HDCN Abstract:  ASN Annual Meeting 2020 -- Digital Meeting  

Manley HJ, Majchrzak KM, Sanders R, et al.

Screening for SARS-CoV-2 (COVID) Infection in Chronic Dialysis Patients: A Nonprofit Provider's Experience

ASN Annual Meeting 2020 -- Digital Meeting
J Am Soc Nephrol (Oct) 31:32A 2020

BACKGROUND

The CDC recommends screening of all patients for COVID exposure history and or signs and symptoms prior to treatment. In order to limit the spread of COVID within our facilities, Dialysis Clinic Inc. screens all patients prior their in-center hemodialysis treatment or peritoneal dialysis visit consistent with recommendations.

METHODS

We describe the outpatient screening results of our dialysis patients having a positive screen as patients under investigation (PUI) to activate local protocols for isolation and testing. We determined the frequencies of positive screening parameters and rate of identifying COVID patients.

RESULTS

From 2/17 to 5/1, 2020, facilities screened 15,602 patients over 402,002 in-person visits, identifying 959 PUI’s (6%). Among PUIs, 61 of 351 (17%) COVID+ patients were correctly triaged prior to COVID+ diagnosis. In the subset of 788 PUIs screened prior to 4/11/20 where we were able to catalogue reasons for positive screening, 149 (19%) had exposure only and 639 exhibited symptoms (81%), of which 15 had exposure; 34 resided in group home (GH) and 7 had both exposure and GH residence. It was determined 41 (6.4%) were COVID+. Frequency of symptoms elicited by PUI are shown below.

CONCLUSION

959 PUIs were identified and isolated by our screening process, resulting in the successful preemptive triage of 61 COVID+ (6%) patients before testing positive, potentially limiting infection spread in the facility. Cough and fever were the most common reasons for positive screen, and fever was most commonly associated with COVID+ diagnosis. However, the majority (83%) of COVID+ patients were primarily asymptomatic and hence not captured by screening.

COVID-related SymptomCOVID+
(n=41)
Non-COVID
(n=598)
Overall
(n=639)
Cough11 (27%)320 (54%)331 (52%)
Fever (≥100 F)30 (73%)153 (26%)183 (29%)
Shortness of Breaths8 (20%)132 (22%)140 (22%)
Sore Throat1 (2%)138 (23%)139 (22%)
02 Saturation ≤90%6 (15%)60 (10%)66 (10%)
Other Symptom2 (5%)43 (7%)45 (7%)
Chills3 (7%)24 (4%)27 (4%)
Diarrhea5 (12%)16 (3%)21 (3%)
Headache1 (2%)13 (2%)14 (2%)
Vomiting2 (5%)7 (1%)9 (1%)
Abdominal pain0 (0%)3 (1%)3 (0%)

c Copyright 2020 -2021 American Society of Nephrology. Reproduced with permission.
All ASN abstracts from the 2020 Annual Meeting are available at this link and also are archived in .pdf form at ASN-Online.org

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