Transmission of SARS-CoV-2 Considering Shared Chairs in Outpatient Dialysis: A Real-World Case-Control Study

Autor: Lemuel Rivera Fuentes, Franklin W. Maddux, Catherine Wang, Len A. Usvyat, John W. Larkin, Jeffrey Hymes, Robert J. Kossmann, Joanna Willetts, Yuedong Wang, Peter Kotanko, Ravi Thadhani, Kathleen Belmonte, Hanjie Zhang
Rok vydání: 2021
Předmět:
Nephrology
Male
medicine.medical_treatment
Medical care
Ambulatory Care Facilities
law.invention
Kidney Failure
law
Outpatients
Infection control
skin and connective tissue diseases
Environmental exposure
Middle Aged
Positive patient
Virus Shedding
Transmission (mechanics)
Fomites
Hemodialysis
Female
Interior Design and Furnishings
Risk
medicine.medical_specialty
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Article
End stage renal disease
Renal Dialysis
Internal medicine
Diabetes mellitus
medicine
Humans
Dialysis
Aged
Retrospective Studies
Infection Control
business.industry
SARS-CoV-2
Research
fungi
Case-control study
COVID-19
Retrospective cohort study
Environmental Exposure
Models
Theoretical
medicine.disease
United States
Diseases of the genitourinary system. Urology
body regions
Logistic Models
Case-Control Studies
RC870-923
End Stage Renal Disease
business
Zdroj: BMC Nephrology
BMC Nephrology, Vol 22, Iss 1, Pp 1-10 (2021)
medRxiv
Popis: BackgroundSARS-CoV-2 is primarily transmitted through aerosolized droplets; however, the virus can remain transiently viable on surfaces.ObjectiveWe examined transmission within hemodialysis facilities, with a specific focus on the possibility of indirect patient-to-patient transmission through shared dialysis chairs.DesignWe used real-world data from hemodialysis patients treated between February 1stand June 8th, 2020 to perform a case-control study matching each SARS-CoV-2 positive patient (case) to a non-SARS-CoV-2 patient (control) in the same dialysis shift and traced back 14 days to capture possible exposure from chairs sat in by SARS-CoV-2 patients. Cases and controls were matched on age, sex, race, facility, shift date, and treatment count.Setting2,600 hemodialysis facilities in the United States.PatientsAdult (age ≥18 years) hemodialysis patients.MeasurementsConditional logistic regression models tested whether chair exposure after a positive patient conferred a higher risk of SARS-CoV-2 infection to the immediate subsequent patient.ResultsAmong 170,234 hemodialysis patients, 4,782 (2.8%) tested positive for SARS-CoV-2 (mean age 64 years, 44% female). Most facilities (68.5%) had 0 to 1 positive SARS-CoV-2 patient. We matched 2,379 SARS-CoV-2 positive cases to 2,379 non-SARS-CoV-2 controls; 1.30% (95%CI 0.90%, 1.87%) of cases and 1.39% (95%CI 0.97%, 1.97%) of controls were exposed to a chair previously sat in by a shedding SARS-CoV-2 patient. Transmission risk among cases was not significantly different from controls (OR=0.94; 95%CI 0.57 to 1.54; p=0.80). Results remained consistent in adjusted and sensitivity analyses.LimitationAnalysis used real-world data that could contain errors and only considered vertical transmission associated with shared use of dialysis chairs by symptomatic patients.ConclusionsThe risk of indirect patient-to-patient transmission of SARS-CoV-2 infection from dialysis chairs appears to be low.Primary Funding SourceFresenius Medical Care North America; National Institute of Diabetes and Digestive and Kidney Diseases (R01DK130067)
Databáze: OpenAIRE
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