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Statewide evaluation of infection control measures for preventing coronavirus disease 2019 in hemodialysis facilities

  • Guedes, Ana Rubia1
  • Tavares, Bruno de Melo1
  • de Assis, Denise Brandão2
  • Freire, Maristela Pinheiro1
  • Madalosso, Geraldine2
  • Levin, Anna S.1, 3
  • Perdigão, Lauro Vieira Neto1
  • de Oliveira, Maura Salaroli1
  • 1 Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
  • 2 Divisao de Infeccoes Hospitares, Centro de Vigilancia Epidemiologica “Prof. Alexandre Vranjac”, Centro de Controle de Doencas, Secretaria de Estado da Saude, Sao Paulo, SP, BR.
  • 3 Departamento de Doencas Infecciosas, Laboratorio de Investigacao Medica - LIM 49 e Instituto de Medicina Tropical, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Published Article
Faculdade de Medicina / USP
Publication Date
Sep 28, 2021
DOI: 10.6061/clinics/2021/e3299
PMCID: PMC8478131
PubMed Central
  • Original Article


OBJECTIVE: This study aimed to evaluate the occurrence of coronavirus disease 2019 (COVID-19) in hemodialysis facilities and the occurrence of and risk factors for clustering of COVID-19 cases. METHODS: We conducted a cross-sectional online survey between March and July 2020, in all dialysis facilities in São Paulo state, using Google Forms. The online questionnaire contained questions addressing specific components of infection prevention and control practices and the number of cases during the COVID-19 pandemic. RESULTS: A total of 1,093 (5%) COVID-19 cases were reported among 20,984 patients; approximately 56% of the facilities had ≥1 cluster. Most facilities implemented various measures (such as allocation of dedicated COVID-19 areas/shifts, symptom screening, environmental disinfection, and maintenance of adequate ventilation) to prevent the transmission of severe acute respiratory syndrome coronavirus 2. Clustering of COVID-19 cases was suspected in only 7% of dialysis facilities. The only variable associated with this event was the performance of aerosol-generating procedures (odds ratio: 4.74; 95% confidence interval: 1.75-12.86). CONCLUSION: Attention should be paid to avoiding the performance of aerosol-generating procedures in dialysis facilities and monitoring the clustering of cases.

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