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Abstract: PO0715

Implementing COVID-19 Infection Control Procedures in Outpatient Dialysis in an Urban US Population

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Apata, Ibironke W., Emory University School of Medicine, Atlanta, Georgia, United States
  • Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
  • Navarrete, Jose E., Emory University School of Medicine, Atlanta, Georgia, United States
  • Lea, Janice P., Emory University School of Medicine, Atlanta, Georgia, United States
Background

Emerging data reveal disparities in the burden and severity of disease among racial and ethnic minorities in the US. Emory Dialysis consists of 4 outpatient dialysis facilities, serving an older, urban and predominantly African-American population. These facilities are in counties with the highest number of COVID-19 cases in Georgia. We describe infection control measures implemented to prevent COVID-19 transmission, and the clinical characteristics of patients with COVID-19 in the facilities.

Methods

Based on CDC’s recommended guidance, we implemented the following infection control procedure between February and April 2020: 1) screening; triaging all patients, and separating patients with symptoms of COVID-19; 2) monitoring staff for COVID-19 symptoms; 3) limiting healthcare personnel in the facilities; 4) universal masking in the dialysis units; 5) conducting PPE re-trainings; 6) assessing facility preparedness; 7) separating high risk patients (nursing home residents); and 8) cohorting patients with COVID-19 to a dedicated dialysis shift.

Results

Of the 745 patients followed at the Emory dialysis facilities, 18 (2.4%) were diagnosed COVID-19 between March 25—May 7, 2020. Among the 18 patients, 17 were receiving in-center hemodialysis and 1 was on peritoneal dialysis. The median age was 66.8 years (range 43–84) and 11 (61.1%) were female. Nine (50%) were residents of a skilled nursing facility. Sixteen (88.9%) patients had a diagnosis of hypertension, 10 (55.6%) had diabetes, and 10 (55.6%) had cardiac disease. Eight patients (44.4%) required hospitalization and 4 patients (22.2%) died from COVID-19 related complications. Two patients with COVID-19 were dialyzing at adjacent dialysis stations and the timing of their symptoms suggested possible transmission in the dialysis facility. In response, education, infection control audits and PPE re-trainings were conducted to bolster infection control practices.

Conclusion

In a high-risk patient dialysis population, we successfully implemented recommended infection control measures to mitigate the spread of SARS-COV-2 in our facilities. Dialysis facilities must stay vigilant and monitor for possible transmission of COVID-19. Regular audits of infection control practices remains critical.