Volume 26, Number 11—November 2020
Detection of SARS-CoV-2 in Hemodialysis Effluent of Patient with COVID-19 Pneumonia, Japan
|Day after symptom onset
||Specimens tested for SARS-CoV-2 by qRT-PCR‡
||Effluent, time collected
|8||2||38.4||Y||Y||9.0||Y||29.6 (1,080.6)§||ND§||38.3 (157.91)||ND|
|22||16||36.7||Chest CT, discharge||N||N||–||–||–|
*AZM, azithromycin; CRP, C-reactive protein; CT, computed tomography; Hydroxy, hydroxychloroquine; Lixelle-DHP, direct hemoperfusion using a β2 microglobulin adsorbent column; NA, not available; ND, not detected; qRT-PCR, quantitative reverse transcription-PCR; –, not done. †We prescribed azithromycin, 500 mg 2 times/d from day 1 to 3 because it was 1 of the potentially effective treatment regimens at the time. We also prescribed hydroxychloroquine 200 mg 2 times/d and initially planned to use it for 10 d in total, but the patient’s liver function tests (LFTs) became elevated during the course. We suspected side effects of hydroxychloroquine and stopped it on day 9. His LFTs returned to normal afterwards. ‡Results for SARS-CoV-2 shown as cycle threshold values (Viral load, copies/μL). Viral loads were not available because PCR was performed at an outside commercial laboratory where they did not report these results. The same PCR method was used (4) at both National Institute of Infectious Diseases (NIID), Japan, and the outside laboratory. HD effluent was collected at 1 hr and 2 hr into hemodialysis. §PCR test was performed at NIID, Japan where they report viral loads.
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