Abstract: Clinical Kidney Journal, 2020, vol. 13, no. 3, 334–339 doi: 10.1093/ckj/sfaa084 Advance Access Publication Date: 22 June 2020 Original Article ORIGINAL ARTICLE Francesco Fontana 1, Francesco Giaroni2, Monica Frisina2, Gaetano Alfano1,2, Giacomo Mori1, Leonardo Lucchi1, Riccardo Magistroni1,2 and Gianni Cappelli1,2 1 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, Modena, Italy 2 Correspondence to: Francesco Fontana; E-mail: francesco.fontana@unimore.it ABSTRACT 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. V This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com 334 SARS-CoV-2 infection in dialysis patients in northern Italy: a single-centre experience SARS-CoV-2 in dialysis patients