Dataset Information

Operational considerations for peritoneal dialysis management during the COVID-19 pandemic.

ABSTRACT:

Background

Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by a novel coronavirus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is spread from human to human and has resulted in a global pandemic, posing a disastrous public health risk worldwide. Patients with chronic kidney disease, especially those on dialysis, are considered to be at higher risk of developing severe COVID-19 due to their immunocompromised status and frail condition. The home treatment setting of peritoneal dialysis (PD) has advantages in terms of implementing self-care when routine hospital visits and social activities are restricted, thus greatly reducing exposure of PD patients to the virus.

Methods and results

We outline general operational considerations in PD management during the COVID-19 pandemic, including precautionary measures for PD patients and healthcare staff. Precautionary measures for PD patients include education on prevention of, and screening for, COVID-19, preclinic screening, in-clinic management, meticulous remote patient management and special hospitalization arrangements. The diagnosis and treatment of PD patients with COVID-19 are discussed. Precautionary measures for PD staff include continuous education on, and training in, COVID-19, exposure history surveillance and self-monitoring for COVID-19 among healthcare personnel, appropriate personal protective equipment and hand hygiene, organization of medical activities and staffing, and adequate environment cleaning.

Conclusions

This is a battle of the entire human society against the novel coronavirus. Integrated teamwork among healthcare providers, supported by society as a whole, is needed as part of the ongoing public health response to try to slow the spread of COVID-19.

SUBMITTER: Yang Z

PROVIDER: S-EPMC7337678 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveIn December 2019, a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an outbreak of coronavirus disease 2019 (COVID-19) that resulted in a global pandemic with substantial morbidity and mortality. Currently, there is no specific treatment or approved vaccine against COVID-19. The underlying associated comorbidity and diminished immune function of some pituitary patients (whether caused by the disease and its sequelae or treatment with excess glucocorticoids) increases their risk of contracting and developing complications from COVID-19 infection.MethodsA review of studies in PubMed and Google Scholar published between January 2020 to the time of writing (May 1, 2020) was conducted using the search terms 'pituitary,' 'coronavirus,' 'COVID-19', '2019-nCoV', 'diabetes mellitus', 'obesity', 'adrenal,' and 'endocrine.'ResultsOlder age and pre-existing obesity, hypertension, cardiovascular disease, and diabetes mellitus increase the risk of hospitalization and death in COVID-19 patients. Men tend to be more severely affected than women; fortunately, most men, particularly of younger age, survive the infection. In addition to general comorbidities that may apply to many pituitary patients, they are also susceptible due to the following pituitary disorder-specific features: hypercortisolemia and adrenal suppression with Cushing disease, adrenal insufficiency and diabetes insipidus with hypopituitarism, and sleep-apnea syndrome and chest wall deformity with acromegaly.ConclusionThis review aims to focus on the impact of COVID-19 in patients with pituitary disorders. As most countries are implementing mobility restrictions, we also discuss how this pandemic has affected patient attitudes and impacted our decision-making on management recommendations for these patients.AbbreviationsACE = angiotensin-converting enzyme; AI = adrenal insufficiency; ARB = angiotensin receptor blocker; ARDS = acute respiratory disease syndrome; COVID-19 = coronavirus disease 2019; CPAP = continuous positive airway pressure; DI = diabetes insipidus; DM = diabetes mellitus; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.