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Article

Triage of Patients Suspected of COVID-19 in Chronic Hemodialysis: Eosinophil Count Differentiates Low and High Suspicion of COVID-19

1
Centre of Nephrology and Renal Transplantation, Hôpital de la Conception, CHU de Marseille, 13005 Marseille, France
2
C2VN, Aix-Marseille University, INSERM 1263, INRAe, 13005 Marseille, France
3
Association des Dialysés Provence et Corse, 13009 Marseille, France
4
Hematology Laboratory, Hôpital de la Conception, CHU de Marseille, 13005 Marseille, France
5
Department of Internal Medicine and Clinical Immunology, CHU de Marseille, Hôpital de la Conception, 13005 Marseille, France
6
MMG, Bioinformatics & Genetics, Aix-Marseille Université, UMR_S910, 13004 Marseille, France
*
Author to whom correspondence should be addressed.
Romain Vial and Marion Gully contributed equally to the work.
J. Clin. Med. 2021, 10(1), 4; https://doi.org/10.3390/jcm10010004
Received: 16 November 2020 / Revised: 16 December 2020 / Accepted: 17 December 2020 / Published: 22 December 2020
(This article belongs to the Special Issue Impact of COVID-19 Pandemic on Global Diseases and Human Well-Being)
Background: Daily management to shield chronic dialysis patients from SARS-CoV-2 contamination makes patient care cumbersome. There are no screening methods to date and a molecular biology platform is essential to perform RT-PCR for SARS-CoV-2; however, accessibility remains poor. Our goal was to assess whether the tools routinely used to monitor our hemodialysis patients could represent reliable and quickly accessible diagnostic indicators to improve the management of our hemodialysis patients in this pandemic environment. Methods: In this prospective observational diagnostic study, we recruited patients from La Conception hospital. Patients were eligible for inclusion if suspected of SARS-CoV-2 infection when arriving at our center for a dialysis session between March 12th and April 24th 2020. They were included if both RT-PCR result for SARS-CoV-2 and cell blood count on the day that infection was suspected were available. We calculated the area under the curve (AUC) of the receiver operating characteristic curve. Results: 37 patients were included in the final analysis, of which 16 (43.2%) were COVID-19 positive. For the day of suspected COVID-19, total leukocytes were significantly lower in the COVID-19 positive group (4.1 vs. 7.4 G/L, p = 0.0072) and were characterized by lower neutrophils (2.7 vs. 5.1 G/L, p = 0.021) and eosinophils (0.01 vs. 0.15 G/L, p = 0.0003). Eosinophil count below 0.045 G/L identified SARS-CoV-2 infection with AUC of 0.9 [95% CI 0.81—1] (p < 0.0001), sensitivity of 82%, specificity of 86%, a positive predictive value of 82%, a negative predictive value of 86% and a likelihood ratio of 6.04. Conclusions: Eosinophil count enables rapid routine screening of symptomatic chronic hemodialysis patients suspected of being COVID-19 within a range of low or high probability. View Full-Text
Keywords: hemodialysis; COVID-19; eosinophil hemodialysis; COVID-19; eosinophil
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MDPI and ACS Style

Vial, R.; Gully, M.; Bobot, M.; Scarfoglière, V.; Brunet, P.; Bouchouareb, D.; Duval, A.; Zino, H.-o.; Faraut, J.; Jehel, O.; Berdad-Haddad, Y.; Burtey, S.; Jarrot, P.-A.; Lano, G.; Robert, T. Triage of Patients Suspected of COVID-19 in Chronic Hemodialysis: Eosinophil Count Differentiates Low and High Suspicion of COVID-19. J. Clin. Med. 2021, 10, 4. https://doi.org/10.3390/jcm10010004

AMA Style

Vial R, Gully M, Bobot M, Scarfoglière V, Brunet P, Bouchouareb D, Duval A, Zino H-o, Faraut J, Jehel O, Berdad-Haddad Y, Burtey S, Jarrot P-A, Lano G, Robert T. Triage of Patients Suspected of COVID-19 in Chronic Hemodialysis: Eosinophil Count Differentiates Low and High Suspicion of COVID-19. Journal of Clinical Medicine. 2021; 10(1):4. https://doi.org/10.3390/jcm10010004

Chicago/Turabian Style

Vial, Romain, Marion Gully, Mickael Bobot, Violaine Scarfoglière, Philippe Brunet, Dammar Bouchouareb, Ariane Duval, He-oh Zino, Julien Faraut, Océane Jehel, Yaël Berdad-Haddad, Stéphane Burtey, Pierre-André Jarrot, Guillaume Lano, and Thomas Robert. 2021. "Triage of Patients Suspected of COVID-19 in Chronic Hemodialysis: Eosinophil Count Differentiates Low and High Suspicion of COVID-19" Journal of Clinical Medicine 10, no. 1: 4. https://doi.org/10.3390/jcm10010004

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