key: cord-0968417-569x32jz
authors: Candellier, Alexandre; Goffin, Éric
title: “SARS-CoV-2 in the peritoneal waste of patients treated with peritoneal dialysis”
date: 2020-06-13
journal: Kidney Int
DOI: 10.1016/j.kint.2020.05.034
sha: 0720c9e0f6eb3e696d074749a665100151397ec9
doc_id: 968417
cord_uid: 569x32jz

nan

We read with interest the letter from Prof Vischini et al about the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the peritoneal effluent of a peritoneal dialysis (PD) patient (1) . Coronavirus transmission occurs primarily via respiratory droplets and, it has inconstantly been found in body secretions and excretions (2) . SARS-CoV-2 virion is 60-140 nanometers and could theoretically enter the peritoneal cavity via hematogenous diffusion or inside the PD catheter after touch contamination.

Vischini et al observation, if confirmed, is important for daily clinical care of PD patients and effluents handling. However, they found positive PCRs in PD effluents in their patient one month after the first symptoms questioning the presence of the virus itself or just of non-contagious RNAs fragments. Our experience about serial PD effluent samplings from three PD patients with mild to moderate active Covid-19 showed discordant results. We used qRT-PCR based on highly specific RdRp gene and E gene, in two independent laboratories. Though nasopharyngeal swabs obtained at admission showed high viral load in all three patients (CT-value <30), decreasing during hospitalization, none of the 11 PD effluent at days 0-3-4-7 sampled after a 12-hours dwell tested positive, even after dialysate centrifugation. Blood sample was positive in only one patient (3) . Our data are also in line with the absence of SARS RNA in effluents from PD patients with SARS infection (4) . The opposite results between both observations argue for performing SARS-CoV-2 culture to confirm PD effluent contagiousness before to impose specific procedures in PD patients.

CoV-2 in the peritoneal waste in a patient treated with peritoneal dialysis

Detection of SARS-CoV-2 in Different Types of Clinical Specimens

Absence of SARS-CoV-2 in the effluent of peritoneal dialysis patients

Severe Acute Respiratory Syndrome in Dialysis Patients