Diagnosis and epidemiology of COVID-19 in the Federal District, in the population of the Unified Health System (SUS), particularly in patients with chronic kidney disease on hemodialysis

According to the Ministry of Health, so far, the number of COVID-19 cases in Brazil has reached 4,256 and caused 136 deaths. In the Federal District, according to the Epidemiological Bulletin of March 29, 2020, the number of confirmed cases was 298, of which, in total, 31 patients were hospitalized and 1 death was recorded. The expectation is that this number will increase exponentially in the next 4 to 8 weeks. Given this scenario, the present project has as main objectives, to increase the number of diagnostic tests to serve SUS patients and to carry out the epidemiological study of this disease in the Federal District, especially of the population with chronic kidney disease who are on hemodialysis. This is a research and technological service project that is expected to be completed in 24 months. It is coordinated by Prof. Dr. Neves and brings together 9 more members, including professionals from the Molecular Pharmacology Laboratory of the Faculty of Health Sciences of the University of Brasília (FarMol-FS-UnB), Morphology Area of ​​the Faculty of Medicine of the University of Brasilia (Morphology FM-UnB), Central Laboratory of Public Health of the Federal District (LACEN-DF) and Sabin Medicina Diagnóstica-Brasília. To increase the number of diagnostic tests, this project proposes the implementation, at FarMol-FS-UnB, of a workstation for nucleic acid extraction and molecular detection of SARS-CoV-2 by quantitative PCR in real time. With this structure, FarMol-FS-UnB will be able to perform approximately 288 tests per day, considerably increasing the amount of tests intended to meet SUS demand, minimizing the overhead of LACEN-DF, which currently has the infrastructure to carry out 320 tests a day. Respiratory secretion samples from the various SUS health units in the Federal District, collected with a sterile swab and stored in saline solution, will be processed at LACEN-DF and FarMol-FS-UnB, where the extraction of viral nucleic acid and the reaction of PCR will be prepared with appropriate kits and carried out in accordance with the recommendations of the Center for Disease Control and Prevention and the World Health Organization. epidemiological analysis of COVID-19 cases treated by SUS in the Federal District, based on the analysis of the natural history of the disease in the Federal District, its form of dissemination and evolution, including geographic distribution, temporal trend, intensity of transmissibility, clinical characteristics, risk groups, complications and clinical severity. In addition, this study aims to investigate the prevalence of COVID-19 in the population of the Federal District with chronic kidney disease undergoing hemodialysis by SUS. These 1,300 patients represent an important risk group because, for the most part, in addition to already presenting risk factors such as arterial hypertension and type 2 diabetes, they cannot be isolated in quarantine, as they need to leave their homes to undergo hemodialysis at least three times a week. This information may serve as a basis for defining prevention and control strategies for COVID-19 in the Federal District, as well as other infectious diseases with epidemic potential that may arise in the future.