Enhanced Sentinel Surveillance System for COVID-19 Outbreak Prediction in a Large European Dialysis Clinics Network

Bellocchio, Francesco; Carioni, Paola; Lonati, Caterina; Garbelli, Mario; Martínez-Martínez, Francisco José; Stuard, Stefano; Neri, Luca

doi:10.3390/ijerph18189739

Cited by 10 publications

(8 citation statements)

References 43 publications

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“…We also performed a pair matched analysis for 88 variables that could have influenced the patient outcomes, including background epidemic risk of infection, socio-demographic factors as well as comorbidities, dialysis related parameters, and biochemical markers serum concentrations. The outcome risk score model incorporated in our matching strategy ( 32 ) allowed a precise risk assessment for a COVID-19 outbreak in our dialysis clinics over a 2-week forecasting horizon and therefore allows to effectively balance the risk of infection in the matched cohorts of vaccinated and unvaccinated patients, because this model captures the local disease spread in the particular and high-risk setting, the dialysis unit, where the human interactions are numerous and unavoidable, more precisely than the simple epidemic status in the general population. The accuracy of our sentinel surveillance system is ensured by our epidemic tracing procedure (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Besides socio-demographic and clinical characteristics, the ORS model also included the local (dialysis center) background risk of SARS-CoV-2 infection at index date. The local (dialysis center) background risk of SARS-CoV-2 infection was estimated by an enhanced sentinel surveillance system based on Artificial Intelligence (AI) ( 32 ). This sentinel surveillance system exploits the interconnection of the FMC NC European centers to estimate the risk of a COVID-19 outbreak in each dialysis center within a 2-week prediction horizon.…”

Section: Methodsmentioning

confidence: 99%

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Effectiveness of COVID-19 vaccines in a large European hemodialysis cohort

Bernardo¹,

Carioni²,

Stuard³

et al. 2022

Front. Nephrol.

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BackgroundHemodialysis patients have high-risk of severe SARS-CoV-2 infection but were unrepresented in randomized controlled trials evaluating the safety and efficacy of COVID-19 vaccines. We estimated the real-world effectiveness of COVID-19 vaccines in a large international cohort of hemodialysis patients.MethodsIn this historical, 1:1 matched cohort study, we included adult hemodialysis patients receiving treatment from December 1, 2020, to May 31, 2021. For each vaccinated patient, an unvaccinated control was selected among patients registered in the same country and attending a dialysis session around the first vaccination date. Matching was based on demographics, clinical characteristics, past COVID-19 infections and a risk score representing the local background risk of infection at vaccination dates. We estimated the effectiveness of mRNA and viral-carrier COVID-19 vaccines in preventing infection and mortality rates from a time-dependent Cox regression stratified by country.ResultsIn the effectiveness analysis concerning mRNA vaccines, we observed 850 SARS-CoV-2 infections and 201 COVID-19 related deaths among the 28110 patients during a mean follow up of 44 ± 40 days. In the effectiveness analysis concerning viral-carrier vaccines, we observed 297 SARS-CoV-2 infections and 64 COVID-19 related deaths among 12888 patients during a mean follow up of 48 ± 32 days. We observed 18.5/100-patient-year and 8.5/100-patient-year fewer infections and 5.4/100-patient-year and 5.2/100-patient-year fewer COVID-19 related deaths among patients vaccinated with mRNA and viral-carrier vaccines respectively, compared to matched unvaccinated controls. Estimated vaccine effectiveness at days 15, 30, 60 and 90 after the first dose of a mRNA vaccine was: for infection, 41.3%, 54.5%, 72.6% and 83.5% and, for death, 33.1%, 55.4%, 80.1% and 91.2%. Estimated vaccine effectiveness after the first dose of a viral-carrier vaccine was: for infection, 38.3% without increasing over time and, for death, 56.6%, 75.3%, 92.0% and 97.4%.ConclusionIn this large, real-world cohort of hemodialyzed patients, mRNA and viral-carrier COVID-19 vaccines were associated with reduced COVID-19 related mortality. Additionally, we observed a strong reduction of SARS-CoV-2 infection in hemodialysis patients receiving mRNA vaccines.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effectiveness of COVID-19 vaccines in a large European hemodialysis cohort

Bernardo¹,

Carioni²,

Stuard³

et al. 2022

Front. Nephrol.

Self Cite

View full text Add to dashboard Cite

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“…It helped the policy-makers identify priority patients for vaccination ( 97 ). But unless other sentinel surveillance system ( 98 ), it was not a real-time information, due to manual collection. However, it allowed various study that may be useful in the event of a new sanitary crisis.…”

Section: Prospects For Renal Registries and Researchmentioning

confidence: 99%

What does the French REIN registry tell us about Stage 4-5 CKD care in older adults?

Moranne

Hamroun²,

Couchoud³

2023

Front. Nephrol.

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The aim of this paper is to illustrate all the clinical epidemiology searches made within the French network REIN to improve CKD stage 4-5 care in older adults. We summarize various studies describing clinical practice, care organization, prognosis and health economics evaluation in order to develop personalized care plans and decision-making tools. In France, for 20 years now, various databases have been mobilized including the national REIN registry which includes all patients receiving dialysis or transplantation. REIN data are indirectly linked to the French administrative healthcare database. They are also pooled with data from the PSPA cohort, a multicenter prospective cohort study of patients aged 75 or over with advanced CKD, monitored for 5 years, and the CKD-REIN clinical-based prospective cohort which included 3033 patients with CKD stage 3-4 from 2013 to 2016. During our various research work, we identified heterogeneous trajectories specific to this growing older population, raising ethical, organizational and economic issues. Renal registries will help clinicians, health providers and policy-makers if suitable decision- making tools are developed and validated.

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“…“Coronavirus Disease 2019 (COVID-19): A Modeling Study of Factors Driving Variation in Case Fatality Rate by Country” by Pan et al [ 5 ], “COVID-19: Detecting Government Pandemic Measures and Public Concerns from Twitter Arabic Data using Distributed Machine Learning” by Alomari et al [ 6 ] and “Enhanced Sentinel Surveillance System for COVID-19 Outbreak Prediction in a Large European Dialysis Clinics Network” by Bellocchio et al [ 7 ] all present research around the COVID-19 pandemic. Pan et al [ 5 ] identified 24 potential risk factors driving variation in SARS-CoV-2 case fatality rate (CFR).…”

mentioning

confidence: 99%

“…), and formulated their information-structural, temporal, and spatio-temporal relationships. Bellocchio et al [ 7 ] present a sentinel surveillance system supported by an ML prediction model, whereby the occurrence of COVID-19 cases in a clinic propagates distance-weighted risk estimates to adjacent dialysis units. The system allows for a prompt risk assessment and a timely response to the challenges posed by the COVID-19 epidemic throughout Fresenius Medical Care (FMC) European dialysis clinics.…”

mentioning

confidence: 99%