Impact of Covid-19 pandemic lockdown on renal patients care. The experience of a single Swiss center
(Abstract accepted at the 52nd Annual Meeting of the Swiss Society of Nephrology 2020*)
Claudia Ferrier (1,2), Paola Rodoni-Cassis (1,3), Bruno Vogt (1)
(1) University Hospital, Berne, Switzerland, (2) NefrocentroTicino and (3) Clinica St. Anna Lugano, Switzerland
Following the Covid-19 pandemic, between March and April 2020 a lockdown was imposed by government to avoid overload and failure of hospitals capacity. During lockdown, regular health care services were interrupted and outpatients clinics were restricted to emergencies only. Elderly people over 65 faced severe confinement rules and many of them remained in voluntary self-isolation for several weeks after the easing of restrictions. The aim of the present survey was to analyze the consequences of lack of regular follow-up on high-risk renal patients due to the Covid-19 pandemic.
Clinical data, renal disease related-complications and co-morbidities were recorded in high-risk renal patients who were subject to tight controls, but attended the Nefrocentro several weeks after lockdown was lifted. We recorded the decrease in renal function with related complications and delays in diagnosing potentially irreversible conditions.
Among all the patients and staff of the Nefrocentro, none were found to be Covid-19-positive so far. Twenty-two high-risk patients required frequent follow-up. Of those patients, 2/22 (9%) presented with uncontrolled blood pressure (BP) and 1/22 (5%) had kidney stones. Nineteen (19/22) (86%) had impaired renal function (G2-G4) and 8/19 (42%) showed a further decrease, ranging from stage G3-G5 at the end of lockdown. In the remaining 11 patients with impaired renal function without further decrease, we observed two statin-induced rhabdomyolyses. Moreover, we found delays in the diagnosis of concomitant pathologies, one lymphoma in a transplant patient, one parathyroid adenoma and three major infections, including one septic shock, due to obstructive kidney stones.
The interruption of regular follow-up of high-risk renal patients was followed by adverse outcome in kidney function, associated complications and delayed diagnosis of other pathologies. This survey underlines the importance of the patient-physician relationship and suggests that telemedicine alone might not be an alternative solution in lockdown situations.
*Meeting cancelled due to COVID-19