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SARS-CoV-2 vs. Hepatitis Virus Infection Risk in the Hemodialysis Population: What Should We Expect?
Luis D'Marco1,2, María Jesús Puchades1,2, Miguel Ángel Serra2,3
1Nephrology Department, Hospital Clínico Universitario (INCLIVA), 46010 Valencia, Spain.
Insights
Patients on dialysis are highly susceptible to COVID-19. Universal screening and precautions are effective, but updated international guidelines are needed for the nephrology community.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Patients undergoing dialysis exhibit increased susceptibility to COVID-19 due to compromised immunity, chronic inflammation, and prevalent comorbidities.
- Reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in dialysis patients is higher than in the general population, despite implemented transmission-minimizing strategies.
Discussion:
- While hepatitis B virus (HBV) vaccination and hepatitis C virus (HCV) treatment have advanced, SARS-CoV-2 necessitates ongoing vigilance in this vulnerable group.
- Universal SARS-CoV-2 screening and strict contact precautions demonstrate effectiveness in curbing transmission within dialysis settings.
Key Insights:
- Dialysis patients represent a high-risk group for COVID-19 infection and severe outcomes.
- Proactive screening and infection control measures are crucial for managing SARS-CoV-2 in dialysis units.
- Existing hepatitis virus management strategies offer a framework for addressing new infectious threats.
Outlook:
- Development of an international consensus with updated protocols is recommended to guide the nephrology community through evolving infectious disease challenges.
- Prioritizing a balance between established and novel indicators in clinical practice will enhance patient care and safety.
- Continued research and adaptation of public health strategies are essential for protecting immunocompromised populations.
Abstract:
Since the dramatic rise of the coronavirus infection disease 2019 (COVID-19) pandemic, patients receiving dialysis have emerged as especially susceptible to this infection because of their impaired immunologic state, chronic inflammation and the high incidence of comorbidities. Although several strategies have thus been implemented to minimize the risk of transmission and acquisition in this population worldwide, the reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence varies across studies but is higher than in the general population. On the contrary, the screening for hepatitis viruses (HBV and HCV) has seen significant improvements in recent years, with vaccination in the case of HBV and effective viral infection treatment for HCV. In this sense, a universal SARS-CoV-2 screening and contact precaution appear to be effective in preventing further transmission. Finally, regarding the progress, an international consensus with updated protocols that prioritize between old and new indicators would seem a reasonable tool to address these unexpended changes for the nephrology community.
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