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Abstract: PO0737

Network Analysis of In-Center Spread of COVID-19: A Single Dialysis Center Experience

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Rivera Fuentes, Lemuel, Renal Research Institute, New York, New York, United States
  • Zhang, Hanjie, Renal Research Institute, New York, New York, United States
  • Cherif, Alhaji, Renal Research Institute, New York, New York, United States
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
Background

The need to continue in-center hemodialysis (HD) during COVID-19 pandemic presents a risk of transmission for patients and staff members. The present study aimed to determine if the periodic interactions among patients and staff resulted in spread of COVID-19 in a HD center during a period of 2 months

Methods

This is a retrospective analysis on a HD center in New York City (172 patients, 32 staff members, 26 chairs, MWF and TTS schedules, and 4 shifts/day). From March 2nd to April 24th we recorded every HD treatment (chair, patient, and staff member involved in care). We kept dated records for positive COVID-19 cases (patients and staff). To estimate the patient-to-patient interaction, we obtained the location coordinates of each dialysis chair, calculated the Euclidian distance between them and weighted the interaction by proximity between chairs. We conducted network analysis to assess these interactions

Results

During the study period, 16 patients and 2 staff members became COVID-19 positive. As shown in Figure 1(a), there were 3 chairs (2, 24, and 25) that had more than 1 positive patient. Clusters in chairs 2 and 25 were ruled out based on a lack of direct contact between the involved patients (at least 2 shifts separating them at all times; no in-between patients became positive); chair 2 had a nonviable temporal direction of transmission. Based on schedule, shift, and a 14-day incubation period, the cluster in chair 24 was dismissed. This was corroborated by network analysis [Fig. 1(b)] where the purple dots represent the COVID-19 positive patients, the blue dots represent negative patients (same shift/schedule), and the edges represent the weighted patient-to-patient interaction. We reasoned that more exposed patients would have had a higher chance of becoming infected. Similar information was found for staff-to-patient interaction

Conclusion

Based on our analysis we consider that for patient-to-patient, staff-to-patient, and staff-to-staff interactions, in-center spread of COVID-19 was unlikely

Figure 1(a)infection history;(b)network analysis patient interaction

Funding

  • Private Foundation Support