Yuka Sugawara1, Masao Iwagami2,3, Yoko Yoshida1, Kan Kikuchi4, Ryoichi Ando5, Toshio Shinoda6, Munekazu Ryuzaki7, Hidetomo Nakamoto8, Ken Sakai9, Norio Hanafusa10, Naoki Kashihara11, Masaomi Nangaku12. 1. Division of Nephrology and Endocrinology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 2. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. 3. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. 4. Division of Nephrology, Shimoochiai Clinic, Tokyo, Japan. 5. Department of Nephrology, Seishokai Memorial Hospital, Tokyo, Japan. 6. Faculty of Medical and Health Sciences, Tsukuba International University, Tsuchiura, Japan. 7. Department of Nephrology, Tokyo Saiseikai Central Hospital, Tokyo, Japan. 8. Department of General Internal Medicine, Saitama Medical University, Saitama, Japan. 9. Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan. 10. Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan. 11. Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan. 12. Division of Nephrology and Endocrinology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. mnangaku-tky@umin.ac.jp.
Abstract
BACKGROUND: There are no reports of a large-scale survey on the infection prevention measures against coronavirus disease 2019 (COVID-19) in nephrology facilities. This study investigated the facility-level nephrology practices adopted during the COVID-19 pandemic and their associated challenges. Additionally, the treatment patterns and outcomes of chronic kidney disease (CKD) patients with COVID-19 were reviewed. METHODS: We conducted a nationwide questionnaire survey of 704 educational facilities that were certified by the Japanese Society of Nephrology (JSN) from October 20, 2020 to November 16, 2020. The questionnaire reviewed the facility characteristics, infection prevention measures taken during routine nephrology practice, impact of COVID-19 on nephrology practice, experiences in managing CKD patients with COVID-19, and nosocomial transmission in the nephrology unit. RESULTS: Of the 347 facilities that responded, 95.1% checked outpatients' body temperatures and COVID-19 symptoms at their visits. To reduce face-to-face contact, 80% and 70% of the facilities lengthened the intervals between outpatient visits and introduced online/telephonic consultations, respectively. As a result, more than half of the hospitals experienced a decrease in the numbers of outpatients and inpatients (64% and 50%, respectively). During the study period, 347 facilities managed 479 CKD patients with COVID-19. Oxygen administration and mechanical ventilation were performed for 47.8% and 16.5% of the patients, respectively, with a 9.2% total mortality rate. CONCLUSION: This survey demonstrated that JSN-certified educational nephrology facilities adopted multiple measures to manage the COVID-19 pandemic; however, they faced several challenges. Sharing these experiences could standardize these approaches and prepare us better for the future.
BACKGROUND: There are no reports of a large-scale survey on the infection prevention measures against coronavirus disease 2019 (COVID-19) in nephrology facilities. This study investigated the facility-level nephrology practices adopted during the COVID-19 pandemic and their associated challenges. Additionally, the treatment patterns and outcomes of chronic kidney disease (CKD) patients with COVID-19 were reviewed. METHODS: We conducted a nationwide questionnaire survey of 704 educational facilities that were certified by the Japanese Society of Nephrology (JSN) from October 20, 2020 to November 16, 2020. The questionnaire reviewed the facility characteristics, infection prevention measures taken during routine nephrology practice, impact of COVID-19 on nephrology practice, experiences in managing CKDpatients with COVID-19, and nosocomial transmission in the nephrology unit. RESULTS: Of the 347 facilities that responded, 95.1% checked outpatients' body temperatures and COVID-19 symptoms at their visits. To reduce face-to-face contact, 80% and 70% of the facilities lengthened the intervals between outpatient visits and introduced online/telephonic consultations, respectively. As a result, more than half of the hospitals experienced a decrease in the numbers of outpatients and inpatients (64% and 50%, respectively). During the study period, 347 facilities managed 479 CKDpatients with COVID-19. Oxygen administration and mechanical ventilation were performed for 47.8% and 16.5% of the patients, respectively, with a 9.2% total mortality rate. CONCLUSION: This survey demonstrated that JSN-certified educational nephrology facilities adopted multiple measures to manage the COVID-19 pandemic; however, they faced several challenges. Sharing these experiences could standardize these approaches and prepare us better for the future.
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Authors: Kunihiro Matsushita; Shoshana H Ballew; Brad C Astor; Paul E de Jong; Ron T Gansevoort; Brenda R Hemmelgarn; Andrew S Levey; Adeera Levin; Chi-Pang Wen; Mark Woodward; Josef Coresh Journal: Int J Epidemiol Date: 2012-12-12 Impact factor: 7.196
Authors: Elizabeth J Williamson; Alex J Walker; Krishnan Bhaskaran; Seb Bacon; Chris Bates; Caroline E Morton; Helen J Curtis; Amir Mehrkar; David Evans; Peter Inglesby; Jonathan Cockburn; Helen I McDonald; Brian MacKenna; Laurie Tomlinson; Ian J Douglas; Christopher T Rentsch; Rohini Mathur; Angel Y S Wong; Richard Grieve; David Harrison; Harriet Forbes; Anna Schultze; Richard Croker; John Parry; Frank Hester; Sam Harper; Rafael Perera; Stephen J W Evans; Liam Smeeth; Ben Goldacre Journal: Nature Date: 2020-07-08 Impact factor: 49.962