Correspondence on ‘What comes after the lockdown? Clustering of ANCA-associated vasculitis: single-centre observation of a spatiotemporal pattern’

Hakroush, Samy; Tampe, Björn

doi:10.1136/annrheumdis-2020-219687

Cited by 5 publications

(10 citation statements)

References 7 publications

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“…Interestingly, we identified that the increase in hemoglobinuria was specifically attributed to patients with hypertensive nephropathy during the COVID-19 pandemic because no such phenomenon was observed in other kidney diseases as compared to 2019 ( Table 4 ). This is in line with our previous observation that during the lockdown period in March and April 2020, an incidence-shift with a COVID-19 gap of non-diagnosed ANCA GN based on renal biopsy was followed by a postlockdown phase in subsequent months ( Hakroush and Tampe, 2021 ). Interestingly, higher incidence of hemoglobinuria among patients admitted with hypertensive nephropathy was associated with increased proteinuria ( Table 4 ).…”

Section: Resultssupporting

confidence: 92%

“…In contrast, the number of renal biopsies in patients requiring IMC/ICU supportive care remained unaffected during the COVID-19 pandemic. This is in line with our previous report that during the lockdown period in March and April 2020, an incidence-shift with a COVID-19 gap of non-diagnosed AAV based on renal biopsy was followed by a postlockdown phase in subsequent months with a compensatory increased incidence rate ( Hakroush and Tampe, 2021 ). According to the literature, various kidney diseases are preceded by a prodromal phase characterized by constitutional symptoms ( Monti et al, 2020 ).…”

Section: Discussionsupporting

confidence: 92%

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Impact of the COVID-19 Pandemic on Kidney Diseases Requiring Renal Biopsy: A Single Center Observational Study

et al. 2021

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BackgroundThe coronavirus disease-2019 (COVID-19) pandemic impacted healthcare services for kidney disease patients. Lockdown and social distancing were mandated worldwide, resulting in closure of medical services. The diagnosis of various kidney diseases may have been delayed during the COVID-19 pandemic because non-urgent tests and visits were postponed due to closure of medical services during the lockdown.MethodsWe here report the impact of the COVID-19 pandemic on a total number of 209 native kidney diseases requiring renal biopsy for diagnosis in a retrospective observational study from a tertiary hospital in Germany.ResultsThe lockdown period in March and April 2020 primarily affected patients admitted to the normal medical ward with a compensatory increased rate of renal biopsies in the postlockdown phase. In addition, there was a shift toward more patients admitted with hemoglobinuria during the COVID-19 pandemic. This phenomenon of an increased number of patients with hemoglobinuria during the COVID-19 pandemic was specifically observed in a subgroup with hypertensive nephropathy requiring renal biopsy and associated with increased proteinuria, not attributed to the COVID-19 lockdown period itself.ConclusionTo our knowledge, this is the first report of identifying a subpopulation susceptible to closure of medical services during the COVID-19 pandemic and diagnostic delay of specific kidney diseases. Therefore, the COVID-19 pandemic should be regarded as a risk factor especially in patients with diseases other than COVID-19 primarily admitted to the normal medical ward.

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Section: Resultssupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Impact of the COVID-19 Pandemic on Kidney Diseases Requiring Renal Biopsy: A Single Center Observational Study

et al. 2021

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“…A high percentage of histological DGGS cases points towards the possibility of their late referral or delay in seeking a medical opinion leading to irreversible pathological damage. Hakroush et al have reported a fall in number of renal biopsies performed in COVID period followed by a late surge in post COVID phase citing lockdown situation and downplay of constitutional symptoms by the patients [ 8 , 9 ]. Although, they did not find any difference in the histological diagnosis between the two periods [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID 19 pandemic on patients requiring renal biopsy

et al. 2022

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Introduction The disruption of healthcare services in coronavirus disease (COVID)19 pandemic was widespread particularly due to lockdown curbs. This study was undertaken to see the effect of this pandemic on subjects requiring renal biopsy. Materials and method Renal biopsies performed during the COVID 19 pandemic between April 2020 and December 2020 (Group 1) were compared with those in pre-COVID period between June 2019 and February 2020 (Group 2). Indication of biopsies, syndromic diagnosis and all baseline laboratory characteristics were retrieved from the hospital records. Results 130 and 191 patients were biopsied in groups 1 and 2, respectively. Patients in group 1 were younger compared with group 2 (32.55 ± 15.60 and 36.37 ± 16.96 years, respectively, p value 0.038). The mean serum creatinine value in group 1 was significantly higher than in group 2 (3.21 ± 2.08 and 2.68 ± 2.02 mg/dl respectively, p value: 0.023). Group 1 comprises a significantly higher percentage of rapidly progressive renal failure patients (RPRF) (39.3 vs 28, p value 0.046). A higher percentage of nephrotics was biopsied in group 2 vs group 1 (46.9 vs 30.4 respectively, p value 0.008). The treatment protocol remained similar in both the groups. Evaluation of the transplant biopsies revealed a nonsignificant higher number of rejections in group 1 (11 out of 18) as compared to group 2 (5 out of 16), p value 0.100. Combined rejection saw a lesser use of rATG in group 1. Conclusion COVID pandemic induced restrictive measures could have led to selective high risk patients with RPRF as presumptive diagnosis and higher creatinine values getting biopsied. Higher rejections were noticed in transplant recipients pointing towards the need of establishing a more efficient support system for managing such patients.

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“…In detail, four patients presented with biopsy-confirmed AAV in the stretch of April-June 2019 (one normal ward, three intensive/immediate care unit), while only one diagnosis was made in the same period in 2020. 2 We agree that containment measures such as a lockdown and reduced attendance of hospitals due to fear of infection may delay diagnosis of less-severely affected patients. In contrast to the observations by Hakroush et al, our patients with new diagnosis and relapse were diagnosed either on the normal ward or in an outpatient setting.…”

mentioning

confidence: 89%

Response to: ‘Correspondence on ‘What comes after the lockdown? Clustering of ANCA-associated vasculitis: single-centre observation of a spatiotemporal pattern’’ by Hakroush and Tampe

Gauckler

Kronbichler

2021

Ann Rheum Dis

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Figure 1 Timeline of incident AAV and COVID-19 cases betweenMarch and November 2020 in Tyrol, Austria. Incidence of AAV cases diagnosed at our centre (either initial manifestation or disease relapse) per month (blue boxes) are compared on a timeline with active positive SARS-CoV-2 cases in Tyrol, Austria (red curve/area). The underlying graph and respective numbers of active SARS-CoV-2 cases are provided by 'Amt Der Tiroler Landesregierung, Landes-Einsatzleitung/COVID-19 Dashboard' and modified in accordance with 'land Tirol-Landes-Einsatzleitung Corona'. AAV, ANCA-associated vasculitis; ANCA; antineutrophil cytoplasmic antibody; AT, Austria.

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Correspondence on ‘What comes after the lockdown? Clustering of ANCA-associated vasculitis: single-centre observation of a spatiotemporal pattern’

Cited by 5 publications

References 7 publications

Impact of the COVID-19 Pandemic on Kidney Diseases Requiring Renal Biopsy: A Single Center Observational Study

Impact of the COVID-19 Pandemic on Kidney Diseases Requiring Renal Biopsy: A Single Center Observational Study

Impact of COVID 19 pandemic on patients requiring renal biopsy

Response to: ‘Correspondence on ‘What comes after the lockdown? Clustering of ANCA-associated vasculitis: single-centre observation of a spatiotemporal pattern’’ by Hakroush and Tampe

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