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2019 novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in Wuhan, China

By Yiqiong Ma, Bo Diao, Xifeng Lv, Jili Zhu, Wei Liang, Lei Liu, Wenduo Bu, Huiling Cheng, Sihao Zhang, Lianhua Yang, Ming Shi, Guohua Ding, Bo Shen, Huiming Wang

Posted 25 Feb 2020
medRxiv DOI: 10.1101/2020.02.24.20027201

Importance: The outbreak of highly contagious COVID-19 has posed a serious threat to human health, especially for those with underlying diseases. However, Impacts of COVID-19 epidemic on HD center and HD patients have not been reported. Objective: To summery an outbreak of COVID-19 epidemic in HD center. Design, Setting, and Participants: We reviewed the epidemic course from the first laboratory-confirmed case of COVID-19 infection on January 14 to the control of the epidemic on March 12 in the HD center of Renmin Hospital of Wuhan University. Total 230 HD patients and 33 medical staff were included in this study Exposures: COVID-19. Main Outcomes and Measures: Epidemiological, clinical, laboratory, and radiological characteristics and outcomes data were collected and analyzed. 19 COVID-19 HD patients, 19 non-COVID-19 HD patients and 19 healthy volunteers were enrolled for further study about the effect of SARS-CoV-2 infection on host immune responses. Results: 42 out of 230 HD patients (18.26%) and 4 out of 33 medical staffs(12.12%) were diagnosed with COVID-19 from the outbreak to March 12, 2020. 13 HD patients (5.65%), including 10 COVID-19 diagnosed, died during the epidemic. Only 2 deaths of the COVID-19 HD patients were associated with pneumonia/lung failure. Except 3 patients were admitted to ICU for severe condition (8.11%), including 2 dead, most COVID-19 diagnosed patients presented mild or none-respiratory symptoms. Multiple lymphocyte populations in HD patients were significantly decreased. HD patients with COVID-19 even displayed more remarkable reduction of serum inflammatory cytokines than other COVID-19 patients. Conclusions and Relevance: HD patients are the highly susceptible population and HD centers are high risk area during the outbreak of COVID-19 epidemic. HD Patients with COVID-19 are mostly clinical mild and unlikely progress to severe pneumonia due to the impaired cellular immune function and incapability of mounting cytokines storm. More attention should be paid to prevent cardiovascular events, which may be the collateral impacts of COVID-19 epidemic on HD patients.

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