Clinical Profiles in Renal Patients with COVID-19

• Main Authors: María Dolores Arenas, Marta Crespo, María José Pérez-Sáez, Silvia Collado, Dolores Redondo-Pachón, Laura Llinàs-Mallol, María Milagro Montero, Judith Villar-García, Carlos Arias-Cabrales, Francesc Barbosa, Anna Buxeda, Carla Burballa, Laia Sans, Susana Vázquez, Anna Oliveras, Marisa Mir, Sara Outón, Isabel Galcerán, Eulalia Solá, Adriana Sierra, Clara Barrios, Eva Rodríguez, Higini Cao, Roberto Güerri-Fernández, Juan Pablo Horcajada, Julio Pascual
• Format: Article
• Language: English
• Published: MDPI AG 2020-08-01
• Series: Journal of Clinical Medicine
• Subjects: COVID-19; SARS-CoV-2; RT-PCR; kidney transplantation; hemodialysis; pneumonia
• Online Access: https://www.mdpi.com/2077-0383/9/8/2665

The COVID-19 pandemic has led to frequent referrals to the emergency department on suspicion of this infection in maintenance hemodialysis (MHD) and kidney transplant (KT) patients. We aimed to describe their clinical features comparing confirmed and suspected non-confirmed COVID-19 cases during the Spanish epidemic peak. Confirmed COVID-19 ((+)COVID-19) corresponds to patient with positive RT-PCR SARS-CoV-2 assay. Non-confirmed COVID-19 ((−)COVID-19) corresponds to patients with negative RT-PCR. COVID-19 was suspected in 61 patients (40/803 KT (4.9%), 21/220 MHD (9.5%)). Prevalence of (+)COVID-19 was 3.2% in KT and 3.6% in MHD patients. Thirty-four (26 KT and 8 MHD) were (+)COVID-19 and 27 (14 KT and 13 MHD) (−)COVID-19. In comparison with (−)COVID-19 patients, (+)COVID-19 showed higher frequency of typical viral symptoms (cough, dyspnea, asthenia and myalgias), pneumonia (88.2% vs. 14.3%) and LDH and CRP while lower phosphate levels, need of hospital admission (100% vs. 63%), use of non-invasive mechanical ventilation (36% vs. 11%) and mortality (38% vs. 0%) (<i>p</i> < 0.001). Time from symptoms onset to admission was longer in patients who finally died than in survivors (8.5 vs. 3.8, <i>p</i> = 0.007). In KT and MHD patients, (+)COVID-19 shows more clinical severity than suspected non-confirmed cases. Prompt RT-PCR is mandatory to confirm COVID-19 diagnosis.