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Infection Control Precautions and Care Delivery in Hemodialysis Unit during Coronavirus Disease 2019 Outbreak: A Case
Shou-Ci Hu1, En-Qing Fu1, Jun-Fen Fan1
1Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China.
Insights
This study outlines a practical workflow for managing dialysis patients during the COVID-19 pandemic, identifying high-risk cases and crucial clinical patterns. It emphasizes the need for tailored infection control in dialysis settings.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- The Coronavirus Disease 2019 (COVID-19) pandemic necessitates robust management strategies for vulnerable populations, including dialysis patients.
- Healthcare personnel (HCP) and caregivers in dialysis units (DUs) are also at risk and require specific protocols.
- Urgent implementation of infection control and clinical management workflows is critical.
Purpose of the Study:
- To report a practical workflow for the clinical management of dialysis patients, caregivers, and HCP during the COVID-19 outbreak.
- To identify high-risk or suspected cases of COVID-19 within dialysis units.
- To describe subsequent response measures and clinical patterns.
Main Methods:
- A single-center retrospective review of high-risk/suspected COVID-19 cases in dialysis units.
- Data collection included epidemiological and clinical features from January 23, 2020, to February 10, 2020.
- Implementation of precautions and practice protocols specific to the COVID-19 outbreak.
Main Results:
- A practical workflow was established for patient-centered management.
- Six high-risk/suspected cases were identified, with specific demographic and clinical features noted (e.g., older age, cardiovascular disease, diabetes).
- Five cases had direct infection evidence or epidemiological risk; no confirmed COVID-19 cases were reported in the DU, but some patients deteriorated due to other severe conditions.
Conclusions:
- A patient-centered workflow for managing dialysis patients during the COVID-19 outbreak was successfully described.
- Key risk factors and clinical patterns associated with suspected COVID-19 in dialysis patients were identified.
- Further research is needed on the efficacy of infection control and protocols for dialysis settings.
Background:
With an estimated basic reproductive number of 3.77, the Coronavirus Disease 2019 (COVID-19) continues to spread. It is urgent to exert adequate efforts for the management of dialysis patients, caregivers, and healthcare personnel (HCP). This study aimed at reporting practical workflow, identification of high-risk or suspected cases of CO-VID-19, and subsequent response measures.
Methods:
At the time of the COVID-19 outbreak, precautions and practice protocols were applied in our dialysis units (DUs). This single-center study retrospectively reviewed all high-risk/suspected cases from January 23, 2020, to February 10, 2020. Epidemiological, clinical feature, and detailed data on all cases were recorded.
Results:
Practical workflow for the clinical management of dialysis patients, caregivers, and HCP was initiated. A total of 6 high-risk/suspected cases were identified. Female gender, older age, presence of cardiovascular disease, diabetes, anuresis, immunocompromised status, hypoalbuminemia, and underweight were noticeable features in these cases. Direct evidence of infection or epidemiological risk was detected in five cases. Close monitoring for temperature and oxygen saturation during hemodialysis sessions may be reasonable. No confirmed COVID-19 cases were reported in our DU, but certain cases showed rapid deterioration due to other critically severe condition needing hospitalization. Portable dialysis machines are of great need to ensure dialysis care provision.
Conclusions:
Our study described a practical workflow for patient-centered management during COVID-19 outbreak. Potential risk factors and underlying clinical patterns were reported. Further studies regarding the efficacy of infection control precautions and practice protocols tailored for dialysis settings are warranted.
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