Are the Latin American recommendations for the management of patients infected with COVID -19 on hemodialysis realistic in health systems with limited resources?

Herrera-Añazco, Percy; Rabanal, Cristian; Benítes-Zapata, Vicente A.

doi:10.1590/2175-8239-jbn-2020-0059

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…The higher proportion of hospitalized and deceased HD patients compared to the general population was striking, and it may be related not only to the higher risk of complications in this population but also to structural issues in the Peruvian health system during the pandemic 14 . Although specific recommendations were issued in Peru to prevent the spread of infection among HD patients 25 , they may not have been followed, as occurred with the recommendations in some Latin American countries 26 . This presumably caused an increase in cases of greater severity and subsequent mortality.…”

Section: Discussionmentioning

confidence: 99%

Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru

et al. 2023

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Background: Patients with chronic kidney disease have a higher risk of severe disease and mortality from COVID-19 than the general population. Objective: To compare hospitalization and mortality rates during the pandemic among chronic hemodialysis (HD) patients and the general population in Lima (Peru). Methods: This retrospective cohort included an assessment of the database of chronic HD patients of the health service providers of the social health insurance benefit networks of Lima and Callao between 2019 and 2021. Hospitalization and mortality rates were obtained for every 1,000 individuals, and variations in the percentages of COVID-19 cases and deaths were calculated. These rates were compared with those of the general population data and standardized by age and sex. Results: An average of 3,937 chronic HD patients were evaluated each month. Of these, 4.8% had COVID-19 and 64.97% were mild cases. The hospitalization rates per 1,000 patients were 19.5, 29.28, and 36.7 in 2019, 2020, and 2021, respectively. The mortality rates per 1,000 patients were 5.9, 9.74, and 11.49 in 2019, 2020, and 2021, respectively. When compared to the standardized general population, the peaks of both rates coincided with the plateaus of the waves during the pandemic. The hospitalization rate for COVID-19 was 12 times higher in HD patients than in the general population, and the mortality rate for COVID-19 was twice as high. Conclusion: HD patients had higher hospitalization and standardized mortality rates than the general population. Peaks in hospitalizations and mortality coincided with the plateaus of the first and second waves of the pandemic.

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Section: Discussionmentioning

confidence: 99%

Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru

et al. 2023

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“…A maior proporção de pacientes em HD hospitalizados e falecidos em comparação com a população em geral foi surpreendente, e pode estar relacionada não apenas ao maior risco de complicações nesta população, mas também a questões estruturais no sistema de saúde peruano durante a pandemia 14 . Embora tenham sido emitidas recomendações específicas no Peru para prevenir a disseminação da infecção entre pacientes em HD 25 , elas podem não ter sido seguidas, como ocorreu com as recomendações em alguns países da América Latina 26 . Isto presumivelmente causou um aumento nos casos de maior gravidade e subsequente mortalidade.…”

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Hospitalização e mortalidade durante a pandemia em pacientes em hemodiálise crônica e na população em geral no Peru

et al. 2023

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Resumo Histórico: Pacientes com DRC apresentam maior risco de doença grave e mortalidade por COVID-19 do que a população geral. Objetivo: Comparar taxas de hospitalização e mortalidade durante a pandemia entre pacientes em hemodiálise crônica (HD) e a população geral em Lima (Peru). Métodos: Esta coorte retrospectiva incluiu avaliação do banco de dados de pacientes em HD crônica dos prestadores de serviços de saúde das redes de benefícios do seguro social de saúde de Lima e Callao, entre 2019–2021. Obteve-se taxas de hospitalização e mortalidade para cada 1.000 indivíduos, e foram calculadas variações nas porcentagens de casos de COVID-19 e óbitos. Estas taxas foram comparadas com os dados da população geral e padronizadas por idade e sexo. Resultados: Uma média de 3.937 pacientes em HD crônica foram avaliados mensalmente. Destes, 4,8% tinham COVID-19, 64,97% eram casos leves. As taxas de hospitalização por 1.000 pacientes foram 19,5; 29,28; e 36,7 em 2019, 2020, e 2021, respectivamente. As taxas de mortalidade por 1.000 pacientes foram 5,9; 9,74 e 11,49 em 2019, 2020, e 2021, respectivamente. Quando comparados à população geral padronizada, os picos das taxas coincidiram com os platôs das ondas da pandemia. A taxa de hospitalização para COVID-19 foi 12 vezes maior em pacientes em HD do que na população geral e a taxa de mortalidade por COVID-19 foi duas vezes maior. Conclusão: Pacientes em HD apresentaram taxas de hospitalização e mortalidade padronizada mais elevadas do que a população geral. Os picos das hospitalizações e mortalidade coincidiram com os platôs da primeira e segunda ondas da pandemia.

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“…This is why, for this group of patients and their healthcare providers, the greatest efforts must be directed at prevention, strengthening all structural biosecurity measures and all logistical stages related to their treatment, including transfers from and to medical centers [8]. However, some of these recommendations are impossible to follow in Latin America because of vast inequalities in terms of health access and lack of resources [9,10].…”

Section: Introductionmentioning

confidence: 99%

Monitoring System, Evolution and Prognosis in Renal Patients on Haemodialysis Infected by Severe Acute Respiratory Syndrome Coronavirus 2

Aroca¹,

SA²,

Vélez-Verbel³

et al. 2021

Int J Nephrol Kidney Fail

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Aim: The novel coronavirus disease 2019 (COVID-19) was first described in Wuhan, China, in December 2019. It has since spread worldwide, leading to high morbidity and mortality. Patients with chronic renal failure on dialysis who also have a confirmed diagnosis of active infection represent a risk group because infections are the second cause of death in this group, followed by immunosuppression caused by the weakening of the innate immunity by uremic toxins. This study aimed to describe the clinical characteristics of patients undergoing haemodialysis who also have a confirmed diagnosis for COVID-19 and its association with short-term outcomes.

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Are the Latin American recommendations for the management of patients infected with COVID -19 on hemodialysis realistic in health systems with limited resources?

Abstract: As recomendações latino-americanas para o manejo de pacientes infectados com COVID-19 em hemodiálise são realistas em sistemas de saúde com recursos limitados?

Cited by 3 publications

References 2 publications

Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru

Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru

Hospitalização e mortalidade durante a pandemia em pacientes em hemodiálise crônica e na população em geral no Peru

Monitoring System, Evolution and Prognosis in Renal Patients on Haemodialysis Infected by Severe Acute Respiratory Syndrome Coronavirus 2

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