PMC:7464116 / 62591-64949
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7464116","sourcedb":"PMC","sourceid":"7464116","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7464116","text":"7.4. Clinical Features in Peritoneal Dialysis Patients (PD)\nThe Italian report created by SIN has collected individual data of peritoneal dialysis (PD) patients with COVID-19; in the last update dating back to May, 57 cases of COVID-19 and 28 deaths were reported in total. This report shows a higher rate of mortality, almost 49%, than the general population [124]. Notably, SARS-CoV-2 positivity corresponded with peritoneal dialysis failure, suggesting a possible effect of the virus on the peritoneal membrane. The first case in the literature which demonstrated SARS-CoV-2 in the peritoneal fluid, was described during an emergency surgical laparotomy in a COVID-19 sick patient. During the procedure laparotomy, two swabs were obtained from peritoneal fluid and then sent for SARS-CoV-2 detection by specific real-time reverse transcriptase–polymerase chain reaction targeting three SARS-CoV-2 genes. It was then detected in the peritoneal fluid at a higher concentration than in the respiratory tract [125]. Recently, an Italian study described for the first time the detection of SARS-CoV-2 in the peritoneal waste of a patient with COVID-19 and ESKD on peritoneal dialysis. The patient showed the following common COVID-19 infection symptoms: fever, cough, myalgia, headache and mild hypoxemia. Chest computed tomography reported bilateral multiple ground-glass opacities and laboratory tests showed mild lymphopenia, increased C-reactive protein and D-dimer levels. The patient’s peritoneal dialysate was tested for SARS-CoV-2 by polymerase chain reaction, and was found to be positive [126]. According to the International Society Peritoneal Dialysis (ISPD) strategies regarding COVID-19 in peritoneal dialysis patients, the management of infection is the same for PD patients as for all other patients. Mild or moderate patients on PD can continue PD treatment as usual, with prescription adjustment according to the usual general evaluation. Those cases that aresevere or critically severe and requiring life support due to multiple organ dysfunction syndrome, can be temporarily transferred to automated peritoneal dialysis or bedside continuous kidney replacement therapy (CKRT). As for patients on hemodialysis, it is advisable to keep patients in a ‘dry’ status, so that an increased ultrafiltration may be required if remaining on PD 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