MHD Patient presenting with

fever- Can we skip Covid testing

Dr. SIDHANT BANSAL
Consultant Nephrology
Paras Hospitals, Panchkula
 OVERVIEW

 INTRODUCTION

 CLINICAL CHARACTERSTICS- ARE THEY

DIFFERENT FROM GENERAL POPULATION

 STUDIES & GUIDELINES

 INTRODUCTION

 CLINICAL CHARACTERSTICS- ARE THEY

DIFFERENT FROM GENERAL POPULATION

 STUDIES & GUIDELINES

 The new coronavirus
•
(SARS-CoV-2)
Coronaviruses are named for the crown-like spikes on their surface. There are four main sub-
groupings of coronaviruses, known as alpha, beta, gamma, and delta.
• Human coronaviruses were first identified in the mid-1960s. The seven coronaviruses that can
infect people are:
• Common human coronaviruses : 229E (alpha coronavirus). NL63 (alpha coronavirus), OC43 (beta
coronavirus), HKU1 (beta coronavirus)
• Other human coronaviruses
• MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
• SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
• SARS-CoV-2 (the novel coronavirus that causes coronavirus disease 2019, or COVID-19)

SARS- COVID-19
CoV-2 = = the
the virus disease
4
 Pathophysiology – COVID -19 induced
cytokine storm

X. Li, M. Geng, Y. Peng, L. Meng, S. Lu, Molecular immune pathogenesis and diagnosis of COVID-19,
 INTRODUCTION

 CLINICAL CHARACTERSTICS- ARE THEY

DIFFERENT FROM GENERAL POPULATION

 STUDIES & GUIDELINES

Suspected Case of COVID-19:
Definition
A patient with acute respiratory illness (fever and
at least one sign/symptom of respiratory disease
(e.g., cough, shortness of breath),
AND
with no other etiology that fully explains the
clinical presentation
AND
a history of travel to or residence in a country/area
reporting high local transmission of COVID-19
disease during the 14 days prior to symptom onset
EVIDENCE: CLINICAL CHARACTERISTICS &
OUTCOMES IN PATIENTS WITH KIDNEY
DISEASE WITH COVID-19
 INTRODUCTION

 CLINICAL CHARACTERSTICS- ARE THEY

DIFFERENT FROM GENERAL POPULATION

 STUDIES & GUIDELINES

 ISN
 Govrnment of India guidelines
 CDC/ASN
 Chinese Society of Nephrology and the

Taiwan Society of Nephrology

 COVID HD Protocol by PGI chandigarh
14% vs 16 %
 "Fixed Dialysis Care Model"
 Place of dialysis treatment.

 Dialysis shift and personnel.

 screened for novel coronavirus before the surgery.

 personal transportation and take fixed

transportation routes.


 last shift
 "Fixed Dialysis Care Model"
 The pick-up and drop-off should not be
shared with other dialysis patients.

 6 feet distance between patients.

 Designated care personnel- undertake full

protection.

 Dialysis machines: disinfected according to

standard protocols.
EVIDENCE: CLINICAL COURSE AND
OUTCOMES IN DIALYSIS PATIENTS: ITALY
EVIDENCE: CLINICAL COURSE AND
OUTCOMES IN DIALYSIS PATIENTS: SPAIN
Reuse of dialysers
Questions
 Covid screening for all patients???