Practical indications for the prevention and management of SARS-CoV-2 in ambulatory dialysis patients: lessons from the first phase of the epidemics in Lombardy

Abstract

Confronting the SARS-CoV-2 outbreak has allowed us to appreciate how efficiently highly-resourced settings can respond to crises. However even such settings are not prepared to deal with the situation, and lessons are only slowly being learnt. There is still an urgent need to accelerate protocols that lead to the implementation of rapid point-of-care diagnostic testing and effective antiviral therapies. In some high-risk populations, such as dialysis patients, where several individuals are treated at the same time in a limited space and overcrowded areas, our objective must be to ensure protection to patients, the healthcare team and the dialysis ward. The difficult Italian experience may help other countries to face the challenges. The experience of the Lombardy underlines the need for gathering and sharing our data to increase our knowledge and support common, initially experience-based, and as soon as possible evidence-based position to face this overwhelming crisis.

COVID-19, Low-Molecular-Weight Heparin, and Hemodialysis

“…In an Italian experience, among 200 patients 18 were infected and isolated (9%), and in another unit of 170 patients only 4 were infected [5]. In the Piedmont and Aosta regions, among 2,893 patients 98 were infected (3.4%) during the first month of the epidemic [6].…”

COVID-19 and dialysis: why we should be worried

“…A number of articles focusing on recommendations to contain the spread of infection in dialysis patients, have been released [2,6,7], anyway, very few reports on the real degree of diffusion of the infection and its outcome in this specific population and among people working in dialysis facilities have been published so far.…”

Safeguarding the Maintenance Hemodialysis Patient Population during the Coronavirus Disease 19 Pandemic

“…For obvious reasons, the nephrology community is on high alert [7,8]. The EUDIAL working group very recently published the first international guidance on the prevention of SARS-CoV-2 infection and mitigation of COVID-19 in this vulnerable patient population [9].…”