Preparation of hemodialysis centers in fighting against the novel coronavirus disease during the 2019-2020 epidemic: the experience in Sichuan province, China.

BACKGROUND: Dialysis patients are at high risk of being infected by the novel coronavirus. This article aimed to share our experience in preparing hemodialysis centers in fighting against the COVID-19 in Sichuan province. METHODS: To control COVID-19, the Sichuan Renal Disease Quality Control Center (SRDQCC) organized a multidisciplinary team to draft and distribute documents for dialysis centers. The SRDQCC also established an online education system and a registry. A survey was used to assess the resources and the preparation of the dialysis centers. Patients with infected COVID-19 were transferred to the referral hospitals and treated with continuous renal replacement therapy (CRRT) in isolated rooms. RESULTS: All 21 regions in Sichuan province had designated specific referral hospitals for COVID-19. The documents drafted by the SRDQCC were distributed to all dialysis centers. A total of 313 records from the survey showed that 96% (301/313) of the dialysis centers had set up an emergency program based on the relevant documents. Only 39% (121/313) of the centers had emergency isolated room(s) for COVID-19. Also, 22% (68/313) of the centers had their patient(s) moved to other centers. The online system educated medical staff in 87% (271/313) of the centers. The online registry received 329 records. Four cases of COVID-19-infected dialysis patients were reported until March 3rd, 2020. There were no outbreaks of COVID-19 in any dialysis center in Sichuan province. CONCLUSIONS: The experience of dialysis centers in Sichuan province in fighting against COVID-19 is worth sharing. Dialysis centers need to be prepared to cope with infectious epidemics guided by national as well as regional quality control centers or other similar organizations.

Impact of vaccination on the spread of SARS-CoV-2 infection in north-east Italy nursing homes. A propensity score and risk analysis.

BACKGROUND: In the Veneto Region, 421,000 coronavirus 2019 disease (COVID-19) cases and 11,000 deaths have been reported since 21 February 2020. The pandemic spread particularly in nursing homes (NH). OBJECTIVE: This study estimated the impact of SARS-CoV-2 infection among NH residents, focusing on the risk of hospitalisation and death due to COVID-19 compared with the general older population. It also provided evidence of risk changes over time. METHODS: Older people, resident in Veneto, were enrolled from the regional registry of the population. We collected also information about demographic characteristics, chronic diseases, COVID-19 positivity, NH institutionalization, hospitalisation and date of death. Patients were assigned to NH or non-NH residents groups through a propensity score 1:1 matching. The follow-up period was defined as 21 February 2020 - 3 May 2021 and then divided into three waves. Risk ratios (RRs) and 95% confidence interval were estimated by using Poisson models with robust estimation of variance. RESULTS: NH residents showed a higher risk of COVID-19 infection (RR = 6.28; 6.03-6.54), hospitalisation for COVID-19 (RR = 2.20; 2.05-2.36) and death with COVID-19 (RR = 6.07; 5.58-6.61). CONCLUSION: NH residents shared common spaces with other patients and healthcare professionals and were more exposed to infections. Nonetheless, in Italy from late December 2020 to May 2021, 95% of NH residents and their healthcare professionals received at least one vaccine dose and RRs for all outcomes decreased in NH.

A rapid near-patient RT-PCR test for suspected COVID-19: a study of the diagnostic accuracy.

BACKGROUND: Management of large numbers of reverse transcriptase-polymerase chain reactions (RT-PCR) for diagnosis of coronavirus 2019 disease (COVID-19) requires robust infrastructures, located in dedicated premises with a high standard of biosafety procedures, and well-trained personnel. The handling of a "run-of-river sample" to obtain rapid reporting of results is challenging. METHODS: We studied the clinical performance of the Idylla™ SARS-CoV-2 Test (index test) on a platform capable of fully automated nucleic acid testing including extraction, amplification, and detection in a single-use cartridge to establish the diagnosis of COVID-19. The study was conducted on a prospective cohort of 112 volunteers with recent symptoms and an unknown SARS-CoV-2 status who came to free screening centers of the Nice metropolitan area. All subjects underwent bilateral nasopharyngeal sampling. One sample was processed using the index test, the other using the standard of care RT-PCR. Samples were treated blind. RESULTS: Most of the participants (70%) were sampled within 4 days of symptom onset. Forty-five (40.2%) were positive for COVID-19. No clinical symptoms were distinguished between SARS-CoV-2 RT-PCR positive and negative subjects except anosmia and dysgeusia. Positive and negative agreement between the index and the standard of care test was 100%. CONCLUSIONS: The Idylla™ SARS-CoV-2 Test is very sensitive, specific, rapid and easy to use in a near-patient RT-PCR approach to distinguish between symptomatic SARS-CoV-2 positive and negative patients in selected settings.