Silent COVID-19 in haemodialysis facilities in Cantabria, Spain: an ecological study

Rodrigo, Emilio; Piñera, Vicente C; Setién, Maria Angeles; Siller, María; Pablo, Daniel; Tejido, Rafael; Ruiz, Juan Carlos

doi:10.1093/ckj/sfaa106

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…As detailed in Table 1S, different screening tests were used to estimate the prevalence of COVID-19. The screening was carried out using real-time polymerase chain reaction (RT-PCR) (45.5%) [ 11 – 21 ], serology (27.2%) [ 18 , 20 , 22 – 25 ], computed tomography (CT) scan (confirmed by SARS-CoV-2 RT-PCR) (13.6%) [ 26 – 28 ] and combination of PCR and serology (13.6%) [ 29 – 31 ]. Considering all modalities of testing, prevalence of COVID-19 among HD patients ranged between 0 and 37.6% [ 11 – 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…When COVID-19 was diagnosed by antibody testing, prevalence varied from 4.8 to 36.2% [ 23 , 25 ]. A seroconversion of 97.5% was detected in PCR-positive patients [ 23 ], whereas it occurred in 4.4–19.0% [ 20 , 23 ] of PCR-negative patients. Prevalence of COVID-19 in pediatric patients was assessed in only two studies reporting a seroprevalence of 23–38% (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…In research articles reporting clinical manifestation and outcome of COVID-19 patients (78[54.4%]) the diagnosis of SARS-CoV-2 infection relied principally on RT-PCR (52[63.4%]) [ 11 – 20 , 32 , 61 , 62 , 69 , 93 , 94 , 100 , 108 – 111 , 113 , 115 – 124 , 126 , 129 , 132 , 134 , 135 , 138 – 151 ], serology (4[6.3%]) [ 18 , 20 , 22 – 24 , 86 , 99 ], RT-PCR and serological assay (5[6.6%])[ 29 – 31 , 85 , 127 , 152 ] or a combination of diagnostic tests including clinical evaluation [ 6 , 13 , 19 , 21 , 112 , 114 , 125 , 128 , 130 , 131 , 133 , 136 , 137 , 153 , 154 ].…”

Section: Resultsmentioning

confidence: 99%

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The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

et al. 2021

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Background Patients undergoing in-centre haemodialysis (HD) are particularly exposed to the dire consequences of COVID-19. The present systematic scoping review aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance HD: it reports specifically the prevalence of the COVID-19 pandemic in the HD population, implementation of strategies for the prevention, mitigation and containment of the COVID-19 pandemic in HD centres, demographic and clinical characteristics, and outcomes of the pediatric and adult HD patients. Methods A multi-step systematic search of the literature in Pubmed, Scopus, Ovid Medline, Embase and Web of Science, published between December 1, 2019, and January 30, 2021 was performed. Two authors separately screened the titles and abstracts of the documents and ruled out irrelevant articles. A report of the papers that met inclusion criteria was performed; then, a descriptive analysis of the characteristics of the included articles and a narrative synthesis of the results were performed. Results The review process ended with the inclusion of 145 articles. Most of them were based on single-centre experiences, which spontaneously developed best practices. Most studies were conducted in high-income countries (69.7%) and a part of them (9.6%) were not in English. Prevalence of COVID-19 among dialysis patients accounted for 0%-37.6%. Preventive measures were reported in 54% of the included articles, with particular emphasis on education, triage, hygiene, and containment measures. Patients experienced a heterogeneous spectrum of symptoms that led 35%-88.2% of them to hospital admission. Median and mean hospital length of stay ranged from 8 to 28.5 and 16.2 to 22 days, respectively. Admission to intensive care units varied widely across studies (from 2.6% to 70.5%) and was associated with high mortality (42.8%-100%). Overall, prognosis was poor in 0%-47% of the hospitalized patients. Conclusions This systematic scoping review provides an overview of the current knowledge on the impact of COVID-19 on the frail world of HD patients. Furthermore, it may help to implement the existing strategies of COVID-19 prevention and provide a list of unmet needs (safe transport, testing, shelter). Finally, it may be a stimulus for performing systematic reviews and meta-analyses which will form the basis for evidence-based guidelines.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

et al. 2021

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“…This is identical to the findings of a similar Italian dialysis cohort [ 29 ] and also supported by data from Spain. [ 41 ] This incidence lies somewhat above the officially reported case-rate of 3.1% in the Heinsberg area's general population but below the 15.5% infection-rate established in the area's hotspot by proactive combinatorial PCR and serologic screening of ∼1000 persons in ∼400 households. [ 3 ] Given the lower number of KTX patients enrolled, we are cautious to derive any incidence, though the resulting 7% (7/∼100 KTX recipients) would be in line with the current literature (see above).…”

Section: Discussionmentioning

confidence: 85%

Time on previous renal replacement therapy is associated with worse outcomes of COVID-19 in a regional cohort of kidney transplant and dialysis patients

Villa

Krüger²,

Seikrit³

et al. 2021

Medicine

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Chronic renal replacement therapy by either a kidney transplant (KTX) or hemodialysis (HD) predisposes patients to an increased risk for adverse outcomes of COVID-19. However, details on this interaction remain incomplete. To provide further characterization, we undertook a retrospective observational cohort analysis of the majority of the hemodialysis and renal transplant population affected by the first regional outbreak of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) in Germany. In a region of 250,000 inhabitants we identified a total of 21 cases with SARS-CoV-2 among 100 KTX and 260 HD patients, that is, 7 KTX with COVID-19, 14 HD with COVID-19, and 3 HD with asymptomatic carrier status. As a first observation, KTX recipients exhibited trends for a higher mortality (43 vs 18%) and a higher proportion of acute respiratory distress syndrome (ARDS) (57 vs 27%) when compared to their HD counterparts. As a novel finding, development of ARDS was significantly associated with the time spent on previous renal replacement therapy (RRT), defined as the composite of dialysis time and time on the transplant (non-ARDS 4.3 vs ARDS 10.6 years, P = .016). Multivariate logistic regression analysis showed an OR of 1.7 per year of RRT. The association remained robust when analysis was confined to KTX patients (5.1 vs 13.2 years, P = .002) or when correlating the time spent on a renal transplant alone ( P = .038). Similarly, longer RRT correlated with death vs survival ( P = .0002). In conclusion our data suggest renal replacement vintage as a novel risk factor for COVID-19-associated ARDS and death. The findings should be validated by larger cohorts.

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“…There are some limitations to our report. Asymptomatic persons with COVID-19 account for a proportion of COVID-19 cases [ 15 , 19 , 20 ]. Therefore, the number of COVID-19 cases may be an underestimate of the burden of disease as the majority of testing for SARS-CoV-2 was in symptomatic patients or patients in high risk settings such as nursing homes.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 infection control measures and outcomes in urban dialysis centers in predominantly African American communities

et al. 2021

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Background Emory Dialysis serves an urban and predominantly African American population at its four outpatient dialysis facilities. We describe COVID-19 infection control measures implemented and clinical characteristics of patients with COVID-19 in the Emory Dialysis facilities. Methods Implementation of COVID-19 infection procedures commenced in February 2020. Subsequently, COVID-19 preparedness assessments were conducted at each facility. Patients with COVID-19 from March 1–May 31, 2020 were included; with a follow-up period spanning March–June 30, 2020. Percentages of patients diagnosed with COVID-19 were calculated, and characteristics of COVID-19 patients were summarized as medians or percentage. Baseline characteristics of all patients receiving care at Emory Dialysis (i.e. Emory general dialysis population) were presented as medians and percentages. Results Of 751 dialysis patients, 23 (3.1%) were diagnosed with COVID-19. The median age was 67.0 years and 13 patients (56.6%) were female. Eleven patients (47.8%) were residents of nursing homes. Nineteen patients (82.6%) required hospitalization and 6 patients (26.1%) died; the average number of days from a positive SARS-CoV-2 (COVID) test to death was 16.8 days (range 1–34). Two patients dialyzing at adjacent dialysis stations and a dialysis staff who cared for them, were diagnosed with COVID-19 in a time frame that may suggest transmission in the dialysis facility. In response, universal masking in the facility was implemented (prior to national guidelines recommending universal masking), infection control audits and re-trainings of PPE were also done to bolster infection control practices. Conclusion We successfully implemented recommended COVID-19 infection control measures aimed at mitigating the spread of SARS-CoV-2. Most of the patients with COVID-19 required hospitalizations. Dialysis facilities should remain vigilant and monitor for possible transmission of COVID-19 in the facility.

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Silent COVID-19 in haemodialysis facilities in Cantabria, Spain: an ecological study

Cited by 4 publications

References 5 publications

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

Time on previous renal replacement therapy is associated with worse outcomes of COVID-19 in a regional cohort of kidney transplant and dialysis patients

COVID-19 infection control measures and outcomes in urban dialysis centers in predominantly African American communities

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