Strategies to prevent SARS-CoV-2 transmission in hemodialysis centres across Europe—lessons for the future
Authors: Noordzij Marlies , Meijers Björn , Gansevoort Ron T , Covic Adrian , Duivenvoorden Raphaël , Hilbrands Luuk B , Hemmelder Marc H , Jager Kitty J , Mjoen Geir , Nistor Ionut , Parshina Ekaterina , Pessolano Giuseppina , Tuglular Serhan , Vart Priya , Zanoli Luca , Franssen Casper F M ,   ERACODA collaborators, van der Net Jeroen B , Essig Marie , du Buf-Vereijken Peggy W G , van Ginneken Betty , Maas Nanda , van Jaarsveld Brigit C , Bemelman Frederike J , Klingenberg-Salahova Farah , Vervloet Marc G , Nurmohamed Azam , Vogt Liffert , Abramowicz Daniel , Verhofstede Sabine , Maoujoud Omar , Malfait Thomas , Fialova Jana , Lips Joy , Hengst Maaike , Konings Constantijn , Rydzewski Andrzej , Oliveira João , Zakharova Elena V , Lepeytre Fanny , Rabaté Clémentine , Rostoker Guy , Marques Sofia , Azasevac Tijana , Majstorovic Gordana Strazmester , Fricke Lutz , Slebe Jeroen J P , ElHafeez Samar Abd , El-Wakil Hala S , Verhoeven Martine , Logan Ian , Panagoutsos Stylianos , Mallamaci Francesca , Postorino Adele , Cambareri Francesco , Matceac Irina , Groeneveld J H M , Jousma Jolanda , van Buren Marjolijn , Pereira Tiago Assis , Arias-Cabrales Carlos , Crespo Marta , Llinàs-Mallol Laura , Buxeda Anna , Tàrrega Carla Burballa , Redondo-Pachon Dolores , Jimenez Maria Dolores Arenas , Mendoza-Valderrey Alberto , Martins Ana Cristina , Mateus Catarina , Alvila Goncalo , Laranjinha Ivo , Arroyo David , Castellano Sandra , Rodríguez-Ferrero Maria Luisa , Lemahieu Wim , Dirim Ahmet Burak , Demir Erol , Sever Mehmet Sukru , Turkmen Aydin , Şafak Seda , Hollander Daan A M J , Büttner Stefan , Sridharan Sivakumar , van der Sande Frank M , Christiaans Maarten H L , Di Luca Marina , Beerenhout Charles , Adema Aaltje Y , Stepanov Vadim A , Zulkarnaev Alexey B , Turkmen Kultigin , Fliedner Anselm , Åsberg Anders , Pini Stefano , de Biase Consuelo , Kerckhoffs Angele , Els van de Logt Anne , Maas Rutger , Lebedeva Olga , Reichert Louis J M , Verhave Jacobien , Marcantoni Carmelita , van Gils-Verrij Liesbeth E A , Battaglia Yuri , Lentini Paolo , Cabezas-Reina Carlos J , Roca Ana Maria , Nauta Ferdau , Goffin Eric , Kanaan Nada , Labriola Laura , Devresse Arnaud , Coca Armando , Naesens Maarten , Kuypers Dirk , Desschans Bruno , Dedinska Ivana , Malik Shafi , Berger Stefan P , Sanders Jan Stephan F , Özyilmaz Akin , Ponikvar Jadranka Buturović , Pernat Andreja Marn , Kovac Damjan , Arnol Miha , Abrahams Alferso C , Molenaar Femke M , van Zuilen Arjan D , Meijvis Sabine C A , Dolmans Helma , Esposito Pasquale , Krzesinski Jean-Marie , Barahira Jean Damacène , Gallieni Maurizio , Guglielmetti Gabriele , Guzzo Gabriella , Luik Antinus J , van Kuijk Willi H M , Stikkelbroeck Lonneke W H , Hermans Marc M H , Rimsevicius Laurynas , Righetti Marco , Islam Mahmud , Heitink-ter Braak Nicole 
Published: December 2022

Background

Early reports on the pandemic nature of coronavirus disease 2019 (COVID-19) directed the nephrology community to develop infection prevention and control (IPC) guidance. We aimed to make an inventory of strategies that dialysis centres followed to prevent infection with COVID-19 in the first pandemic wave.

Methods

We analyzed IPC measures taken by hemodialysis centres treating patients presenting with COVID-19 between 1 March 2020 and 31 July 2020 and that completed the European Renal Association COVID-19 Database centre questionnaire. Additionally, we made an inventory of guidelines published in European countries to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in dialysis centres.

Results

Data from 73 dialysis units located in and bordering Europe were analyzed. All participating centres implemented IPC measures to mitigate the impact of SARS-CoV-2 during the first pandemic wave. Measures mentioned most often included triage with questions before entering the dialysis ward, measuring body temperature, hand disinfection, masking for all patients and staff, and personal protective equipment for staff members. These measures were also recommended in most of the 14 guidelines that were identified in the inventory of national guidelines and were also scored as being among the most important measures by the authors of this paper. Heterogeneity existed between centres and national guidelines regarding the minimal distance between dialysis chairs and recommendations regarding isolation and cohorting.

Conclusions

Although variation existed, measures to prevent transmission of SARS-CoV-2 were relatively similar across centres and national guidelines. Further research is needed to assess causal relationships between measures taken and spread of SARS-CoV-2.