SARS-CoV-2 infection in patients on renal replacement therapy. Report of the COVID-19 Registry of the Spanish Society of Nephrology (SEN)

Nefrologia (Engl Ed). 2020 May-Jun;40(3):272-278. doi: 10.1016/j.nefro.2020.04.002. Epub 2020 Apr 16.
[Article in English, Spanish]

Abstract

Introduction: The recent appearance of the SARS-CoV-2 coronavirus pandemic has had a significant impact on the general population. Patients on renal replacement therapy (RRT) have not been unaware of this situation and due to their characteristics they are especially vulnerable. We present the results of the analysis of the COVID-19 Registry of the Spanish Society of Nephrology.

Material and methods: The Registry began operating on March 18th, 2020. It collects epidemiological variables, contagion and diagnosis data, signs and symptoms, treatments and outcomes. It is an online registry. Patients were diagnosed with SARS-CoV-2 infection based on the results of the PCR of the virus, carried out both in patients who had manifested compatible symptoms or had suspicious signs, as well as in those who had undergone screening after some contact acquainted with another patient.

Results: As of April 11, the Registry had data on 868 patients, from all the Autonomous Communities. The most represented form of RRT is in-center hemodialysis (ICH) followed by transplant patients. Symptoms are similar to the general population. A very high percentage (85%) required hospital admission, 8% in intensive care units. The most used treatments were hydroxychloroquine, lopinavir-ritonavir, and steroids. Mortality is high and reaches 23%; deceased patients were more frequently on ICH, developed pneumonia more frequently, and received less frequently lopinavir-ritonavir and steroids. Age and pneumonia were independently associated with the risk of death.

Conclusions: SARS-CoV-2 infection already affects a significant number of Spanish patients on RRT, mainly those on ICH, hospitalization rates are very high and mortality is high; age and the development of pneumonia are factors associated with mortality.

Keywords: España; Registro; Registry; Renal replacement therapies; SARS-CoV-2; Sociedad Española de Nefrología; Spain; Spanish Society of Nephrology; Tratamiento renal sustitutivo.

MeSH terms

  • Age Factors
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Chi-Square Distribution
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / mortality
  • Female
  • Hemodialysis Units, Hospital / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Nephrology / statistics & numerical data*
  • Pandemics*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / mortality
  • Registries / statistics & numerical data*
  • Renal Replacement Therapy / statistics & numerical data*
  • SARS-CoV-2
  • Societies, Medical
  • Spain / epidemiology
  • Statistics, Nonparametric
  • Symptom Assessment / statistics & numerical data
  • Transplant Recipients / statistics & numerical data