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COVID-19 Rapid Antigen Test Screening in Patients on Hemodialysis

Gaetano Alfano1, Roberta Scarmignan2, Niccolò Morisi2

  • 1Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy.

International Journal of Nephrology
|September 26, 2022
PubMed

Insights

Bimonthly COVID-19 rapid antigen screening of hemodialysis patients is not effective for early diagnosis. More frequent testing is needed to prevent outbreaks in this vulnerable population.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Nephrology

Background:

  • Patients undergoing in-center hemodialysis are at high risk for COVID-19.
  • The effectiveness of routine screening for asymptomatic hemodialysis patients remains unclear.

Purpose of the Study:

  • To evaluate the efficacy of bimonthly COVID-19 rapid antigen screening in asymptomatic hemodialysis patients.
  • To determine if this screening strategy can prevent outbreaks in dialysis units.

Main Methods:

  • Retrospective analysis of 277 hemodialysis patients from February to December 2021.
  • Bimonthly nasal rapid antigen testing for asymptomatic patients, confirmed by RT-PCR.
  • RT-PCR testing for symptomatic patients and contacts.

Main Results:

  • 4079 rapid antigen tests were performed; 0.9% were positive, with only 13.8% confirmed by RT-PCR.
  • COVID-19 was diagnosed in 6.4% of the population; routine screening detected only 27.7% of cases.
  • No outbreaks were identified, but rapid antigen tests missed many infections.

Conclusions:

  • Bimonthly rapid antigen screening is inadequate for early COVID-19 detection in hemodialysis patients.
  • The short incubation period of SARS-CoV-2 variants necessitates more frequent testing.
  • Increased testing frequency may improve the utility of rapid antigen tests in this population.
Abstract

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