Abstract Background and Aims Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infections emerged in Wuhan, China in December 2019 and rapidly became pandemic. Unfortunately, there is lack of evidence… Click to show full abstract
Abstract Background and Aims Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infections emerged in Wuhan, China in December 2019 and rapidly became pandemic. Unfortunately, there is lack of evidence about the optimal management of corona virus disease-2019 (COVID-19) and even less is available in patients on maintenance haemodialysis. Patient receiving maintenance haemodialysis are at increased risk for infection by SARS-CoV-2 with poor outcome. So, the purpose of this study was to identify the incidence of SARS-CoV-2 infection among end-stage kidney disease (ESKD) patients on maintenance haemodialysis. Method A cross-sectional study was conducted at a haemodialysis unit of tertiary care hospital of Bangladesh from April to August 2020. All patients, who were on maintenance haemodialysis, twice or thrice weekly, were screened by reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, irrespective of symptoms. All data were collected in case record forms and patients were followed-up over phone. Results During the study period, a total of 133 patients (males 70, 52.6%) were on regular maintenance haemodialysis in the study centre. Most patients were in 5th and 6th decades of life. Twenty-one (15.8%) patients tested positive for SARS-CoV-2 by RT-PCR with female (16, 76.2%) predominance. Eighteen (18/21, 85.7%) patients had symptoms suggestive of SARS-CoV-2 infection and rest three (3/21, 14.3%) patients were diagnosed during routine screening. Common presentations were fever (42.9%), cough (66.7%) and respiratory distress (66.7%) and most had multiple symptoms. The incidence of SARS-CoV-2 infection in blood group A was 8(38%) and blood group O was 8(38%). There were no significant differences of mortality rate among blood groups. Most patients (16/21, 76.2%) infected by SARS-CoV-2 were referred to COVID-dedicated hospitals, five (5/21, 23.8%) were shifted to intensive care unit (ICU). Outcome was poor; 17 (17/21, 89%) patients died in hospitals and four (4/21, 19%) patients became free of SARS-CoV-2 infection. Caregivers/relative of our patients acquired COVID-19 in course of disease. Conclusion One-sixth of patients on maintenance haemodialysis acquired SARS-CoV-2 infection with nearly ninety percent fatality rates. Despite having risk factors for severe infection by SARS-CoV-2, patients on dialysis must visit health care facilities. So, utmost care should be taken to reduce risk of COVID-19 among such vulnerable group of patients.
               
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