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Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients

Caplin, B; Ashby, D; McCafferty, K; Hull, R; Asgari, E; Ford, M; Cole, N; ... Salama, A; + view all (2021) Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients. Clinical Journal of the American Society of Nephrology , 16 (5) , Article 03180321. 10.2215/CJN.03180321. Green open access

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Abstract

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.

Type: Article
Title: Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.2215/CJN.03180321
Publisher version: https://doi.org/10.2215/CJN.03180321
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10129021
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