Jang-Hee Cho1, Seok Hui Kang2, Hayne Cho Park3, Dong Ki Kim4, Sang-Ho Lee5, Jun Young Do2, Jong Won Park2, Seong Nam Kim6, Myeong Seong Kim7, Kyubok Jin8, Gun Woo Kang9, Sun-Hee Park1, Yong-Lim Kim1, Young-Ki Lee10. 1. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. 2. Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea. 3. Department of Internal Medicine, Hallym University College of Medicine, Hallym Kidney Research Institute, Seoul, Korea. 4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. 5. Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea km2071@naver.com. 6. Department of Internal Medicine, Kim Seong Nam Internal Medicine Clinic, Seoul, Republic of Korea. 7. Department of Internal Medicine, Gojan Myeong Internal Medicine Clinic, Ansan, Republic of Korea. 8. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea. 9. Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea. 10. Department of Internal Medicine, Hallym University College of Medicine, Hallym Kidney Research Institute, Seoul, Korea km2071@naver.com.
Abstract
BACKGROUND: Health care-associated infections during previous coronavirus epidemics involving severe acute respiratory syndrome and Middle East respiratory syndrome resulted from human-to-human transmission in hemodialysis (HD) facilities. The effect of a strategy of HD with cohort isolation-separate dialysis sessions for close contacts of patients with confirmed coronavirus disease 2019 (COVID-19)-on the prevention of secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in HD units is unknown. METHODS: Our multicenter cohort study of an HD with cohort isolation strategy enrolled close contacts of patients with confirmed COVID-19, including patients on HD and health care workers in HD units. Close contacts had been identified by epidemiologic investigation and tested negative on an immediate screening test for SARS-CoV-2. RESULTS: As of March 14, 11 patients on HD and 7 health care workers from 11 HD centers were diagnosed as having COVID-19. The immediate screening test was performed in 306 people, and among them, 302 close contacts with negative test results were enrolled. HD with cohort isolation was performed among all close contacts for a median of 14 days in seven centers. During cohort isolation, nine patients showed symptoms but tested negative for SARS-CoV-2. Two health care workers in the HD units (0.66% of the total group) were diagnosed at the termination test for SARS-CoV-2. CONCLUSIONS: The transmission of COVID-19 can be controlled without closure of HD centers by implementing preemptive activities, including early detection with rapid testing, cohort isolation, collaboration between institutions, and continuous monitoring of infection. Our strategy and experience may provide helpful guidance for circumstances involving the rapid spread of infectious diseases such as COVID-19.
BACKGROUND: Health care-associated infections during previous coronavirus epidemics involving severe acute respiratory syndrome and Middle East respiratory syndrome resulted from human-to-human transmission in hemodialysis (HD) facilities. The effect of a strategy of HD with cohort isolation-separate dialysis sessions for close contacts of patients with confirmed coronavirus disease 2019 (COVID-19)-on the prevention of secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in HD units is unknown. METHODS: Our multicenter cohort study of an HD with cohort isolation strategy enrolled close contacts of patients with confirmed COVID-19, including patients on HD and health care workers in HD units. Close contacts had been identified by epidemiologic investigation and tested negative on an immediate screening test for SARS-CoV-2. RESULTS: As of March 14, 11 patients on HD and 7 health care workers from 11 HD centers were diagnosed as having COVID-19. The immediate screening test was performed in 306 people, and among them, 302 close contacts with negative test results were enrolled. HD with cohort isolation was performed among all close contacts for a median of 14 days in seven centers. During cohort isolation, nine patients showed symptoms but tested negative for SARS-CoV-2. Two health care workers in the HD units (0.66% of the total group) were diagnosed at the termination test for SARS-CoV-2. CONCLUSIONS: The transmission of COVID-19 can be controlled without closure of HD centers by implementing preemptive activities, including early detection with rapid testing, cohort isolation, collaboration between institutions, and continuous monitoring of infection. Our strategy and experience may provide helpful guidance for circumstances involving the rapid spread of infectious diseases such as COVID-19.
Authors: Abdullah Assiri; Allison McGeer; Trish M Perl; Connie S Price; Abdullah A Al Rabeeah; Derek A T Cummings; Zaki N Alabdullatif; Maher Assad; Abdulmohsen Almulhim; Hatem Makhdoom; Hossam Madani; Rafat Alhakeem; Jaffar A Al-Tawfiq; Matthew Cotten; Simon J Watson; Paul Kellam; Alimuddin I Zumla; Ziad A Memish Journal: N Engl J Med Date: 2013-06-19 Impact factor: 91.245
Authors: Abdullah Assiri; Glen R Abedi; Abdulaziz A Bin Saeed; Mutwakil A Abdalla; Malak al-Masry; Abdul Jamil Choudhry; Xiaoyan Lu; Dean D Erdman; Kathleen Tatti; Alison M Binder; Jessica Rudd; Jerome Tokars; Congrong Miao; Hussain Alarbash; Randa Nooh; Mark Pallansch; Susan I Gerber; John T Watson Journal: Emerg Infect Dis Date: 2016-01 Impact factor: 6.883
Authors: Anwar E Ahmed; Abeer N Alshukairi; Hamdan Al-Jahdali; Mody Alaqeel; Salma S Siddiq; Hanan A Alsaab; Ezzeldin A Sakr; Hamed A Alyahya; Munzir M Alandonisi; Alaa T Subedar; Nouf M Aloudah; Salim Baharoon; Majid A Alsalamah; Sameera Al Johani; Mohammed G Alghamdi Journal: Hemodial Int Date: 2018-04-14 Impact factor: 1.812
Authors: Stephen A Lauer; Kyra H Grantz; Qifang Bi; Forrest K Jones; Qulu Zheng; Hannah R Meredith; Andrew S Azman; Nicholas G Reich; Justin Lessler Journal: Ann Intern Med Date: 2020-03-10 Impact factor: 25.391
Authors: Candice Clarke; Maria Prendecki; Amrita Dhutia; Mahrukh A Ali; Hira Sajjad; Oshini Shivakumar; Liz Lightstone; Peter Kelleher; Matthew C Pickering; David Thomas; Rawya Charif; Megan Griffith; Stephen P McAdoo; Michelle Willicombe Journal: J Am Soc Nephrol Date: 2020-07-30 Impact factor: 10.121
Authors: Bruce M Robinson; Murilo Guedes; Mohammed Alghonaim; Aleix Cases; Indranil Dasgupta; Liangying Gan; Stefan H Jacobson; Talerngsak Kanjanabuch; Yong-Lim Kim; Werner Kleophas; Laura Labriola; Rachel L Perlman; Gianpaolo Reboldi; Vesh Srivatana; Rita S Suri; Kazuhiko Tsuruya; Pablo Urena Torres; Ronald L Pisoni; Roberto Pecoits-Filho Journal: Kidney Med Date: 2021-05-14
Authors: Samira Bell; Jacqueline Campbell; Jackie McDonald; Martin O'Neill; Chrissie Watters; Katharine Buck; Zoe Cousland; Mark Findlay; Nazir I Lone; Wendy Metcalfe; Shona Methven; Robert Peel; Alison Almond; Vinod Sanu; Elaine Spalding; Peter C Thomson; Patrick B Mark; Jamie P Traynor Journal: BMC Nephrol Date: 2020-10-01 Impact factor: 2.388