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Risk of COVID-19 disease, dialysis unit attributes, and infection control strategy among London in-center hemodialysis patients

Research output: Contribution to journalArticlepeer-review

Pan-London COVID-19 Renal Audit Group

Original languageEnglish
Pages (from-to)1237-1246
Number of pages10
JournalClinical Journal Of The American Society Of Nephrology
Volume16
Issue number8
DOIs
PublishedAug 2021

Bibliographical note

Funding Information: M. Antonelou reports receiving research funding from Medical Research Council. D. Ashby reports receiving honoraria from Fibr-ogen. D. Banerjee reports receiving research funding from the British Heart Foundation; receiving grants from AstraZeneca and Kidney Research UK; and receiving honoraria from AstraZeneca, Pfizer, and Viforpharma. S.A. Blakey reports employment with West London Renal and Transplant Centre. K. Bramham reports consultancy agreements with Alexion; receiving honoraria from Alexion and Otsuka; and serving as a scientific advisor or member of Alexion. B. Caplin reports consultancy agreements with LifeArc and receiving research funding from AstraZeneca and grants from Colt Foundation, Medical Research Council, and Royal Free Charity outside the submitted work. R. Corbett has been issued Patent WO2017148836A1: “A device for maintaining vascular connections.” M.L. Ford reports other interests/relationships with the AstraZeneca advisory board, which led to the publication of the paper. A. Frankel reports receiving research funding from Boehringer Ingelheim/Lilly Alliance and receiving honoraria from AstraZeneca, Boehringer Ingelheim/Lilly Alliance, Merck Sharp & Dohme, Napp Pharmaceuticals Limited, and Novo Nordisk. R. Hull reports consultancy agreements with AstraZeneca, Pharmo-cosmos UK Ltd., and Travere Pharmaceuticals; speakers bureau for Napp Phamaceuticals; serving as an elected council member of Renal Association, UK; and other interests/relationships with Joint Specialist Committee Renal Medicine, Royal College Physicians, London. K. McCafferty reports receiving research funding from AstraZeneca and receiving honoraria from Bayer, Napp, Pharma-cosmos, and Vifor Fresenius. A.D. Salama reports receiving research funding from Chiesi and Natera; receiving honoraria from AnaptysBio, AstraZeneca, Hansa Medical, and Vifor Pharmaceuticals; and serving as Nephrology Dialysis Transplantation Editor and a UK Renal Association Executive Member. C.C. Sharpe reports consultancy agreements with Novartis Pharmaceuticals; receiving honoraria from Napp Pharmaceuticals; serving as an Editor for BMC Nephrology and as a trustee and treasurer for the Renal Association; and speakers bureau for Napp Pharmaceuticals. All remaining authors have nothing to disclose. Publisher Copyright: © 2021 by the American Society of Nephrology. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

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.

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