2020 Volume 53 Issue 11 Pages 567-572
An 85-year-old female was admitted to hospital with mental status changes and a 2-day history of loss of consciousness. She had been started on hemodialysis 9 years ago for diabetic nephropathy. On initial presentation to the hospital, she was afebrile and demonstrated decreased peripheral capillary oxygen saturation values. She was diagnosed with coronavirus disease 19 (COVID-19) using the real-time polymerase chain reaction. Her C-reactive protein level was high, and chest computed tomography revealed ground-glass opacities. Subsequently, she was transferred to our hospital. The day after admission she was started on maintenance dialysis 3 times a week for 3 hours, and nafamostat was used as an anticoagulant. Levofloxacin was administered after the dialysis, and she regained consciousness on hospital day 3. Beginning on hospital day 5, lopinavir/ritonavir (LPV/r) was administered after the dialysis, and both the inflammatory reaction and the patient’s imaging findings improved. The characteristics of this case include: 1) an elderly person with diabetes and dementia; 2) bacterial pneumonia as a complication; and 3) the successful treatment of COVID-19 with LPV/r. We report a case of COVID-19 in a dialysis patient, which will aid the treatment of future cases of COVID-19.
