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World J Virol. Sep 25, 2021; 10(5): 264-274
Published online Sep 25, 2021. doi: 10.5501/wjv.v10.i5.264
COVID-19 in dialysis units: A comprehensive review
Gabriel Martins Nogueira, Moisés Santana Oliveira, Ana Flávia Moura, Constança Margarida Sampaio Cruz, José A Moura-Neto
Gabriel Martins Nogueira, Moisés Santana Oliveira, Department of Medicine, Bahiana School of Medicine and Public Health, Salvador 40290-000, Brazil
Ana Flávia Moura, Constança Margarida Sampaio Cruz, José A Moura-Neto, Department of Internal Medicine, Bahiana School of Medicine and Public Health, Salvador 40290-000, Brazil
Constança Margarida Sampaio Cruz, Department of Internal Medicine, Hospital Santo Antônio, Salvador 40415-006, Brazil
Author contributions: Nogueira GM and Oliveira MS collected and read the base material and wrote the paper; Moura AF, Cruz CMS and Moura-Neto JA reviewed the paper and added relevant information.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: José A Moura-Neto, MD, FASN, Professor, Department of Internal Medicine, Bahiana School of Medicine and Public Health, Av. Dom João VI, 275 - Brotas, Salvador 40290-000, Brazil. mouraneto@bahiana.edu.br
Received: April 21, 2021
Peer-review started: April 21, 2021
First decision: June 7, 2021
Revised: June 21, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: September 25, 2021
Processing time: 148 Days and 7.6 Hours
Abstract

The coronavirus disease 2019 (COVID-19) pandemic has been challenging for healthcare professionals worldwide. One of the populations affected by the pandemic are patients on renal replacement therapy, as kidney disease is an independent risk factor for severe COVID-19 and maintenance dialysis (a life-sustaining therapy) cannot be interrupted in the vast majority of cases. Over the past months, several authors and medical societies have published recommendations and guidelines on the management of this population. This article is a comprehensive review regarding the measures to prevent, contain and deal with a COVID-19 pandemic in the dialysis setting. We recapitulate the epidemiology and pathophysiology of COVID-19 in kidney dysfunction and present the main recommendations concerning the screening of healthcare personnel, dialysis patients and visitors as well as measures to improve the safety of the dialysis facilities’ environments. In addition to preventive measures, this article briefly describes actions directed towards management of an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within a dialysis facility, the management of complications in dialysis patients with COVID-19 and overall data regarding the management of children with kidney disease.

Keywords: COVID-19; SARS-CoV-2; Renal dialysis; Renal replacement therapy; Hemodialysis units, Hospital

Core Tip: Dialysis patients are more vulnerable to develop severe coronavirus disease 2019 (COVID-19) infection. To minimize risks, some measures should be followed by dialysis units, healthcare personnel, patients and visitors. Until vaccination against COVID-19 is widely available to dialysis patients worldwide, an evidence-based approach is required to avoid the spread of the virus and consequently more death of patients.