Novi sistem bodovanja za Covid-19 pacijenata na hemodijalizi - modifikovani skor ranog upozorenja

Radojica Stolić,Sanja Jovanović,Roksanda Krivcević,Tatjana Labudović,Saša Sovtić,Tomislav Nikolić,Milena Jovanović,Dušica Miljković,Kristina Bulatović,Aleksandra Balović,Dragica Bukumirić,Vekoslav Mitrović

doi:10.5937/pramed2102001s

Abstract

Introduction. At the very beginning of the Corona virus epidemic there was not enough data on whether hemodialysis patients have a higher risk for Corona virus infection and which factors may affect the severity of clinical picture. Objective. The aim of the study was to determine the significance of the Modified Early Warning Assessment (MEWS) score for the assessment of coronavirus disease exacerbation. Methods. The research was conducted in COVID dialysis, as a retrospective, descriptive-analytical study, at the University Clinical Center Kragujevac, Serbia, which was organized ad-hoc for treatment of SARS-Cov-2 infection positive patients, which are transfered from Center for Hemodialysis "Ćuprija". They were evaluated routine laboratory findings, demographic and gender structure, arterial blood pressure, presence of comorbidities and residual diuresis, duration of dialysis, radiological evaluation of lungs, determination of MEWS score were the parameters that were monitored. The results were monitored on admission and and in the end of treatment. Results. A statistically significant difference was registered in serum lactate dehydrogenase concentration (486 ± 107.62 vs. 423.7 ± 92.4 U/L); p = 0.022 and absolute monocyte count (0.46 ± 0.15 vs. 0.67 ± 0.34 x 103; p = 0.008). The significant increase in MEWS score was also found (b = 0.017; p = 0.030). There was a positive correlation between increase of MEWS score and age (b = 0.027; p = 0.002) and arterial hypertension as a concomitant comorbidity (b = 0.700; p = 0.033). Conclusion. In the observed period, there was a significant increase in the degree of MEWS score of dialysis patients who had SARS-Cov-2 infection.

Highlights

New coronavirus disease (COVID-19) is a newly discovered infectious disease caused by severe acute respiratory syndrome (SARS) - coronavirus (CoV) - 2 virus, which often manifests as acute respiratory disease with interstitial and alveolar pneumonia, and may affect other organs
Among twelve patients treated in the CORONA 4 dialysis center, there were 8 (66.7%) women and 4 (33.3%) men, with a mean age of 62.5 ± 13 years, with the average period spent on dialysis 18 ± 64.9 month
*Statistically significant parameter ALT: alanine aminotransferase; GGT: gamma-glutamyl transferase In Figure 1, showing the Modified Early Warning Assessment (MEWS) for 12 days of treatment, there is a significant increase in the MEWS for the period shown (b = 0.017; p = 0.030). 2021; 50 (1,2) 1-5//

Summary

Introduction

New coronavirus disease (COVID-19) is a newly discovered infectious disease caused by severe acute respiratory syndrome (SARS) - coronavirus (CoV) - 2 virus, which often manifests as acute respiratory disease with interstitial and alveolar pneumonia, and may affect other organs. Hemodialysis patients represent a special group of patients with certain characteristics that can make them susceptible to infections or severe diseases. They may be at increased risk of COVID-19 infection due to many comorbid conditions. Due to association of uremic status with severe impairment of lymphocyte and granulocyte function, an abnormal immune system may alter the response to SARSCoV infection [2]

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