Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore, 169856, Singapore.
DUKE-NUS Medical School, Singapore, Singapore.
Int Urol Nephrol. 2023 Aug;55(8):2075-2081. doi: 10.1007/s11255-023-03496-2. Epub 2023 Feb 23.
There were discrete outbreaks of SARS-CoV-2 infection in 2021 (Delta wave) and 2022 (Omicron wave) in Singapore, which affected patients receiving peritoneal dialysis (PD).
This study included all PD patients with COVID-19 infection from a single center between October 2021 and March 2022. The clinical presentation, management and outcomes of patients during the Delta and Omicron outbreaks were compared.
A total of 44 PD patients developed SARS-CoV-2 infection (23 during the Delta wave and 21 during the Omicron wave): median age 66 (60.5-68.5) years, male (63.6%), Chinese ethnic (77.3%), diabetes mellitus (56.8%), and cardiovascular disease (45.5%). Approximately, 93.2% received two doses of the mRNA COVID-19 vaccine. Cough (81.8%) and fever (54.5%) were common presenting symptoms. Chest radiography showed ground glass opacity in 23.5% of patients, consolidation in 55.6%, and bilateral lung involvement in 33.3%. Eleven patients (25.6%) received antiviral therapy (Remdesivir), 7 (16.3%) received steroid, and 4 (9.3%) received monoclonal antibodies. Patients infected during the Delta wave were more likely to be hospitalized (73.9 vs 14.3%; p < 0.001) and receive antiviral therapy (39.1 vs 10.0%; p = 0.03) than those during the Omicron wave. The overall mortality rate was 11.4%, with significantly higher mortality during the Delta wave than during the Omicron wave (21.7 vs 0%; p = 0.03).
The mortality rate was high among infected PD patients during Delta wave of COVID-19 infection. However, during the Omicron wave, most infected patients were treated in the community with favorable outcomes.
2021 年（德尔塔波）和 2022 年（奥密克戎波）新加坡曾发生过几波 SARS-CoV-2 感染，这影响了接受腹膜透析（PD）的患者。
本研究纳入了 2021 年 10 月至 2022 年 3 月期间在一家中心发生 COVID-19 感染的所有 PD 患者。比较了德尔塔波和奥密克戎波期间患者的临床表现、治疗和结局。
共有 44 名 PD 患者感染 SARS-CoV-2（德尔塔波期间 23 例，奥密克戎波期间 21 例）：中位年龄 66（60.5-68.5）岁，男性（63.6%），华裔（77.3%），糖尿病（56.8%）和心血管疾病（45.5%）。约 93.2%的患者接种了两剂 mRNA COVID-19 疫苗。咳嗽（81.8%）和发热（54.5%）是常见的首发症状。胸部影像学显示，23.5%的患者有磨玻璃影，55.6%的患者有实变，33.3%的患者有双侧肺部受累。11 名患者（25.6%）接受了抗病毒治疗（瑞德西韦），7 名（16.3%）接受了皮质类固醇治疗，4 名（9.3%）接受了单克隆抗体治疗。德尔塔波期间感染的患者更有可能住院（73.9% vs 14.3%；p<0.001）和接受抗病毒治疗（39.1% vs 10.0%；p=0.03）。总体死亡率为 11.4%，德尔塔波期间的死亡率明显高于奥密克戎波期间（21.7% vs 0%；p=0.03）。
在 COVID-19 感染的德尔塔波期间，感染 PD 的患者死亡率较高。然而，在奥密克戎波期间，大多数感染患者在社区得到治疗，结局良好。
