Infección por COVID-19 en pacientes en Hemodiálisis en Panamá 2020

Courville, Karen; Bustamante, Norman; Mosquera, Herna; Viggiano, Carlos; Pérez-Carillo, Rafaél; Niedda, María; Cuero, César; Tomlinson, J.; Manzanares, José; Arroyo, Rocio; Alvarado, Ernesto; Saldo, Dayan; Vargas, Francisco Suso; Valdés, Régulo

doi:10.37980/im.journal.rmdp.20211787

Cited by 3 publications

(4 citation statements)

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“…Studies in the literature agree that the most frequently isolated microorganism in cases of IE in HD patients is S. aureus and other coagulase-negative staphylococci such as S. epidermidis [ 2 , 3 , 6 , 7 , 10 , 16 - 19 ], representing almost 50% of the isolates, as corroborated in our study. This indicates that the most frequent port of bacteremia in these patients corresponds to the vascular access site [ 6 , 7 , 18 ].…”

Section: Discussionsupporting

confidence: 90%

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Factors Related to the Development of Infective Endocarditis in Hemodialysis Patients in a Third-Level Hospital in Panama

Bravo Thompson,

Campos Herrera,

Macías Ibiricu

et al. 2024

Cureus

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Introduction: Venous access for hemodialysis (HD) makes patients more susceptible to transient bacteremia, predisposing them to the development of infective endocarditis (IE). Among the risk factors observed in this population are temporary access to HD, hypoalbuminemia, diabetes mellitus, female gender, anemia, and colonization by methicillin-resistant Staphylococcus aureus (MRSA). Methodology: A retrospective case-control study with a one-to-two ratio was carried out on patients with chronic kidney disease (CKD) undergoing renal replacement therapy with at least one vascular access for HD at Complejo Hospitalario Dr. Arnulfo Arias Madrid (CHDrAAM) from 2010 to 2020. Sociodemographic variables, past medical history, and data on current HD were studied. The odds ratio (OR) and adjusted odds ratio (aOR) were calculated for the collected variables. Results: No statistically significant differences between the groups were observed in sociodemographic variables. In terms of past medical history, the cases showed a predominance of coronary disease (47.6% vs 4.8%; OR: 37.27), valvular disease (23.8% vs 0%), and heart failure (33.3% vs 4.8%; OR: 10). In the cases, the use of a temporary catheter was more prevalent (61.9% vs 33.3%; OR: 3.25), and subclavian access was more frequently recorded (28.6% vs 2.4%; OR: 14.4). A short duration of venous access (<30 days) was found in a greater proportion of cases (23.8% vs 4.8%; OR: 6.25). The main pathogen isolated was S. aureus (33.3%), and the most affected valve was the aortic valve (59.1%). Fever was found in 100% of the reported cases, and up to 47.6% presented with a recent murmur. Discussion: Similar to previous studies conducted in other countries, we identified a history of pre-existing valve disease, the use of a temporary catheter, and recent venous access as risk factors. Contrary to what has been reported in the literature, this study did not find female sex, diabetes mellitus, and hypoalbuminemia as risks. Conclusion: Factors such as a history of coronary artery disease, heart failure, preexisting valvular disease, the use of a temporary catheter, subclavian venous access, and short duration of venous access (<30 days) were identified as risk factors for the development of IE in patients with CKD on HD.

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Section: Discussionsupporting

confidence: 90%

“…Bacteremia is the second leading cause of death in hemodialysis (HD) patients, after cardiovascular diseases [ 2 ]. In Panama, according to the National Dialysis Coordination of the Social Security Fund, there are 2,714 patients with chronic renal disease on HD and only 17 HD units [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Related to the Development of Infective Endocarditis in Hemodialysis Patients in a Third-Level Hospital in Panama

Bravo Thompson,

Campos Herrera,

Macías Ibiricu

et al. 2024

Cureus

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“…Vaccination coverage for first dose was similar between groups, with a 98% for dialysis patients and 95% for general population; 86% for second dose and 79.5% for the third dose in dialysis patients; and 77% for second dose and 39% for third dose for general population. Dialysis patients had a high vaccination rate, probably because awareness was made after publication of mortality data of patients with a 26% for the period pre-vaccination in the 2020 for patients in hemodialysis in Panama, higher than the 2% mortality for general population for that period [ 16 ]. Some studies have addressed that dialysis patients’ immune response to vaccination is worse than in general population [ 17 ], but some studies have demonstrated a robust immune response after a third dose [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Vaccination and mortality from COVID-19: a comparative study between hemodialysis, peritoneal dialysis, and non-dialysis adult population in Panama

et al. 2023

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Purpose Dialysis patients have a different response than the non-dialysis population to infection with COVID-19. This study evaluates the prevalence of infection and lethality in patients receiving hemodialysis or peritoneal dialysis in Panama, compared to non-dialysis adult population, and reports of adverse events of vaccination. Methods This is a prospective, multi-center cohort study of spatients aged 18 years or older and receiving in-center hemodialysis or ambulatory peritoneal dialysis in 13 centers in Panama from March 2021 to 2022. For comparison with general population, the study used an extended period of two years. Results A total of 1531 patients receiving dialysis treatment accepted to participate. PD patients represented an 18% of study patients. Lethality was higher in peritoneal dialysis patients with COVID-19 infection than in hemodialysis in the study group (p 0.02). Total deaths in dialysis patients for 2020 were 156 patients, before vaccination; 79 in 2021; and 25 for the first trimester of 2022. Lethality for the period of 2020–2022 was 9.3% for dialysis patients and 0.2% for non-dialysis population. There was no difference in symptoms in first dose, but with second dose, hemodialysis patients reported fewer symptoms than peritoneal dialysis patients (p < 0.0001). Conclusion Ninety one percent of people in the country received BNT162b2 Pfizer BionTech vaccine. Lethality decreased from 30 to 5% once vaccination was available. There were no severe adverse effects and symptoms reported were less frequent than in general population, probably due to low reactogenicity in dialysis patients, or better tolerance to pain.

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“…According to the experts, during the COVID-19 pandemic, the lethality rate among COVID-19 patients with CKD on dialysis was 36 of 100 in Colombia, whereas in Panama, the mortality rate was 26%. 66 The odds of lethality further increased in patients with kidney disease who were undergoing KRT. A similar situation was observed in Mexico, where the lethality rate of patients with advanced CKD with COVID-19 was 40%.…”

Section: Role Of Innovative Therapies In the Management Of Ckdmentioning

confidence: 99%