COVID-19 in chronic hemodialysis patients: A report of 9 cases in Madrid, Spain

Clin Nephrol. 2021 Jan;95(1):45-53. doi: 10.5414/CN110210.

Abstract

Introduction: In December 2019, a new respiratory disease, named COVID-19, caused by a novel coronavirus, emerged in Wuhan and since then spread rapidly throughout China and worldwide. Hemodialysis patients are an especially vulnerable subgroup of the general population. However, there are only a few reports on the course of COVID-19 in maintenance hemodialysis patients.

Case report: We describe in depth the clinical, analytical, and radiological details of 9 hemodialysis patients from a single center in Madrid (Spain) diagnosed with COVID-19. Furthermore, we describe and discuss the therapeutic aspects and the patients' outcomes.

Discussion: We present one of the first case series of chronic hemodialysis patients with COVID-19. Between March 14 and April 8, 2020, out of 76 prevalent patients in our hemodialysis unit, 9 (11.8%) patients were diagnosed with COVID-19. The most common symptoms were fever (77.8%), asthenia (77.8%), cough (55.6%), and dyspnea (33.3%). A total of 3 patients developed severe pneumonia, whereas 4 patients developed mild pneumonia. In 2 patients, no pathologic changes were found on chest radiography. All patients presented lymphopenia. While 6 (66.7%) patients required hospitalization, none of them was admitted to intensive care unit. The most common treatments used were azithromycin (100%), hydroxychloroquine (66.7%), lopinavir/ritonavir (55.6%) and β-interferon (22.2%). In general, we observed a mild to moderate severity of disease in our case series. One patient died, however due to a cause not related to COVID-19.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19* / complications
  • COVID-19* / diagnostic imaging
  • COVID-19* / pathology
  • Fatal Outcome
  • Female
  • Hospitalization
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / therapy
  • SARS-CoV-2
  • Spain