COVID-19 Disease Complicated with Severe Pneumonia in a Patient with End Stage Renal Disease (ESRD): A Case Report from Bangladesh

Abstract

Background: Since 2019, the pandemic of Coronavirus disease 2019 (COVID-19) has spread very rapidly in China and Worldwide. COVID-19 is a highly contagious, infectious and rapidly spreading viral disease with an alarming case fatality rate up to 5%. Case Report: In this article, we report a case of 60 years old non diabetic, hypertensive woman infected with COVID-19 who has end stage renal disease (ESRD) on hemodialysis for last 18 months. COVID-19 patients with ESRD need isolation dialysis but most of them cannot be handled properly due to limited hemodialysis machine. With these unavailability and risk, we continue the treatment along with hemodialysis for controlling uraemia and fluid balance. With all effort this patient ended with an uneventful course with clinical improvement, improvement of all laboratory parameters and resolution of radiological findings but follow up RT-PCR cannot done due to changing guideline of discharge criteria of COVID-19 patient in Bangladesh. He positively responded to meropenem, clarithromycin, favipiravir, thromboprophylaxis with enoxaparin along with supplemental oxygen therapy. After that she was discharged with an advice of 14 days home isolation with regular hemodialysis and a follow up visit after 14 days in the outpatient department. Conclusion: An ESRD patient on regular hemodialysis suffering from severe pneumonia has high risk of mortality. Combined effort from the health care workers are needed to decrease the mortality of COVID-19 infected ESRD patients.