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Submitted: 01 Jun 2020
Accepted: 07 Jun 2020
ePublished: 19 Jun 2020
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J Renal Inj Prev. 2021;10(1): e07.
doi: 10.34172/jrip.2021.07
  Abstract View: 70
  PDF Download: 25

Case Report

Persistence of coronavirus disease 2019 (COVID-19) in patients with end-stage renal disease; an unrecognized phenomenon?

Macaulay Amechi Chukwukadibia Onuigbo 1,2 * ORCID logo

1 The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
2 College of Business, University of Wisconsin MBA Consortium, Eau Claire, WI, USA
*Corresponding author: Macaulay Amechi Chukwukadibia Onuigbo, Email: macaulay.onuigbo@uvmhealth.org

Abstract

Since the global coronavirus disease 2019 (COVID-19) pandemic hit most parts of the world, the nephrology community has primarily focused on the associated incidence of often severe acute kidney injury (AKI) with the disease pandemic. For patients on maintenance in-center outpatient hemodialysis, the primary concern has been on prevention of the spread of COVID-19 among this vulnerable patient group. Our recent experience with one end-stage renal disease (ESRD) patient early in the Spring of 2020 has led us to speculate that ESRD patients may well exhibit an unusually prolonged period of persistence of COVID-19. This may explain the recent report of the unanticipated demonstration of a high rate of positive COVID-19 antibody testing among the staff of a Pediatric Outpatient Hemodialysis Unit in New York. Further studies are mandated as these investigations would help guide the implications of preventative measures against the spread of COVID-19 among both patients and staff of hemodialysis units around the world.
Keywords: Coronavirus disease 2019 (COVID-19), End-stage renal disease, Hemodialysis, Reverse transcription polymerase chain reaction (, Acute kidney injury

Implication for health policy/practice/research/medical education:

Since the emergence of the global pandemic of coronavirus disease 2019 (COVID-19), the attention of nephrologists and critical care physicians has centered around the associated incidence of acute kidney injury, sometimes requiring renal replacement therapy, and the devastating impact on ICU admissions and patient mortality. Generally, the duration of positive reverse transcription polymerase chain reaction (RT-PCR) tests of nasopharyngeal swabs among patients with COVID-19 is usually less than 14 days. Our recent experience with one ESRD patient early in the Spring of 2020 has led us to speculate that ESRD patients may well exhibit an unusually prolonged period of persistence of COVID-19. If confirmed, this would lead to major paradigm shifts in continued vigilance to mitigate COVID-19 spread within hemodialysis units around the world.

Please cite this paper as: Onuigbo MAC. Persistence of coronavirus disease 2019 (COVID-19) in patients with end-stage renal disease; An unrecognized phenomenon? J Renal Inj Prev. 2021; 10(1): e07. doi: 10.34172/jrip.2021.07.

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