Severe acute respiratory syndrome in haemodialysis patients: a report of two cases

Tang, Hon Lok

doi:10.1093/ndt/gfg454

Cited by 10 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on 157 observations from nine observational studies, 6 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 we estimate the median incubation period of SARS-associated coronavirus to be 4·0 days (95% CI 3·6–4·4), and the dispersion to be 1·81 (95% CI 1·67–1·95). 5% of SARS-associated coronavirus cases will develop symptoms by 1·5 days (95% CI 1·2–1·7), and 95% by 10·6 days (95% CI 8·9–12·2) after infection.…”

Section: Resultsmentioning

confidence: 99%

Incubation periods of acute respiratory viral infections: a systematic review

Lessler

Reich

Brookmeyer

et al. 2009

The Lancet Infectious Diseases

748

547

View full text Add to dashboard Cite

Knowledge of the incubation period is essential in the investigation and control of infectious disease, but statements of incubation period are often poorly referenced, inconsistent, or based on limited data. In a systematic review of the literature on nine respiratory viral infections of public-health importance, we identified 436 articles with statements of incubation period and 38 with data for pooled analysis. We fitted a log-normal distribution to pooled data and found the median incubation period to be 5·6 days (95% CI 4·8–6·3) for adenovirus, 3·2 days (95% CI 2·8–3·7) for human coronavirus, 4·0 days (95% CI 3·6–4·4) for severe acute respiratory syndrome coronavirus, 1·4 days (95% CI 1·3–1·5) for influenza A, 0·6 days (95% CI 0·5–0·6) for influenza B, 12·5 days (95% CI 11·8–13·3) for measles, 2·6 days (95% CI 2·1–3·1) for parainfluenza, 4·4 days (95% CI 3·9–4·9) for respiratory syncytial virus, and 1·9 days (95% CI 1·4–2·4) for rhinovirus. When using the incubation period, it is important to consider its full distribution: the right tail for quarantine policy, the central regions for likely times and sources of infection, and the full distribution for models used in pandemic planning. Our estimates combine published data to give the detail necessary for these and other applications.

show abstract

Section: Resultsmentioning

confidence: 99%

Incubation periods of acute respiratory viral infections: a systematic review

Lessler

Reich

Brookmeyer

et al. 2009

The Lancet Infectious Diseases

748

547

View full text Add to dashboard Cite

show abstract

“…At presentation, patients on dialysis exhibit similar symptoms (fever, myalgia, chills and rigors, gastrointestinal symptoms) as the nondialysis patients (1). However, it is our impression that dialysis patients tend to have less pronounced symptoms (8,9), which may be difficult to distinguish from uremic symptoms. In addition, dialysis patients tended to seek medical attention at a later stage, which might cause a delay in diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 97%

Severe Acute Respiratory Syndrome in Dialysis Patients

Kwan¹,

Leung²,

Szeto³

et al. 2004

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Abstract. Reviewed are the clinical features and outcome of 12 chronic dialysis patients (six men) who contracted severe acute respiratory syndrome (SARS) compared with 23 sex-and agematched nonuremic SARS patients as controls. Eight were on peritoneal dialysis (PD) and four on hemodialysis. Mean age was 58 Ϯ 12 yr for the dialysis patients, and 57 Ϯ 12 yr for the controls. The presenting symptoms of dialysis patients were similar to the controls. With appropriate protection measures, hemodialysis was performed in a dedicated area of the SARS isolation ward, while PD was continued as intermittent PD. In all seven patients with PD effluent tested, SARS-related coronavirus (CoV) could not be identified by polymerase chain reaction (PCR) or viral culture. Three dialysis patients had persistent positive stool PCR after 5 wk, whereas all nondialysis patients had negative stool PCR after 1 wk. Despite dosage adjustment, ribavirin-induced hemolytic anemia was more severe in the dialysis patients. Dialysis patients required longer hospitalization than the controls, but the mortality was similar. With appropriate protective measures, dialysis could be safely performed. Dialysis patients with SARS often require prolonged hospitalization. Furthermore, these patients may have an extended period of viral shedding, which should be carefully monitored for the purpose of infection control.From March to July 2003, there was a global outbreak of severe acute respiratory syndrome (SARS) (1). It affected more than 8000 people in over 30 countries (2), including China, Vietnam, Singapore, Taiwan, Germany, France, Italy, Thailand, the United Kingdom, the United States, and Canada (1,3-6). In Hong Kong, more than 1750 people contracted SARS, and nearly 300 people died (7).There are additional difficulties in the management of chronic dialysis patients who contract SARS. For example, early diagnosis is difficult, dose of antiviral medications needs to be adjusted, and there are additional infection control issues in the disposal of spent dialysate (both hemodialysis and peritoneal dialysis [PD]) and in preventing cross-contamination within the dialysis unit. To date, there have only been isolated case reports on the management of SARS in chronic dialysis patients (8 -10). Here we report the clinical features, treatment, and outcome of 12 dialysis patients with SARS from a hospital cluster in Hong Kong. Materials and MethodsWe reviewed all chronic dialysis patients from a hospital cluster in Hong Kong who were hospitalized for SARS during the epidemic period. SARS was defined according to the World Health Organization (WHO) criteria (11). The list was complied after searching through the regional database for all of the patients who were diagnosed to have or who died of SARS. One of the patients has been described in a previous report (10).We reviewed the case notes of the SARS group. The symptoms at presentation, presence of comorbidities, laboratory results, treatment regimens, need for admission to intensive care unit (ICU), lengt...

show abstract

“…A wide range of nonrespiratory symptoms has subsequently been reported suggesting other organ involvements including the liver and gastrointestinal tract during the course of the disease [4,10,11]. With the exception of a few chronic dialysis patients complicated by SARS [12][13][14], impaired renal function with raised plasma creatinine is not a common finding in most SARS patients at the time of first clinical presentation. A preliminary study of 12 patients with SARS who developed ARF reports a high mortality rate of 77% [abstract; Tsai HB, et al, J Am Soc Nephrol 14:513A, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…The poor survival of chronic dialysis patients complicated by SARS was not surprising [11][12][13] as patients with chronic illness recovered poorly following SARS [17,19]. However, this cohort of patients with ARF demonstrated an extremely poor prognosis.…”

Section: Discussionmentioning

confidence: 99%