NURSING home residents receiving haemodialysis for chronic kidney disease may be at greater risk of COVID-19. Researchers at the Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, identified residents at a nursing home, an already vulnerable population, who were found to have repeated and prolonged exposure to the virus.
An outbreak of infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in a nursing home with 170 residents in Maryland. Within the vulnerable population in nursing homes, COVID-19 can spread rapidly and long-term care facilities may see high numbers of confirmed cases and deaths. In the nursing home, 29 out of 32 patients receiving dialysis from an on-site haemodialysis centre were tested for exposure to SARS-CoV-2, of whom 15 tested positive (47%), compared to only 16% of the residents in the home not receiving dialysis. Mr Benjamin Bigelow, medical student and lead author, commented: “Based on our results, we believe that nursing home residents undergoing dialysis are more likely than others in a facility to have repeated and prolonged exposures to the SARS-CoV-2 virus, and therefore may be at greater risk of infection and subsequent COVID-19.”
The researchers highlighted the importance of clear and ongoing communication between nursing homes and dialysis centres to ensure prevention of infection when the resident is being transported for dialysis and during the procedure itself. Consideration for these practices are important in preventing COVID-19 outbreaks in this vulnerable population. The researchers also suggested careful monitoring and prioritisation of testing for those who have come into contact with dialysis staff with previous exposure to SARS-CoV-2. “Identifying cases early, along with aggressive infection prevention and control, are the keys to protecting those in nursing homes with chronic kidney disease and who are most at risk during the pandemic,” stated senior author, Dr Morgan Katz.