Nursing Status of Dialysis CLTI Patients under COVID-19 In-Hospital Cluster

Abstract

 Our cardiology department experienced an in-hospital cluster of COVID-19 in January 2022. Among the infected, we isolated six dialysis patients（aged 62-80 years, five males）with comprehensive critical limb ischemia（CLTI）. All treatments for CLTI, including revascularization, hyperbaric oxygen therapy, LDL apheresis, and rehabilitation, were discontinued, and only wound care that could be performed in the hospital room was administered. Dialysis frequency was limited to three-hour sessions, three times a week in the isolation ward. Moreover, a third of the nursing staff on the ward contracted the virus, posing challenges to providing adequate foot care. Two patients developed COVID-19 pneumonia leading to one patient developing retroperitoneal hematoma, and one dying due to acute myocardial infarction. Furthermore, one patient became bedridden due to reduced food intake and progressive disuse syndrome, one died of aspiration pneumonia, and one remained asymptomatic throughout. Finally, three patients were discharged. The combined effects of infection and exacerbation of underlying conditions during the 10-day isolation period due to COVID-19 led to decreased activities of daily living, compromised staff capacity for patient care, and limited dialysis. These factors were believed to contribute to the patients’ poor prognosis.