Two episodes of acute dyspnea that were induced by COVID-19 in a peritoneal dialysis patient

Abstract

Dialysis patients have an increased risk of coronavirus disease 2019 (COVID-19)-related mortality. Acute heart failure is a frequent, lethal complication of COVID-19, and it is a risk factor for mortality in hemodialysis patients. Therefore, it is crucial to rapidly distinguish heart failure from COVID-19 pneumonia. Here, we report a case of two episodes of acute dyspnea that were induced by COVID-19 in a peritoneal dialysis (PD) patient. The first episode of acute dyspnea was an exacerbation of heart failure caused by COVID-19 when the patient had a volume overload status due to a peritoneal dialysis catheter malfunction. Heart failure induced by a catheter malfunction was due to omental wrapping, and it was treated with ultrafiltration by hemodialysis and mini-laparotomy. The patient's acute dyspnea was immediately resolved. The second episode of acute dyspnea was caused by COVID-19 pneumonia, which occurred 1 week after the first episode. This case suggests the importance of identifying heart failure and beginning adequate treatment, in COVID-19 patients with PD.