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Abstract: PO0753

Screen for Initial assessment of COVID-19 Infection Using Lung CT and Lymphocyte Count in Patients Under Hemodialysis

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Li, Cuifang, , Xiangya Hospital, Central South University, Changsha, Hunan, China
  • Yuan, Xiangning, , Xiangya Hospital, Central South University, Changsha, Hunan, China
  • Xu, Hui, , Xiangya Hospital, Central South University, Changsha, Hunan, China
Background

The maintenance hemodialysis (MHD) patients with elder age and more comorbidities are more susceptible to SARS-CoV-2 than the general population. There is a clear need to effective assessment of COVID-19 infection status in these patients in hemodialysis center in order to prevent virus spread and decrease mortality in MHD patients.

Methods

MHD patients in the hemodialysis center and patients screening for COVID-19 in the fever clinic were enrolled from February,21 2020 to February,29 2020. Baseline characteristics, lung CT, blood routine and COVID-19 nucleic acid test results were collected.

Results

276 MHD patients and 313 patients screening for COVID-19 in the fever clinic were collected.After matching for age and gender, 136 MHD patients and 136 patients in fever clinic were included. Compared with patients screening for COVID-19 in fever clinic, more MHD patients showed decreased white blood cell count and lymphocyte count (18.4% VS 5.9%, P<0.001; 59.6% VS 36.8%,P<0.001; respectively). 48.5% of the MHD patients and 41.2%of patients in the fever clinic with positive CT findings.Compared with the MHD patients, patients screening for COVID-19 in fever clinic showed more ground glass opacity (GGO) (80.3%VS 98.2%,P=0.002), more consolidation (16.7% VS 67.9%, P<0.001), and less pleural effusion (40.9% and 19.6% ,P=0.01). Among them, centrally distributed GGO was more common in MHD patients than patients in the fever clinic (42.4% vs 23.2%,P=0.03), while diffuse GGO was more common in patients with pulmonary infection in the fever clinic than MHD patients (37.5% vs 4.5%; P<0.001). There was no significant difference in the proportion of peripheral GGO distribution between the two groups (33.3% vs 39.3%,P=0.5). Thirteen patients in the fever clinic and none of the MHD patient were positive for SARS-CoV-2 by RT-PCR analysis. 109 pairs of MHD patients underwent CT examination before and after dialysis were analyzed, results showed no significant difference between the CT lesion detection rate pre- and post-dialysis (48.6% vs 47.7% ,P=0.89).

Conclusion

Lymphocyte count decrease is common in MHD patients, and pulmonary CT of MHD patients may show signs similar to that of COVIP at some time. RT-PCR is of great significance for the differential diagnosis, while pulmonary CT are conducive.

Funding

  • Government Support - Non-U.S.