Incidencia y resultados de la COVID-19 en una unidad de diálisis domiciliaria en Madrid (España) durante el pico de la pandemia
María Maldonado, Marta Ossorio, Gloria Del Peso, Carlos Santos, Laura Álvarez, Rafael Sánchez-Villanueva, Begoña Rivas, Cristina Vega, Rafael Selgas, María A Bajo
Nefrología, doi:10.1016/j.nefro.2020.09.002
Introducción: La enfermedad por coronavirus 2019 (COVID-19) es una infección viral causada por un nuevo coronavirus que está afectando a todo el mundo. Hay estudios previos de pacientes en hemodiálisis en centro, pero hay pocos datos sobre población en diálisis domiciliaria. Nuestro objetivo es estudiar la incidencia y evolución de la COVID-19 en una unidad de diálisis domiciliaria (UDD) durante el pico de la pandemia. Métodos: Estudio observacional y retrospectivo que incluye todos los pacientes diagnosticados de COVID-19 de la UDD del Hospital Universitario La Paz (Madrid, Espa ña) entre el 10 de marzo y el 15 de mayo de 2020. Se recogieron los datos clínicos de la UDD (57 pacientes en diálisis peritoneal y 22 pacientes en hemodiálisis domiciliaria) y comparamos las características clínicas y la evolución de los pacientes con o sin infección por COVID-19. Resultados: Doce pacientes fueron diagnosticados de COVID-19 (9 diálisis peritoneal, 3 hemodiálisis domiciliaria). No hubo diferencias estadísticamente significativas entre las características clínicas de los pacientes con COVID-19 y el resto de la unidad. La edad media fue 62 ± 18,5 a ños; la mayoría eran varones (75%). Todos los pacientes menos uno necesitaron hospitalización. Diez pacientes (83%) fueron dados de alta tras una media de 16,4 ± 9,7 días de hospitalización. Dos pacientes fueron diagnosticados durante su hospitalización por otro motivo y fueron los únicos que fallecieron. Los fallecidos eran de mayor edad que los supervivientes. Conclusión: La incidencia de COVID-19 en nuestra UDD en Madrid durante el pico de la pandemia fue alto, especialmente en los pacientes en diálisis peritoneal, sin observarse un * Autor para correspondencia.
Conflicto de intereses Los autores declaran no tener ningún conflicto de intereses.
Agradecimientos Nos gustaría agradecer a todo el equipo de médicos, enfermería, auxiliares de enfermería, celadores, limpieza, administrativos y demás personal del Hospital Universitario La Paz su gran labor durante la pandemia de COVID-19, destacando el gran trabajo en equipo que se realizó. También nos gustaría agradecer a los centros de hemodiálisis asociados al Hospital Universitario La Paz (Centro de Diálisis de Madrid El Pilar [Fresenius Medical Care], Centro de Diálisis Alcobendas [Fresenius Medical Care] y Centro de Diálisis Diaverum Madrid) su importante papel durante la pandemia, al prestar el apoyo logístico necesario para poder concentrar todos los casos COVID-19 positivos en la unidad hospitalaria y derivar los pacientes sanos a dichos centros. b i b l i o g r a f í a
References
Albalate, Arribas, Torres, Cintra, Alcázar et al., Alta prevalencia de covid19 asintomático en hemodiálisis. Aprendiendo dia a dia el primer mes de pandemia de covid19
Alberici, Delbarba, Manenti, Econimo, Valerio et al., A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection, Kidney Int
Alberici, Delbarba, Manenti, Econimo, Valerio et al., Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in
Basile, Combe, Pizzarelli, Covic, Davenport et al., Recommendations for the prevention, mitigation and containment of the emerging SARS-CoV-2 (COVID-19) pandemic in haemodialysis centres, Nephrol Dial Transplant
Borobia, Carcas, Arnalich, Alvarez-Sala, Montserrat et al., A cohort of patients with COVID-19 in a major teaching hospital in Europe, J Clin Med
El Shamy, Sharma, Winston, Uribarri, Peritoneal dialysis during the coronavirus disease-2019 (COVID-19) Pandemic: Acute inpatient and maintenance outpatient experiences, Kidney Medicine
Goicoechea, Cámara, Macías, Mu Ñoz De Morales, Rojas et al., COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain
Huang, Wang, Li, Ren, Zhao et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Ital, None
Kliger, Cozzolino, Jha, Harbert, Ikizler, Managing the COVID-19 Pandemic: International Comparisons in Dialysis Patients, Kidney Int
Lai, Wang, Guo, Recommendations for prevention and management of COVID-19 in peritoneal dialysis patients, Chronic Dis Transl Med
Ma, Diao, Lv, Zhu, Liang et al., novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in
Madjid, Safavi-Naeini, Solomon, Vardeny, Potential effects of coronaviruses on the cardiovascular system: A review, JAMA Cardiol
Meyer, Hostetter, Watnick, Twice-weekly hemodialysis is an option for many patients in times of dialysis unit stress, J Am Soc Nephrol
Richardson, Hirsch, Narasimhan, Crawford, Mcginn et al., Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area, JAMA
Rodriguez-Morales, Cardona-Ospina, Gutiérrez-Ocampo, Villamizar-Pe Ña, Holguin-Rivera et al., Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis, Travel Med Infect Dis
Rothan, Byrareddy, The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak, J Autoimmun
Rowland, Kunadian, Challenges in the management of older patients with acute coronary syndromes in the COVID-19 pandemic, Heart,
doi:10.1136/heartjnl-2020-317011Scarpioni, Manini, Valsania, De Amicis, Albertazzi et al., Covid-19 and its impact on nephropathic patients: the experience at Ospedale "Guglielmo da Saliceto
Valeri, Robbins-Juarez, Stevens, Ahn, Rao et al., Presentation and Outcomes of Patients with ESKD and COVID-19, J Am Soc Nephrol
Wang, Liao, He, Hu, Wei et al., COVID-19 in Hemodialysis Patients: A Report of 5 Cases, Am J Kidney Dis
Wu, Chen, Cai, Xia, Zhou 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 [Internet
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 cases from the Chinese Center for Disease Control and Prevention, JAMA
Zheng, Ma, Zhang, Xie, COVID-19 and the cardiovascular system, Nature Reviews Cardiology. Nature Research
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'article-title': 'Management of Patients on Dialysis and With Kidney Transplantation '
'During the SARS-CoV-2 (COVID-19) Pandemic in Brescia, Italy [Internet]. '
'Vol. 5, Kidney International Reports',
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'article-title': 'COVID-19: clinical course and outcomes of 36 hemodialysis patients in '
'Spain [Internet]. Vol. 98, Kidney International',
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'article-title': 'The epidemiology and pathogenesis of coronavirus disease (COVID-19) '
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'author': 'Rothan',
'year': '2020',
'journal-title': 'J Autoimmun'},
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'DOI': '10.1016/S0140-6736(20)30183-5',
'article-title': 'Clinical features of patients infected with 2019 novel coronavirus in '
'Wuhan, China',
'volume': '395',
'author': 'Huang',
'year': '2020',
'journal-title': 'Lancet.'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0155',
'doi-asserted-by': 'crossref',
'first-page': '737',
'DOI': '10.1093/ndt/gfaa069',
'article-title': 'Recommendations for the prevention, mitigation and containment of the '
'emerging SARS-CoV-2 (COVID-19) pandemic in haemodialysis centres',
'volume': '35',
'author': 'Basile',
'year': '2020',
'journal-title': 'Nephrol Dial Transplant [Internet].'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0160',
'doi-asserted-by': 'crossref',
'DOI': '10.1001/jamainternmed.2020.0994',
'article-title': 'Risk Factors Associated With Acute Respiratory Distress Syndrome and '
'Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, '
'China',
'author': 'Wu',
'year': '2020',
'journal-title': 'JAMA Intern Med [Internet].'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0165',
'doi-asserted-by': 'crossref',
'DOI': '10.1016/j.kint.2020.04.007',
'article-title': 'Managing the COVID-19 Pandemic: International Comparisons in Dialysis '
'Patients',
'author': 'Kliger',
'year': '2020',
'journal-title': 'Kidney Int.'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0170',
'doi-asserted-by': 'crossref',
'DOI': '10.1053/j.ajkd.2020.03.009',
'article-title': 'COVID-19 in Hemodialysis Patients: A Report of 5 Cases',
'author': 'Wang',
'year': '2020',
'journal-title': 'Am J Kidney Dis.'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0175',
'article-title': 'Alta prevalencia de covid19 asintomático en hemodiálisis',
'author': 'Albalate',
'year': '2020',
'journal-title': 'Aprendiendo dia a dia el primer mes de pandemia de covid19. Nefrología '
'[Internet].'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0180',
'unstructured': 'COVID-19. Situación actual en la Comunidad de Madrid. Informe de '
'situación del 24 de May. [consultado 26 May 2020]. Disponible en: '
'https://www.comunidad.madrid/sites/default/files/doc/sanidad/200525_cam_covid19.pdf. '
'Vol. 438. 2020.'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0185',
'doi-asserted-by': 'crossref',
'DOI': '10.1681/ASN.2020040470',
'article-title': 'Presentation and Outcomes of Patients with ESKD and COVID-19',
'author': 'Valeri',
'year': '2020',
'journal-title': 'J Am Soc Nephrol [Internet].'},
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'article-title': 'Covid-19 and its impact on nephropathic patients: the experience at '
'Ospedale “Guglielmo da Saliceto” in Piacenza [Internet]',
'volume': '37',
'author': 'Scarpioni',
'year': '2020',
'journal-title': 'G Ital Nefrol'},
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'article-title': '2019 novel coronavirus disease in hemodialysis (HD) patients: Report '
'from one HD center in Wuhan, China',
'author': 'Ma',
'year': '2020',
'journal-title': 'medRxiv. Cold Spring Harbor Laboratory Press'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0200',
'doi-asserted-by': 'crossref',
'DOI': '10.1177/0896860820921657',
'article-title': 'Peritoneal dialysis in the time of COVID-19',
'author': 'Wilkie',
'year': '2020',
'journal-title': 'Perit Dial Int J Int Soc Perit Dial [Internet].'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0205',
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'article-title': 'Twice-weekly hemodialysis is an option for many patients in times of '
'dialysis unit stress',
'volume': '31',
'author': 'Meyer',
'year': '2020',
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'Pandemic: Acute inpatient and maintenance outpatient experiences',
'author': 'El Shamy',
'year': '2020',
'journal-title': 'Kidney Medicine. Elsevier Inc'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0215',
'article-title': 'Recommendations for prevention and management of COVID-19 in peritoneal '
'dialysis patients',
'author': 'Lai',
'year': '2020',
'journal-title': 'Chronic Dis Transl Med.'},
{ 'key': '10.1016/j.nefro.2020.09.002_bib0220',
'doi-asserted-by': 'crossref',
'first-page': '1733',
'DOI': '10.3390/jcm9061733',
'article-title': 'A cohort of patients with COVID-19 in a major teaching hospital in '
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'volume': '9',
'author': 'Borobia',
'year': '2020',
'journal-title': 'J Clin Med'},
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'volume': '34',
'author': 'Rodriguez-Morales',
'year': '2020',
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'year': '2020',
'journal-title': 'JAMA Cardiol.'},
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'article-title': 'COVID-19 and the cardiovascular system. Vol. 17, Nature Reviews '
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'author': 'Richardson',
'year': '2020',
'journal-title': 'JAMA [Internet].'},
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