Practical indications for the prevention and management of SARS-CoV-2 in ambulatory dialysis patients: lessons from the first phase of the epidemics in Lombardy
Giuseppe Rombolà, Marco Heidempergher, Luciano Pedrini, Marco Farina, Filippo Aucella, Piergiorgio Messa, Giuliano Brunori, Giuseppe Rombolà, Marco Heidempergher, Luciano Pedrini, Marco Farina, Filippo Aucella, Piergiorgio Messa, Giuliano Brunori
Abstract
Confronting the SARS-CoV-2 outbreak has allowed us to appreciate how efficiently highly-resourced settings can respond to crises. However even such settings are not prepared to deal with the situation, and lessons are only slowly being learnt. There is still an urgent need to accelerate protocols that lead to the implementation of rapid point-of-care diagnostic testing and effective antiviral therapies. In some high-risk populations, such as dialysis patients, where several individuals are treated at the same time in a limited space and overcrowded areas, our objective must be to ensure protection to patients, the healthcare team and the dialysis ward. The difficult Italian experience may help other countries to face the challenges. The experience of the Lombardy underlines the need for gathering and sharing our data to increase our knowledge and support common, initially experience-based, and as soon as possible evidence-based position to face this overwhelming crisis.
Conflict of interest statement
None.
References
- . Accessed 3 Mar 2020
- Guan WJ, Ni ZY, Hu Y, China Medical Treatment Expert Group for Covid-19 et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 doi: 10.1056/NEJMoa2002032.
- Zhang W, Du RH, Li B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020;9(1):386–389. doi: 10.1080/22221751.2020.1729071.
- Bai Y, Yao L, Wei T, et al. Presumed asymptomatic carrier transmission of COVID-19. JAMA. 2020 doi: 10.1001/jama.2020.2565.
- Hellewell J, Abbott S, Gimma A, et al. Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. Lancet Glob Health. 2020 doi: 10.1016/S2214-109X(20)30074-7.
- Boyce JM, Hymes JL. What we learned from Ebola: preparing dialysis units for the next outbreak. Clin J Am SocNephrol. 2018;13(4):669–670. doi: 10.2215/CJN.11061017.
- Ahmed AE, Alshukairi AN, Al-Jahdali H, et al. Development of a risk-prediction model for Middle East respiratory syndrome coronavirus infection in dialysis patients. Hemodial Int. 2018;22(4):474–479. doi: 10.1111/hdi.12661.
- Peeri NC, Shrestha N, Rahman MS, et al. The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? Int J Epidemiol. 2020 doi: 10.1093/ije/dyaa033.
- Syed-Ahmed M, Narayanan M. Immune dysfunction and risk of infection in chronic kidney disease. Adv Chronic Kidney Dis. 2019;26(1):8–15. doi: 10.1053/j.ackd.2019.01.004.
- Betjes MG. Immune cell dysfunction and inflammation in end-stage renal disease. Nat Rev Nephrol. 2013;9(5):255–265. doi: 10.1038/nrneph.2013.44.
- Naicker S, Yang C, Hwang S, Liu C, Jha V. The 2019 Coronavirus epidemics and kidney disease. Kidney Int. 2020 doi: 10.1016/j.kint.2020.03.001.
- Smith N, Fraser M. Straining the system: novel coronavirus (COVID-19) and preparedness for concomitant disasters. Am J Public Health. 2020 doi: 10.2105/AJPH.2020.305618.
- Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020 doi: 10.1093/jtm/taaa020.
Source: PubMed