The possibility of SARS-CoV-2 transmission in a haemodialysis unit – report from a large in-hospital centre

Gubenšek, Jakob; Trampuž, Barbara Vajdič; Peršič, Vanja; Gregorčič, S.; Mrvič, Tatjana; Arnol, Miha

doi:10.1017/s0950268820002277

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…According to staff availability, dialysis staff phoned all patients before each dialysis shift to determine whether they had COVID-19 symptoms [ 17 , 33 , 45 , 88 ]. Another strategy consisted of informing the facility of suspicious symptoms or contacts with COVID-19 subjects [ 38 , 42 – 44 , 49 – 53 , 55 , 57 , 63 , 65 , 67 , 72 , 86 , 88 , 89 ] or in case of contact with COVID-19 patients [ 70 ].…”

Section: Resultsmentioning

confidence: 99%

“…Body temperature was measured to all people prior entry to the dialysis centre [ 12 , 29 , 38 , 41 , 47 , 53 , 58 , 61 , 64 , 66 , 68 – 70 , 73 , 80 , 92 – 95 ] using digital [ 12 , 93 ] or infrared thermal devices [ 88 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patients were instructed to wear a surgical mask since leaving house [38] until hospital arrival [16,35,38,43,56,63,66,68] and also during the ride [49,54,55]. To reduce the risk of infection within facilities, the use of the mask was recommended throughout the dialysis session [35,36,44,49,51,54,55,57,60,61,63,[69][70][71][72][73] unless it was made of textiles [54] or was worn by someone that was incapacitated to remove it without assistance [48]. Conversely, some recommendations supported the choice to wear a mask according to the epidemiology risk in the community principally for asymptomatic patients [38].…”

Section: Education and Recommendationsmentioning

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: Education and Recommendationsmentioning

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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“…It is difficult to compare infection control measures to those taken elsewhere in our region. One report from Slovenia described better PPE, a more favourable nurse-to-patient ratio and distance between dialysis beds but also noted the lack of individualised transport for COVID-19 positive patients [ 31 ]. Finally, lower rates of staff infection in Tuzla may be due to the fact than in the centre in Niš had surveillance testing for COVID19 for their staff, which Tuzla did not.…”

Section: Discussionmentioning

confidence: 99%

COVID – 19 in two dialysis centers situated in two neighbouring states of the Western Balkans

Mešić¹,

Alečković-Halilović²,

Paunovic

et al. 2023

BMC Nephrol

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Background Bosnia and Herzegovina (BiH) and Serbia are countries in the Western Balkans that share parts of their social and political legacy from the former Yugoslavia, such as their health care system and the fact that they are not members of European Union. There are very scarce data on COVID – 19 pandemic from this region when compared to other parts of the world and even less is known about its impact on the provision of renal care or differences between countries in the Western Balkans. Materials and methods This observational prospective study was conducted in two regional renal centres in BiH and Serbia, during the COVID – 19 pandemic. We obtained demographic and epidemiological data, clinical course and outcomes of dialysis and transplant patients with COVID – 19 in both units. Data were collected a via questionnaire for two consecutive time periods: February – June 2020 with a total number of 767 dialysis and transplant patients in the two centres, and July – December 2020 with a total number of 749 studied patients, corresponding to two of the largest waves of the pandemic in our region. Departmental policies and infection control measures in both units were also recorded and compared. Results For a period of 11 months, from February to December 2020, 82 patients on in-centre haemodialysis (ICHD), 11 peritoneal dialysis patients and 25 transplant patients who tested positive for COVID-19. In the first study period, the incidence of COVID – 19 positive in Tuzla was 1.3% among ICHD patients, and there were no positive peritoneal dialysis patients, or any transplant patients who tested positive. The incidence of COVID-19 was significantly higher in both centres in the second time period, which corresponds to the incidence in general population. Total deaths of COVID-19 positive patients was 0% in Tuzla and 45.5% in Niš during first, and 16.7% in Tuzla and 23.4% in Niš during the second period. There were notable differences in the national and local/departmental approach to the pandemic between the two centres. Conclusion There was poor survival overall when compared to other regions of Europe. We suggest that this reflects the lack of preparedness of both of our medical systems for such situations. In addition, we describe important differences in outcome between the two centres. We emphasize the importance of preventative measures and infection control and highlight the importance of preparedness.

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COVID – 19 in Two Dialysis Centers Situated in Two Neighbouring States of the Western Balkans

Mešić¹,

Alečković-Halilović²,

Paunovic³

et al. 2022

Preprint

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Background: Bosnia and Herzegovina (B&H) and Serbia are developing countries in the Western Balkans that share similar social and political legacy from the former Yugoslavia including the health care system and are not members of European Union. There are very scarce data on COVID – 19 pandemic from this region. Materials and methods: This observational prospective study was conducted in two dialysis and transplant centres in B&H and Serbia, during the COVID – 19 pandemic. We monitored: demographic and epidemiological data, preventive and control measures in dialysis centres, clinical course and outcomes of dialysis and transplanted patients with COVID – 19. Data were collected by filling out an agreed questionnaire and were analysed and compared for two consecutive time periods: February – June 2020 with total number of 767 studied patients, and July – December 2020 with total number of 749 studied patients. Results: For a period of 11 months, from February to December 2020, there were 82 ICHD patients, 11 CAPD patients and 25 kidney transplant patients who tested positive for COVID-19. In the first study period, the incidence of COVID – 19 positive in Tuzla was 1.32% among ICHD patients, and there were no positive CAPD patients, nor patients with kidney graft. The incidence was significantly higher in both centres in the second time period. These data correspond to incidence in general population. Total deaths of COVID-19 positive patients was 0% in Tuzla DC and 45.45% in Niš DC during first, and 16.67% in Tuzla DC and 23.44% in Niš DC during the second period. Conclusion: Very bad overall survival was direct reflection of unpreparedness of our medical systems for such situations, and reminder of importance of preventive measures. Spreading of COVID-19 and similar respiratory infections within DC can be achieved using cheap measures that we have described here. It might also shift fight in more developed countries toward cheaper and simpler preventive measures, which could result in money and lifesaving results.

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The possibility of SARS-CoV-2 transmission in a haemodialysis unit – report from a large in-hospital centre

Abstract: The possibility of SARS-CoV-2 transmission in a haemodialysis unitreport from a large in-hospital centre. Epidemiology and Infection 148, e226, 1-3.

Cited by 3 publications

References 10 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

COVID – 19 in two dialysis centers situated in two neighbouring states of the Western Balkans

COVID – 19 in Two Dialysis Centers Situated in Two Neighbouring States of the Western Balkans

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