCR and IgG and/or IgM were positive in 27 and 32 patients. Eighty-three patients had evidence of COVID-19 infection, who were significantly older (62.2 ± 16.6 vs. 56.1 ± 16.02, P < .05). There was no difference in the rate of infection considering gender, diabetes mellitus, hypertension and different blood groups.

CONCLUSION

Asymptomatic SARS- COV 2 infection may affect a large number of dialysis patients. We highly recommend a screening strategy whenever the number of patients is increasing.

摘要

引言

在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒出现七个月后,关于该病毒在血液透析患者中的流行病学数据匮乏。我们旨在呈现一家转诊血液透析病房在新型冠状病毒肺炎(COVID-19)疫情爆发后实施的筛查项目结果。

方法

我们于2020年2月20日开始对透析患者和工作人员进行临床筛查并强制佩戴口罩。然而,直到第36天出现了11例有症状的COVID-19患者。在第39天和第40天实施了一项筛查项目,包括检测SARS-CoV-2聚合酶链反应(PCR)以及免疫球蛋白G和M(IgG/IgM),并进行胸部计算机断层扫描(CCT)。根据2019冠状病毒病(COVID-19)报告和数据系统(CO-RADS)分类对CCT扫描结果进行分类;分为COVID-19可能性极低(1级 - 正常)、低、不确定、高和极高(分别为2、3、4和5级),用于对患者进行分层。

结果

在178例患者中(男性占68.2%,平均年龄 = 58.7 ± 16.6岁),11例在筛查前感染了COVID-19,其中2例死亡。CCT扫描结果正常的占71.3%,2级、3级、4级和5级的分别占7.9%、4.5%、5.6%和10.7%。PCR以及IgG和/或IgM检测呈阳性的分别有27例和32例患者。83例患者有COVID-19感染证据,这些患者年龄显著更大(62.2 ± 16.6岁对56.1 ± 16.02岁,P < 0.05)。考虑性别、糖尿病、高血压和不同血型,感染率没有差异。

结论

无症状的SARS-CoV-2感染可能影响大量透析患者。每当患者数量增加时,我们强烈推荐采用筛查策略。

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