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COVID-19 and maintenance hemodialysis: a systematic scoping review of practice guidelines
Hossein Akbarialiabad1, Shahin Kavousi1, Aria Ghahramani2
1Shiraz University of Medical Sciences, Shiraz Medical School, Zand Street, Shiraz, 7134845794, Iran.
Insights
This review of COVID-19 and maintenance hemodialysis literature found most articles offered recommendations for outpatient units. These single-center experiences inform future infection prevention and End-Stage Renal Disease patient management.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Coronavirus Disease 2019 (COVID-19) significantly disrupted medical services, including End-Stage Renal Disease (ESRD) care.
- Hemodialysis facilities faced challenges in patient and staff safety during the pandemic.
- A review of existing literature is needed to identify research gaps and guide future strategies.
Purpose of the Study:
- To conduct a scoping review of articles on COVID-19 and maintenance hemodialysis.
- To identify the extent, range, and nature of published research.
- To understand research gaps and propose recommendations for future studies.
Main Methods:
- Systematic literature search using terms for dialysis and COVID-19 in major databases (PubMed, Scopus, Embase, Web of Science).
- Screening of titles, abstracts, and full texts by two independent authors.
- Descriptive analysis and narrative synthesis of 22 included English-language articles published from December 2019 to May 2020.
Main Results:
- Twenty-two articles were included, predominantly perspectives, editorials, and case series, mainly from Italy and the US.
- Seventy-seven percent of articles focused on recommendations for outpatient hemodialysis units.
- Significant overlap in recommendations was noted, alongside unique suggestions across studies.
Conclusions:
- Most included articles originated from single-center experiences that developed "best practices".
- These emergent practices have influenced current policies and guidelines.
- Findings highlight the need for continued research to refine infection prevention and management strategies for ESRD patients during pandemics.
Background:
Coronavirus Disease 2019 (COVID-19) has substantially impacted the provision of medical services. During the pandemic, many medical services, including facilities providing care to patients with end stage renal disease faced challenges in safeguarding patients and staff while providing clinical care. This study aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance hemodialysis to understand the research gaps and propose recommendations for future research.
Methods:
Using the terms: "Dialysis" OR "RRT" OR "Renal replacement therapy" AND "SARS-COV-2" OR "COVID-19" OR "novel coronavirus" OR "2019-nCov", we performed a multi-step systematic search of the literature in the English language in Pubmed, Scopus, Embase, and Web of Science published from December 1, 2019, to May 13, 2020. Two authors separately screened the title and abstracts of the documents and ruled out irrelevant articles. We obtained a full report of the papers that met our inclusion criteria and screened the full texts. We conducted a descriptive analysis of the characteristics of the included articles and performed a narrative synthesis of the results. We conducted this scoping review in accordance with the PRISMA-ScR Checklist.
Results:
We included 22 articles in this scoping review. Perspectives (n = 9), editorials (n = 4), and case series (n = 5) were the most common types of articles. Most articles were from Italy and the United States. Seventeen (77.3%) of the articles focused on the topic of recommendation for outpatient hemodialysis units. While many of the recommendations overlapped in several articles, there were also many unique recommendations.
Conclusions:
most of the articles are based on single-center experience, which spontaneously developed best practices. Many of these practices have formed the basis for policies and guidelines that will guide future prevention of infection and management of patients with End Stage Renal Disease (ESRD) and COVID-19.
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