COVID-19 IN A PATIENT WITH CHRONIC KIDNEY DISEASE: A CASE OF COINCIDENCE IN INDONESIA

Abstract

Background: Chronic kidney disease (CKD) increases the risk of mortality during coronavirus disease 2019 (COVID-19) episodes. Patients with end-stage renal disease (ESRD) are highly vulnerable with the multiple comorbidities that make them susceptible to adverse outcomes with COVID-19. There is limited data about patients with ESRD who also suffer from COVID-19. We discuss the case of a hemodialysis patient who had comorbidities and developed COVID-19 pneumonia in the clinical course. Case descriptions: A 40‐year‐old woman who had ESRD on regular hemodialysis, admitted to hospital for presented intermittent fever, dyspnea, and fatigability. The patient had comorbidities, Hepatitis C, Human Immunodefisiency Virus (HIV), and Hypertension. Patient had continuous renal replacement therapy (CRRT) three times a week. She was diagnosed with COVID-19 by the reverse-transcriptase polymerase chain reaction (RT-PCR), and her pharyngeal swab for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was positive. Chest X-ray showed bilateral pneumonia. She was intensively monitored and treated with antiviral drugs, oxygen, broadspectrum antibiotics, steroids, nutrition, and other supporting drugs. After 24 days, an RTPCR assay for SARS-CoV-2 was negative, and pulmonary involvement improved significantly. The patient was discharged on day 28 after recovering from COVID-19 infection. Conclusion: The disease courses and treatment options for the patient were significantly more complicated. The patient had through the deteriorating illness and recovered after following treatment and CRRT. It is essential to ensure the continuous of dialysis, and might be an important option for hemodialysis patients with COVID-19.