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


Journal

BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793

Informations de publication

Date de publication:
06 03 2021
Historique:
received: 26 10 2020
accepted: 24 02 2021
entrez: 7 3 2021
pubmed: 8 3 2021
medline: 18 3 2021
Statut: epublish

Résumé

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. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 33676397
doi: 10.1186/s12882-021-02281-6
pii: 10.1186/s12882-021-02281-6
pmc: PMC7936604
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

81

Références

J Am Soc Nephrol. 2020 Aug;31(8):1815-1823
pubmed: 32561681
Kidney Int Rep. 2020 May 24;5(7):1095-1099
pubmed: 32642606
Kidney Med. 2020 Mar 31;2(3):227-230
pubmed: 32363338
N Engl J Med. 2020 May 28;382(22):2158-2160
pubmed: 32329972
Kidney Int. 2020 Jul;98(1):12-16
pubmed: 32471637
Clin Kidney J. 2020 Jul 02;13(3):475-476
pubmed: 32695330
Clin J Am Soc Nephrol. 2020 May 7;15(5):710-713
pubmed: 32222700

Auteurs

Ibironke W Apata (IW)

Division of Renal Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA. iapata@emory.edu.

Jason Cobb (J)

Division of Renal Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA.

Jose Navarrete (J)

Division of Renal Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA.

John Burkart (J)

Renal Division, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Laura Plantinga (L)

Division of Renal Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA.
Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, USA.

Janice P Lea (JP)

Division of Renal Medicine, Emory University School of Medicine, 101 Woodruff Circle, WMB 3300, Atlanta, GA, 30322, USA.

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