Ossareh Shahrzad, Bagheri Morteza, Abbasi Mohsen, Abolfathi Sara, Bohlooli Azam
Nephrology Section, Hasheminejad Kidney Centre, Iran University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2020 Sep;14(5):389-398.
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.
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.
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.
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.
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。
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。
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。
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。
