SARS-CoV-2 infection in dialysis patients in northern Italy: a single-centre experience
Fontana et al.
, SARS-CoV-2 infection in dialysis patients in northern Italy: a single-centre experience
, Clinical Kidney Journal, 13:3, 334–339, doi:10.1093/ckj/sfaa084
Very small observational study of 15 dialysis patients showing HCQ mortality RR 0.50, p = 0.53.
risk of death, 50.0% lower, RR 0.50, p = 0.53, treatment 4 of 12 (33.3%), control 2 of 3 (66.7%), NNT 3.0.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fontana et al., 22 Jun 2020, retrospective, Italy, peer-reviewed, 8 authors.
Abstract: Clinical Kidney Journal, 2020, vol. 13, no. 3, 334–339
Advance Access Publication Date: 22 June 2020
Francesco Fontana 1, Francesco Giaroni2, Monica Frisina2, Gaetano
Alfano1,2, Giacomo Mori1, Leonardo Lucchi1, Riccardo Magistroni1,2 and
Struttura Complessa di Nefrologia e Dialisi, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy and
Surgical Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia,
Correspondence to: Francesco Fontana; E-mail: email@example.com
Background. Dialysis patients are considered at high risk for COVID-19 and the infection can easily spread in dialysis units.
Methods. We conducted an observational single-centre cohort study to describe clinical characteristics, treatments and
outcomes of dialysis patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We tested
patients who presented symptoms or had contact with a confirmed case. We enrolled 15 patients positive for SARS-CoV-2.
Results. We tested 37 of 306 dialysis patients. Patients with SARS-CoV-2 infection were older (mean age 75.96 6 11.09 years)
and all had comorbidities. At presentation, most had interstitial infiltrates on chest X-ray, three-quarters had leucopenia
and none had respiratory insufficiency. During follow-up, there was an increase in serum C-reactive protein and
interleukin-6. Eighty percent of patients received supplemental oxygen; none received non-invasive ventilation, one was
intubated. Most patients (80%) were treated with oral hydroxychloroquine for a median time of 6.5 days [interquartile range
(IQR) 5–14.5] and 40% received azithromycin; two patients received a short course of antivirals and one received a single
dose of tocilizumab. Only two patients did not require hospitalization. Of the nine survivors, eight still tested positive for
SARS-CoV-2 a median of 19 days (IQR 9.25–23) after diagnosis. Six patients died (case fatality rate 40%) a median of 5.5 days
(IQR 1.75–9.75) after diagnosis. The main reported cause of death was respiratory failure related to COVID-19 (five patients).
Conclusions. We report a single-centre experience of SARS-CoV-2 infection in dialysis patients. The disease showed a high
case fatality rate and most patients required hospitalization. Survivors show prolonged viral shedding.
Keywords: COVID-19, dialysis, SARS-CoV-2
Received: 14.4.2020; Editorial decision: 22.4.2020
C The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.
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SARS-CoV-2 infection in dialysis patients in northern
Italy: a single-centre experience
SARS-CoV-2 in dialysis patients
is less effective
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