Critical Coronavirus Disease 2019 in a Hemodialysis Patient: A Proposed Clinical Management Strategy

• Main Authors: Charmaine Si Min Sia, Samantha Hui Ling Cheong, Clara Lee Ying Ngoh, Yi Hern Tan, Weng Kin Wong
• Format: Article
• Language: English
• Published: Karger Publishers 2020-07-01
• Series: Case Reports in Nephrology and Dialysis
• Subjects: coronavirus disease 2019; infection control; hemodialysis
• Online Access: https://www.karger.com/Article/FullText/509792

The coronavirus disease 2019 (COVID-19) pandemic has caused a catastrophic global health crisis. There is a lack of mitigation and clinical management strategies for COVID-19 in specific patient cohorts such as hemodialysis (HD) patients. We report our experience in treating the first case of COVID-19 in a HD patient in Singapore who had a severe clinical course including acute respiratory distress syndrome and propose a clinical management strategy. We propose a clinical workflow in managing such patients based on available evidence from literature review. We also highlight the importance of early recognition and intervention for disease control, dialysis support in an acute hospital isolation facility, deisolation protocol, and discharge planning due to prolonged viral shedding. The case highlights important points specific to a HD patient with a COVID-19 diagnosis, tailored interventions for each stage of the disease, and deisolation considerations in the recovery phase.