Search

The Covid-19 pandemic has been responsible for millions of deaths worldwide. Patients with comorbidities- such as those on peritoneal dialysis (PD)- present higher morbidity and mortality than the general population. We prospectively evaluated all Chilean patients on PD (48 centres) and followed those who had Covid-19 from the beginning of the Covid-19 pandemic in Chile (March 2020) to January 2021 (start of vaccination campaign). We described demographic history, comorbidities, factors related to infection, need for hospitalisation and death due to Covid-19. During the study period, 106 adults on PD were infected by SARS-CoV-2, with a mean age of 53.1 (±16.3) and of which 53.9% were female. From that group, 54.8% required hospitalisation and 24.5% ( n = 26) died due to Covid-19. Most of the patients (63.4%) were infected at home and 22.8% during hospitalisation for other reasons. There was a significant association for Covid-19 mortality with: being ≥60 years old, diabetes, time on PD ≥5 years, need for hospitalisation and hospital-acquired infection. At 90 days of follow-up, all deaths associated to Covid-19 occurred before 40 days. We conclude that patients on PD without Covid-19 vaccination have a high mortality and need for hospitalisation associated to Covid-19. To avoid this negative outcome, it is necessary to intensify strategies to avoid contagion, especially in those ≥60 years old, with diabetes and/or ≥5 years spent on PD.

Between 1988 and 1991, the Acute Physiologic Score (APS-2) was applied to 1000 critically ill patients admitted to an intensive care unit of a general hospital in Chile. Its predictive capacity was assessed and compared with two series from United States and New Zealand. The mean admission APS-2 in Chilean patients was 12.8 and there was a progressive increase in mortality with elevating scores; no patient with an APS-2 over 30 survived. Admission APS-2 scores in USA and New Zealand were 10.7 and 14.2. Overall mortality in Chilean patients was 28%, compared with 12% in USA and 15% in New Zealand. Within different score ranges, mortality was higher in Chilean patients than those from USA or New Zealand. It is concluded that the assessment of admission APS-2 score underlying diagnosis, physiologic age and previous health status of a patient may help to predict the success of intensive care.