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COVID-19 对血液透析患者的影响:一家医院透析单元的经验。

The impact of COVID-19 in hemodialysis patients: Experience in a hospital dialysis unit.

机构信息

Nephrology Department, Hospital Sant Joan Despí Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain.

出版信息

Hemodial Int. 2021 Apr;25(2):205-213. doi: 10.1111/hdi.12905. Epub 2020 Nov 22.

Abstract

INTRODUCTION

COVID-19 is a very high transmission disease with a variable prognosis in the general population. Patients in hemodialysis therapy are particularly vulnerable to developing an infectious disease, but the incidence and prognosis of hemodialysis patients with COVID-19 is still unclear. The main objective is to describe the experience of our dialysis unit in preventing and controlling the spread of SARS-CoV-2 infection.

METHODS

Preventive structural and organizational changes were applied to all patients and health care personnel in order to limit the risk of local transmission of SARS-CoV-2 infection.

FINDINGS

The Nephrology department at Sant Joan Despí Moises Broggi Hospital-Consorci Sanitari Integral is a reference for two satellite hemodialysis centers caring for 156 patients. We combine our own hemodialysis maintenance program for 87 patients with hospitalized patients from peripheral hemodialysis centers. In this area, the reported incident rate of COVID-19 in these peripherical hemodialysis centers was 9.5% to 19.9% and the death rate 25% to 30.5%. In our hemodialysis program, the incidence rate was 5.7%. Three out of five required hospitalization (60%) and nobody died.

DISCUSSION

Although the risk of local transmission of the disease was very high due to the increase in hemodialysis patients from peripheral centers admitted to hospital, the incidence rate of COVID-19 was very low in our own hemodialysis patients. We believe that the structural and organizational changes adopted early on and the diagnosis algorithm played an important role in minimizing the spread of the disease.

摘要

介绍

COVID-19 在普通人群中具有高度传染性,预后多变。接受血液透析治疗的患者尤其容易感染传染病,但 COVID-19 血液透析患者的发病率和预后仍不清楚。主要目的是描述我们透析单位在预防和控制 SARS-CoV-2 感染传播方面的经验。

方法

对所有患者和医务人员实施了预防结构性和组织性变革,以限制 SARS-CoV-2 感染在当地传播的风险。

结果

Sant Joan Despí Moises Broggi 医院-Consorci Sanitari Integral 的肾脏病科是两个卫星血液透析中心的参考,共照顾 156 名患者。我们将自己的血液透析维持计划与来自周边血液透析中心的住院患者相结合。在该地区,这些周边血液透析中心报告的 COVID-19 发病率为 9.5%至 19.9%,死亡率为 25%至 30.5%。在我们的血液透析计划中,发病率为 5.7%。五名患者中有三名需要住院(60%),没有人死亡。

讨论

尽管由于来自周边中心的住院血液透析患者增加,疾病在当地传播的风险非常高,但我们自己的血液透析患者 COVID-19 的发病率非常低。我们认为,早期采取的结构性和组织性变革以及诊断算法在最大限度地减少疾病传播方面发挥了重要作用。

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