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Publication Detail
Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Caplin B, Ashby D, McCafferty K, Hull R, Asgari E, Ford M, Cole N, Antonelou M, Blakey S, Srinivasa V, Braide-Azikiwe D, Roper T, Clark G, Cronin H, Hayes N, Manson B, Sarnowski A, Corbett R, Bramham K, Lioudaki E, Kumar N, Frankel A, Makanjuola D, Sharpe C, Banerjee D, Salama A
  • Publisher:
    American Society of Nephrology
  • Publication date:
  • Journal:
    Clinical Journal of the American Society of Nephrology
  • Status:
  • Country:
    United States
  • Print ISSN:
  • PII:
  • Language:
Background Patients receiving in-center hemodialysis treatment face unique challenges during the 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. Methods We explored the role of variables including community disease burden, dialysis unit attributes (size, layout) and infection control strategies, on rates of COVID-19 among patients receiving in center hemodialysis in London, UK, between March 2nd 2020 and May 31st 2020. The two outcomes were defined as (i) a positive test for infection or admission with suspected COVID19 and (ii) admission to the hospital with suspected infection. Associations were examined using a discrete-time multi-level time-to-event analysis. Results Data on 5,755 patients, dialysing in 51 units were analysed. 990 (17%) tested positive and 465 (8%) were admitted with suspected COVID-19 between 2nd March and 31st May 2020. Outcomes were associated with age, diabetes, local community COVID-19 rates and dialysis unit size. Greater number of available side rooms and 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.
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