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Abstract
Dialysis patients are at risk group for SARS-CoV-2 infection and possibly have more complications. Healthcare professionals have faced an unprecedented pandemic, for which little information existed. The objective of this study was to describe the experience of a Madrid hospital haemodialysis unit during the first month of the SARS-CoV-2 pandemic, both in relation to patients and healthcare personnel. Likewise, it is intended to report the health actions. The total number of patients in the unit was 90. In all patients, the PCR test was performed. 37 (41.1%) tested positive for COVID-19, of these 22 (59.4%) were symptomatic and 15 (40.5%) were asymptomatic. Of the positive patients, 16 (43.2%) required hospital admission, 6 of whom died (16.2%). The deceased patients were older than the survivors. Health professionals were 44, of whom 15 (34%) had symptoms. The Occupational Health service only performed PCR on the symptomatic group, having 4 professionals (9%) positive PCR. However, after considering the clinical / radiological criteria, 9 professionals were diagnosed as COVID-19 positive, 1 of them requiring hospital admission. Conclusions: A high prevalence of positive COVID-19 was detected in patients in the dialysis unit, highlighting the high number of asymptomatic patients detected by PCR screening. Some healthcare professionals presented some type of symptoms corresponding to the COVID-19 disease, however, few cases were detected with positive PCR.
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References
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References
Adhanom T. WHO Director-General´s opening remarks at the Mission briefing on COVID-19-12 March 2020. Ginebra, Suiza: World Health Organization [consultado 3 abril 2020]. Disponible en: https://www.who.int/dg.
Coronavirus disease 2019. World Health Organization. [Consultado 19 marzo 2020]. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020 Mar 13. doi: 10.1001/jamainternmed.2020.0994. [En prensa].
Zheng Y, Xu H, Yang M, Zeng Y, Chen H, Liu R et al. Epidemiological characteristics and clinical features of 32 critical and 67 noncritical cases of COVID-19 in Chengdu. J Clin Virol. 2020 Apr 10;127:104366. doi: 10.1016/j.jcv.2020.10436.
American Society of Nephrology Information for Screening and Management of COVID-19 in the Outpatient Dialysis Facility Release [Consultado 4 marzo 2020]. https://www.asn-online.org/ntds/.
Basile C, Combe C, Pizzarelli F, Covic A, Davenport A, Kanbay M et al. Recommendations for the prevention, mitigation and containment of the emerging SARS-CoV-2 (COVID-19) pandemic in haemodialysis centres. Nephrol Dial Transplant. 2020 Mar 20. pii: gfaa069. doi: 10.1093/ndt/gfaa069. [En prensa].
Arenas MD, Villar J, González C, Cao H, Collado S, Crespo M, et al. Manejo de la epidemia por coronavirus SARS-CoV-2 (COVID 19) en unidades de hemodiálisis. Nefrologia. 2020. https://doi.org/10.1016/j.nefro.2020.04.001.
Red de Vigilancia Epidemiológica de la Comunidad de Madrid, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid. Infección acumulada por Covid-19 en los municipios y distritos de la Comunidad de Madrid, Madrid Capital. [Consultado el 15 abril 2020]. Disponible en: https://comunidadmadrid.maps.arcgis.com/apps/PublicInformation/index.html?appid=cdfb61b3eb3a49c2b990b4fdb41dfcfe.
Garrido H. Mapa del coronavirus: así afecta el Covid-19 a los municipios y distritos de Madrid. Diario El Mundo. 8 abril 2020. [Consultado 15 abril 2020]. Disponible en: https://www.elmundo.es/madrid/2020/04/08/5e8db41c21efa06f278b4570.html.
Ma Y, Diao B, Lv X, Zhu J, Liang W, Liu L et al. 2019 novel coronavirus disease in hemodyalisis (HD) patients: report from one HD center in Wuhan, China medrxiv 2020. [Consultado el 23 abr 2020]. Disponible en: https://www.medrxiv.org/content/10.1101/2020.02.24.20027201v3.
Ministerio de Sanidad. Procedimiento de actuación frente a casos de nuevo coronavirus. (Actualización 11.04.2020). http://www.aeemt.com/web/wp-content/uploads/2020/04/Procedimiento_COVID_19-11042020.pdf.
De Sequera-Ortiz P, Quiroga-Gili B, De Arriba-De la Fuente G, Macía-Heras M, Salgueira Lazo M, Del Pino y Pino MD. Sociedad Española de Nefrología. Protocolo de actuación ante la epidemia de enfermedad por coronavirus en los pacientes de diálisis y trasplantados renales. Nefrologia 2020; 40(3):253-7.
Rombolà G, Heidempergher M, Pedrini L, Farina M, Aucella F, Messa P, Brunori G. Practical indications for the prevention and management of SARS-CoV-2 in ambulatory dialysis patients: lessons from the first phase of the epidemics in Lombardy. J Nephrol. 2020 Apr;33(2):193-6.
Wang H. Maintenance Hemodialysis and Coronavirus Disease 2019 (COVID-19): Saving Lives With Caution, Care, and Courage. Kidney Med. 2020 Mar 26. doi: 10.1016/j.xkme.2020.03.003.
Olynka Vega-Vega, Mauricio Arvizu-Hernánde, José Guillermo Domínguez-Cherit, Juan Sierra-Mader, Ricardo Correa-Rotter. Prevención y control de la infección por coronavirus SARS-CoV-2 (COVID-19) en unidades de hemodiálisis. Salud Pública Mex 2020;62:1-7.
Wang X, Liu W, Zhao J, Lu Y, Wang X, Yu C, Hu S, Shen N, Liu W, Sun Z, Li W. Clinical characteristics of 80 hospitalized frontline medical workers infected with COVID-19 in Wuhan, China J Hosp Infect. 2020 Apr 14. pii: S0195-6701(20)30194-8. doi: 10.1016/j.jhin.2020.04.019.