Effective prevention and management of COVID-19 in outpatient hemodialysis patients.

The authors introduce a mobile phone app that may effectively prevent and manage coronavirus disease 2019 (COVID-19) in outpatient hemodialysis patients in Sichuan Province, China.

Preparation of hemodialysis centers in fighting against the novel coronavirus disease during the 2019-2020 epidemic: the experience in Sichuan province, China.

BACKGROUND: Dialysis patients are at high risk of being infected by the novel coronavirus. This article aimed to share our experience in preparing hemodialysis centers in fighting against the COVID-19 in Sichuan province. METHODS: To control COVID-19, the Sichuan Renal Disease Quality Control Center (SRDQCC) organized a multidisciplinary team to draft and distribute documents for dialysis centers. The SRDQCC also established an online education system and a registry. A survey was used to assess the resources and the preparation of the dialysis centers. Patients with infected COVID-19 were transferred to the referral hospitals and treated with continuous renal replacement therapy (CRRT) in isolated rooms. RESULTS: All 21 regions in Sichuan province had designated specific referral hospitals for COVID-19. The documents drafted by the SRDQCC were distributed to all dialysis centers. A total of 313 records from the survey showed that 96% (301/313) of the dialysis centers had set up an emergency program based on the relevant documents. Only 39% (121/313) of the centers had emergency isolated room(s) for COVID-19. Also, 22% (68/313) of the centers had their patient(s) moved to other centers. The online system educated medical staff in 87% (271/313) of the centers. The online registry received 329 records. Four cases of COVID-19-infected dialysis patients were reported until March 3rd, 2020. There were no outbreaks of COVID-19 in any dialysis center in Sichuan province. CONCLUSIONS: The experience of dialysis centers in Sichuan province in fighting against COVID-19 is worth sharing. Dialysis centers need to be prepared to cope with infectious epidemics guided by national as well as regional quality control centers or other similar organizations.

Kidney manifestations of mild, moderate and severe coronavirus disease 2019: a retrospective cohort study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a pandemic that has affected more than 3 million patients globally. Previous data from Wuhan city showed that acute kidney injury (AKI), proteinuria and hematuria occurred frequently in patients with severe COVID-19. However, the prevalence of kidney injury in milder cases remains unclear. METHODS: This retrospective study included two major consecutive cohorts of COVID-19 patients in Sichuan Province. Baseline characteristics, laboratory data including renal function, proteinuria and dipstick hematuria, and other laboratory parameters were collected. A subgroup of patients was followed up for 2-4 weeks to evaluate the short-term outcome of renal impairment. RESULTS: Overall, 168 COVID-19-positive patients were included in the study. The majority of patients (79.7%) were diagnosed with mild or moderate disease. Half of patients presented with fever; however, in The Tibetan cohort, fever only occurred in 13.4% of patients. On hospital admission, proteinuria and dipstick hematuria were noted in 18.4% and 17.4% of patients, respectively, while AKI only occurred in one patient. Further analysis showed that severe or critical COVID-19 was associated with higher risk of proteinuria [relative risk (RR) 7.37, 95% confidence interval (CI) 2.45-22.18, P = 3.8 × 10-4] and dipstick hematuria (RR 8.30, 95% CI 2.69-25.56, P = 2.3 × 10-4). Proteinuria, dipstick hematuria, or the combination of proteinuria and hematuria could significantly predict severe or critical severe COVID-19. CONCLUSIONS: Proteinuria and dipstick hematuria are not uncommon in patients with COVID-19 infection, especially in severe or critical cases.

Management of peritoneal dialysis under COVID-19: The experience in Sichuan Province People's Hospital, China.

The outbreak of coronavirus disease 2019 (COVID-19) is becoming a severe challenge to China and the whole world. By now, there is no report about medical support to peritoneal dialysis (PD) patient during COVID-19 pandemic. In this essay, we summed up our safety measures on how to protect PD patients and our staffs, and our experience on how to ensure the dialysis treatment of PD patients during the pandemic period. Using of telehealth has potential to improve patient care quality. As a result, by applying all the actions and efforts above, most of patients got enough medical support. According to the patient survey, 11 patients (3.3% of the total) reduced their treatment of dialysis exchange due to the shortage of PD solution or the affection of the pandemic. None of the PD patient and staff reported COVID-19. We successfully prevented COVID-19 transmission and ensured medical safety in our PD patients during the crisis.