COVID-19 Infection in a Patient with End-Stage Kidney Disease

Abstract

Since December 2019, the epidemic of coronavirus disease 2019 (COVID-19) has spread very rapidly in China and worldwide. In this article, we report on a 75-year-old man infected with 2019 novel coronavirus who has end-stage kidney disease (ESKD). COVID-19 patients with ESKD need isolation dialysis, but most of them cannot be handled in time due to limited continuous renal replacement therapy (CRRT) machines. CRRT provided benefits for this patient by removing potentially damaging toxins and stabilizing his metabolic and hemodynamic status. With the control of uremia and fluid status, this patient ended up with an uneventful post-CRRT course, absence of clinical symptoms, and negative PCR tests. Greater efforts are needed to decrease the mortality of COVID-19-infected ESKD patients.

Keywords: Continuous renal replacement therapy; Coronavirus disease 2019; Dialysis; End-stage kidney disease.

Fig. 1

a-d Previous chest CT scan of the patient showing ground-glass opacity in both lungs on January 30, 2020, after symptom onset. There were multiple pieces of slightly higher density shadows scattered in the lungs, which were mostly ground glass-like changes, mainly distributed in the middle and outer zones. Inflammation affected 5.6% of the bilateral lungs. e-h Chest CT on February 22, 2020, showing absorption of bilateral ground-glass opacity after treatment. Less than 1% of the bilateral lungs was affected by inflammation.