Clinical characteristics of COVID-19 infection in a dialysis center during a nosocomial outbreak.

ABSTRACT

BACKGROUND: Blood purification therapy is a treatment method, wherein many patients gather in the same space to receive regular treatments, possibly increasing the risk of contracting the coronavirus disease 2019 (COVID-19) through contact, droplet, and aerosol. We experienced a nosocomial outbreak and evaluated the clinical characteristics of COVID-19 infection in patients undergoing blood purification therapy. METHODS: We retrospectively analyzed 28 patients who underwent blood purification therapy at the dialysis center of our hospital from April 2, 2020, to April 29, 2020. Logistic regression analysis was performed to identify clinical factors related to COVID-19 for 18 patients who were tested using real-time reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: Of the 28 patients, seven were COVID-19 positive, as confirmed by RT-PCR. The median age was 77 years, 22 patients were male (79%), four patients had acute kidney injury (14%), and six patients were bedridden (21%). All infected patients had been admitted to the wards where the nosocomial outbreak had occurred. Logistic regression analysis revealed that being bedridden (odds ratio 13.33, 95% confidence interval 1.05-169.56, p < 0.05) was significantly related to COVID-19 infection. However, the Charlson comorbidity index, receiving dialysis in the same room, and adjacency of the dialysis bed to COVID-19-positive patients before the confirmation of infection did not reveal any significant relationship. CONCLUSION: Bedridden patients admitted to nosocomial infection wards were associated with COVID-19 infection, and transmission within the dialysis center was not observed. More rigorous infection control measures need to be implemented for bedridden patients undergoing blood purification therapy.