Impact of SARS-CoV-2 infection in the population on peritoneal dialysis. The Spanish experience : preliminary results.

Authors

  • Emilio Sanchez-Alvarez Hospital Universitario de Cabueñes (Gijón)
  • Maria Auxiliadora Bajo Rubio Hospital Universitario La Paz (Madrid) https://orcid.org/0000-0001-7364-557X
  • Vicente Paraíso Cuevas Hospital Universitario del Henares (Coslada)
  • Virginia López de la Manzanara Hospital Clínico San Carlos (Madrid)
  • Rosario Llópez Carratala Hospital Universitario Puerta de Hierro (Madrid)
  • Diego Rodríguez Puyol Hospital Universitario Príncipe de Asturias (Alcalá de Henares) https://orcid.org/0000-0002-9125-9311
  • Hernando Trujillo Cuéllar Hospital Universitario 12 de octubre (Madrid) https://orcid.org/0000-0002-3520-1422
  • Jesús Grande Villoria Complejo Hospitalario de Zamora
  • Luz Maria Cuiña Barja Complejo Hospitalario de de Pontevedra

DOI:

https://doi.org/10.25796/bdd.v3i3.57873

Keywords:

Peritoneal dialysis, renal replacement therapies, COVID-19, SARS-Cov2

Abstract

The recent appearance of the SARS-CoV-2 pandemic has had a significant impact on the general population. Patients on renal replacement therapy (RRT) have not been unaware of this situation, and due to their characteristics, they are especially vulnerable. We present the results of the analysis of the COVID-19 Registry of the Spanish Society of Nephrology. This online registry began operating on March 18, 2020. It collects epidemiological variables, contagion and diagnosis data, signs and symptoms, treatments, and outcomes. Patients were diagnosed with SARS-CoV-2 infection based on the results of the PCR of the virus, carried out both in patients who had manifested compatible symptoms or had suspicious signs and in those who had undergone screening after contact with another patient.

As of July 18, the registry had data on 1748 patients, from all the autonomous communities. The most represented form of RRT is in-center hemodialysis (HDC), followed by transplant patients. Only 55 (4%) were on peritoneal dialysis (PD). PD patients’ symptoms are similar to those of the general population. A very high percentage (93%) required hospital admission, but none in intensive care units. The most used treatments were hydroxychloroquine, lopinavir–ritonavir, and steroids. Mortality is high and reaches 18%. Age and pneumonia were independently associated with the risk of death. We also found a beneficial effect of PD over HDC.

As conclusions, SARS-CoV-2 infection already affects a significant number of Spanish patients on RRT, mainly those on HDC. The proportion of infected patients on PD is significantly lower. Hospitalization rates are very high, and mortality is high; age and the development of pneumonia are factors associated with mortality, while those on PD had lower mortality.

References

1. World Health Organization. https://covid19.who.int/
2. Ministry of Health; Government of Spain. https://covid19.isciii.es/
3. Annual report of the Spanish Registry of Renal Patients. (2018). https://senefro.org/contents/webstructure/SEN_2019_REER_modificada.pdf
4. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708-1720.
5. Sánchez-Álvarez JE, Pérez Fontán M, Jiménez Martín C, et al. SARS-CoV-2 infection in patients on renal replacement therapy. Report of the COVID-19 Registry of the Spanish Society of Nephrology (SEN). Nefrologia 2020; 40: 272-278.
6. Ferrey AJ, Choi G, Hanna RM, et al. A Case of Novel Coronavirus Disease 19 in a Chronic Hemodialysis Patient Presenting with Gastroenteritis and Developing Severe Pulmonary Disease. Am J Nephrol 2020; 51: 337-342.
7. S. Garg, L. Kim, M. Whitaker, A. O’Halloran, C. Cummings, R. Holstein, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease COVID-NET-2019, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep, 69 (2020), pp. 458-464.
8. Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. Int Urol Nephrol. 2020; 52: 1193-1194.
9. Liu WJ, Zhao M, Liu K, et al. T-cell immunity of SARS-CoV: Implications for vaccine development against MERS-CoV. Antiviral Res. 2017; 137: 82-92.
10. Y. Liu, Huang, J. Xu, P. Yang, Y. Qin, M. Cao, et al. Anti-hypertensive Angiotensin II receptor blockers associated to mitigation of disease severity in elderly COVID-19 patients. medRxiv., (2020), http://dx.doi.org/10.1101/2020.03.20.20039586.
11. M.A. Sparks, S. Hiremath, A. South, P. Welling, M. Luther, J. Cohen, et al. The coronavirus conundrum: ACE2 and hypertension edition. NephJC (2020).
12. Nouvier M, Verger C, Fouque D. Situation of the Covid-19 epidemic in patients on peritoneal dialysis on 2020/05/15 in France according to RDPLF data-base. Bull Dial Domic 2020, vol 3. https://doi.org/10.25796/bdd.v3i2.55433.

Published

2020-08-21

How to Cite

1.
Sanchez-Alvarez E, Bajo Rubio MA, Paraíso Cuevas V, López de la Manzanara V, Llópez Carratala R, Rodríguez Puyol D, Trujillo Cuéllar H, Grande Villoria J, Cuiña Barja LM. Impact of SARS-CoV-2 infection in the population on peritoneal dialysis. The Spanish experience : preliminary results. . Bull Dial Domic [Internet]. 2020 Aug. 21 [cited 2024 Nov. 12];3(3):147-54. Available from: https://bdd.rdplf.org/index.php/bdd/article/view/57873