Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients. Issue 8 (August 2021)

• Record Type: Journal Article
• Authors: Caplin, Ben; Ashby, Damien; McCafferty, Kieran; Hull, Richard; Asgari, Elham; Ford, Martin L.; Cole, Nicholas; Antonelou, Marilina; Blakey, Sarah A.; Srinivasa, Vinay; Braide-Azikwe, Dandisonba C.B.; Roper, Tayeba; Clark, Grace; Cronin, Helen; Hayes, Nathan J.; Manson, Bethia; Sarnowski, Alexander; Corbett, Richard; Bramham, Kate; Lioudaki, Eirini; Kumar, Nicola; Frankel, Andrew; Makanjuola, David; Sharpe, Claire C.; Banerjee, Debasish; Salama, Alan D.
• Other Names: author non-byline.; Elham Asgari author non-byline.; Damien Ashby author non-byline.; Debasish Banerjee author non-byline.; Sarah Blakey author non-byline.; Kate Bramham author non-byline.; Rosalind Brewster author non-byline.; Dandisonba Briade-Azikwe author non-byline.; Hugh Cairns author non-byline.; Ben Caplin author non-byline.; Paramit Chowdhury author non-byline.; Grace Clark author non-byline.; Nicholas Cole author non-byline.; Richard Corbett author non-byline.; Andrea Cove-Smith author non-byline.; Helen Cronin author non-byline.; Maria Davari author non-byline.; Abigail Dias author non-byline.; Kevin Evans author non-byline.; Suzanne Forbes author non-byline.; Martin Ford author non-byline.; Andrew Frankel author non-byline.; Sahana Gnansampanthan author non-byline.; Catriona Goodlad author non-byline.; Nathan Hayes author non-byline.; Heidy Hendra author non-byline.; Richard Hull author non-byline.; Nicola Kumar author non-byline.; Eirini Lioudaki author non-byline.; Marina Loucaidou author non-byline.; David Makanjuola author non-byline.; Bethia Manson author non-byline.; Kieran McCafferty author non-byline.; Daniel McGuinness author non-byline.; Aegida Neradova author non-byline.; Mysore Phanish author non-byline.; Katherine Price author non-byline.; Ravi Rajakariar author non-byline.; Alex Rankin author non-byline.; Tayeba Roper author non-byline.; Noam Roth author non-byline.; Alan Salama author non-byline.; Alexander Sarnowski author non-byline.; Cassim Schott author non-byline.; Claire Sharpe author non-byline.; Vinay Srinivasa author non-byline.; Damir Tandaric author non-byline.; Sujanita Thyagarajan author non-byline.; Gisele Vajgel author non-byline.; Gregor Young author non-byline.;
• Is Part Of: Clinical journal of the American Society of Nephrology. Volume 16:Issue 8(2021)
• Page Start: 1237
• Page End: 1246
• Publication Date: 2021-08
• Subjects: hemodialysis -- COVID-19 -- infection control
• DOI: 10.2215/CJN.03180321
• Languages: English
• ISSNs: 1555-9041

Abstract

Visual Abstract: Abstract : Background and objectives: Patients receiving in-center hemodialysis treatment face unique challenges during the coronavirus disease 2019 (COVID-19) pandemic, specifically the need to attend for treatment that prevents self-isolation. Dialysis unit attributes and isolation strategies that might reduce dialysis center COVID-19 infection rates have not been previously examined. Design, setting, participants, & measurements: We explored the role of variables, including community disease burden, dialysis unit attributes (size and layout), and infection control strategies, on rates of COVID-19 among patients receiving in-center hemodialysis in London, United Kingdom, between March 2, 2020 and May 31, 2020. The two outcomes were defined as ( 1 ) a positive test for infection or admission with suspected COVID-19 and ( 2 ) admission to the hospital with suspected infection. Associations were examined using a discrete time multilevel time-to-event analysis. Results: Data on 5755 patients dialyzing in 51 units were analyzed; 990 (17%) tested positive and 465 (8%) were admitted with suspected COVID-19 between March 2 and May 31, 2020. Outcomes were associated with age, diabetes, local community COVID-19 rates, and dialysis unit size. A greater number of available side rooms and the introduction of mask policies for asymptomatic patients were inversely associated with outcomes. No association was seen with sex, ethnicity, or deprivation indices, nor with any of the different isolation strategies. Conclusions: Rates of COVID-19 in the in-center hemodialysis population relate to individual factors, underlying community transmission, unit size, and layout.