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Siblings with coronavirus disease 2019 infection and opposite outcome—the hemodialysis’s better outcome paradox:Two case reports

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World Journal of Nephrology 2021年第2期10卷 21-28页

作者： Dimitra Bacharaki Evangelia Chrysanthopoulou Sotiria Grigoropoulou Panagiotis Giannakopoulos Panagiotis Simitsis Frantzeska Frantzeskaki Aikaterini Flevari minas karagiannis Aggeliki Sardeli DimitraKavatha Anastasia Antoniadou Demetrios Vlahakos Department of Nephrology B Propaideutiki Internal Medicine ClinicAttikon University HospitalChaidari 12064Greece Intensive Care Unit Attikon University HospitalChaidari 12064Greece D Internal Medicine Clinic Attikon University HospitalChaidari 12064Greece

BACKGROUND Coronavirus disease 2019(COVID-19)is a highly contagious infection caused by the severe acute respiratory syndrome coronavirus 2 virus and has a unique underlying ***(HD)patients experience high risk of contamination with COVID-19 and are considered to have higher mortality rates than the general population by most but not all clinical *** aim to highlight the peculiarities in the immune state of HD patients,who seem to have both immune-activation and immune-depression affecting their outcome in COVID-19 *** SUMMARY We report the opposite clinical outcomes(nearly asymptomatic course vs death)of two diabetic elderly patients infected simultaneously by COVID-19,one being on chronic HD and the other with normal renal *** were both admitted in our hospital with COVID-19 symptoms and received the same treatment by *** non-HD sibling deteriorated rapidly and was intubated and transferred to the Intensive Care Unit,where he died despite all supportive *** HD sibling,although considered more“high-risk”for adverse outcome,followed a benign course and left the hospital alive and *** These cases may shed light on aspects of the immune responses to COVID-19 between HD and non-HD patients and stimulate further research in pathophysiology and treatment of this dreadful disease.

关键词： Case report Hemodialysis Siblings COVID-19 Host response Immuneactivation Immune-depression

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Clinical presentation and outcomes of chronic dialysis patients with COVID-19:A single center experience from Greece

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World Journal of Nephrology 2022年第2期11卷 58-72页

作者： Dimitra Bacharaki minas karagiannis Aggeliki Sardeli Panagiotis Giannakopoulos Nikolaos Renatos Tziolos Vasiliki Zoi Nikitas Piliouras Nikolaos-Achilleas Arkoudis Nikolaos Oikonomopoulos Kimon Tzannis Dimitra Kavatha Anastasia Antoniadou Demetrios Vlahakos Sophia Lionaki Nephrology Unit Department of Internal Medicine"Attikon"University HospitalChaidari 12462Greece Medical School National and Kapodistrian University of AthensAthens 15772Greece Department of Internal Medicine "Attikon"University HospitalChaidari 12462Greece Department of Radiology "Attikon"University HospitalChaidari 12462Greece

BACKGROUND Coronavirus disease 2019(COVID-19)is still a menacing pandemic,especially in vulnerable *** and mortality from COVID-19 in maintenance hemodialysis(MHD)patients are considered worse than those in the general population,but vary across continents and countries in *** To describe the clinical course and outcomes of hospitalized MHD patients with COVID-19 in a retrospective observational single center study in *** We correlated clinical,laboratory,and radiological data with the clinical outcomes of MHD patients hospitalized with COVID-19 during the *** diagnosis was confirmed by real-time polymerase chain *** was determined as survivors vs non-survivors and“progressors”(those requiring oxygen supplementation because of COVID-19 pneumonia worsening)vs“non-progressors”.RESULTS We studied 32 patients(17 males),with a median age of 75.5(IQR:58.5-82)years *** those,12 were diagnosed upon screening and 20 with related *** to the World Health Organization(WHO)score,the severity on admission was mild disease in 16,moderate in 13,and severe in 3 *** computed tomography(CT)showed 1-10%infiltrates in 24 ***“progressors”were recorded among included *** case fatality rate was 5/32(15.6%).Three deaths occurred among“progressors”and two in“non-progressors”,irrespective of co-morbidities and *** of mortality on admission included frailty index,chest CT findings,WHO severity score,and thereafter the increasing values of serum LDH and D-dimers and decreasing serum *** of becoming a“progressor”included increasing number of neutrophils and neutrophils/lymphocytes *** Patients on MHD seem to be at higher risk of COVID-19 mortality,distinct from the general *** laboratory parameters on admission and during follow-up may be helpful in risk stratification and management of patients.

关键词： COVID-19 SARS-CoV-2 Dialysis Greece Clinical course Outcome

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