Many individuals with kidney failure have been unable to self-isolate during the COVID-19 pandemic because they require dialysis treatments in clinics several times a week. New research that will appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN) highlights the risks faced by these patients and the factors involved.
For the study, Ben Caplin (University College London, London, UK) and colleagues, on behalf of the Pan-London COVID-19 Renal Audit Group, examined information on 5,755 patients who received dialysis in 51 clinics in London. Between 2 March and 31 May 2020, a total of 990 (17%) patients tested positive and 465 (8%) were admitted to hospitals with suspected COVID-19.
COVID-19 risks were higher in patients who were older, had diabetes, lived in local communities with higher COVID-19 rates, and received dialysis at dialysis clinics that served a larger number of patients. Risks were lower in patients who received dialysis in clinics with a higher number of available side rooms and that had mask policies for asymptomatic patients. No independent association was seen with sex, ethnicity, or measures of deprivation.
“Taken together, the findings confirm the high rates of symptomatic COVID-19 among patients receiving in-centre dialysis and suggest sources of transmission both within dialysis units and patients’ home communities,” said Caplin. “The work also suggests that, in addition to isolation of confirmed cases, addressing factors that might reduce transmission from patients without suspected or confirmed disease might provide an additional opportunity to further modify the impact of COVID-19 in this population.”