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2020 ; 33
(4
): 725-736
Nephropedia Template TP
gab.com Text
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English Wikipedia
Exposure to novel coronavirus in patients on renal replacement therapy during the
exponential phase of COVID-19 pandemic: survey of the Italian Society of
Nephrology
#MMPMID32621109
Quintaliani G
; Reboldi G
; Di Napoli A
; Nordio M
; Limido A
; Aucella F
; Messa P
; Brunori G
J Nephrol
2020[Aug]; 33
(4
): 725-736
PMID32621109
show ga
BACKGROUND: Between February and April 2020, Italy experienced an overwhelming
growth of the COVID-19 pandemic. Little is known, at the country level, where and
how patients on renal replacement therapy (RRT) have been mostly affected.
METHODS: Survey of the network of Nephrology centers using a simplified 17 items
electronic questionnaire designed by Italian Society of Nephrology COVID-19
Research Group. We used spatial epidemiology and geographical information systems
to map SARS-CoV-2 spread among RRT patients in Italy. RESULTS: On April 9th 2020,
all nephrology centers (n?=?454) listed in the DialMap database were invited to
complete the electronic questionnaire. Within 11 days on average, 365 centers
responded (80.4% response rate; 2.3% margin of error) totaling 60,441 RRT
patients. The surveyed RRT population included 30,821 hemodialysis (HD), 4139
peritoneal dialysis (PD), and 25,481 transplanted (Tx) patients respectively. The
proportion of SARS-CoV-2 positive RRT patients in Italy was 2.26% (95% CI
2.14-2.39) with significant differences according to treatment modality
(p?0.001). The proportion of patients positive for SARS-CoV-2 was significantly
higher in HD (3.55% [95% CI 3.34-3.76]) than PD (1.38% [95% CI 1.04-1.78] and Tx
(0.86% [95% CI 0.75-0.98]) (p?0.001), with substantial heterogeneity across
regions and along the latitude gradient (p?0.001). In RRT patients the highest
rate was in the north-west (4.39% [95% CI 4.11-4.68], followed by the north-east
(IR 2.06% [1.79-2.36]), the center (0.91% [0.75-1.09]), the main islands (0.67%
[0.47-0.93]), and the south (0.59% [0.45-0.75]. During the COVID-19 pandemic,
among SARS-Cov-2 positive RRT patients the fatality rate was 32.8%, as compared
to 13.3% observed in the Italian population as of April 23rd. CONCLUSIONS: A
substantial proportion of the 60,441 surveyed RRT patients in Italy were
SARS-Cov-2 positive and subsequently died during the exponential phase of
COVID-19 pandemic. Infection risk and rates seems to differ substantially across
regions, along geographical latitude, and by treatment modality.