Maldonado María, Ossorio Marta, Del Peso Gloria, Santos Carlos, Álvarez Laura, Sánchez-Villanueva Rafael, Rivas Begoña, Vega Cristina, Selgas Rafael, Bajo María A
Departamento de Nefrología, Hospital Universitario La Paz, Madrid, España.
Departamento de Nefrología, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación La Paz (IdiPAZ), Madrid, España.
Nefrologia (Engl Ed). 2021 May-Jun;41(3):329-336. doi: 10.1016/j.nefro.2020.09.002. Epub 2020 Nov 5.
The 2019 coronavirus (COVID-19) is a viral infection caused by a new coronavirus that is affecting the entire world. There have been studies of patients on in-center hemodialysis, but home dialysis population data are scarce. Our objective is to study the incidence and course of COVID-19 in a home dialysis unit (HDU) at the height of the pandemic.
An observational, retrospective study enrolling all patients diagnosed with COVID-19 from the HDU of Hospital Universitario La Paz (La Paz University Hospital) (Madrid, Spain) between March 10 and May 15, 2020. We collected clinical data from the HDU (57 patients on peritoneal dialysis and 22 patients on home hemodialysis) and compared the clinical characteristics and course of patients with and without COVID-19 infection.
Twelve patients were diagnosed with COVID-19 (9 peritoneal dialysis; 3 home hemodialysis). There were no statistically significant differences in terms of clinical characteristics between patients with COVID-19 and the rest of the unit. The mean age was 62±18.5 years; most were men (75%). All patients but one required hospitalization. Ten patients (83%) were discharged following a mean of 16.4±9.7 days of hospitalization. Two patients were diagnosed while hospitalized for other conditions, and these were the only patients who died. Those who died were older than those who survived.
The incidence of COVID-19 in our HDU in Madrid at the height of the pandemic was high, especially in patients on peritoneal dialysis. No potential benefit for preventing the infection in patients on home dialysis was observed. Advanced age and nosocomial transmission were the main factors linked to a worse prognosis.
2019冠状病毒病(COVID-19)是由一种新型冠状病毒引起的病毒感染,正在影响全球。已有针对接受中心血液透析患者的研究,但家庭透析人群的数据却很稀少。我们的目的是研究在疫情高峰期一家家庭透析单位(HDU)中COVID-19的发病率及病程。
一项观察性回顾性研究,纳入了2020年3月10日至5月15日期间在西班牙马德里拉巴斯大学医院HDU确诊为COVID-19的所有患者。我们收集了HDU的临床数据(57例腹膜透析患者和22例家庭血液透析患者),并比较了感染和未感染COVID-19患者的临床特征及病程。
12例患者被诊断为COVID-19(9例腹膜透析;3例家庭血液透析)。COVID-19患者与该单位其他患者在临床特征方面无统计学显著差异。平均年龄为62±18.5岁;大多数为男性(75%)。除1例患者外,所有患者均需住院治疗。10例患者(83%)在平均住院16.4±9.7天后出院。2例患者在因其他疾病住院期间被诊断出感染,这也是仅有的死亡患者。死亡患者比存活患者年龄更大。
在疫情高峰期,我们位于马德里的HDU中COVID-19的发病率很高,尤其是在腹膜透析患者中。未观察到对家庭透析患者预防感染有潜在益处。高龄和医院内传播是与预后较差相关的主要因素。