Introduction. Patients receiving in-center hemodialysis are extremely vulnerable to COVID-19. It is unclear if routine screening of asymptomatic hemodialysis patients is an effective strategy to prevent COVID-19 outbreaks within the dialysis unit. Methods. We conducted a retrospective analysis of in-center hemodialysis patients who underwent bimonthly COVID-19 rapid antigen test screening from February 15(th) to December 26(th), 2021. Nasal rapid antigen testing was performed in all asymptomatic patients. All rapid antigen-positive tests were confirmed by RT-PCR nasopharyngeal swab. Besides universal rapid antigen screening, RT-PCR testing was conducted in all symptomatic patients and contacts of COVID-19 subjects. Results. Overall, 4079 rapid antigen tests were performed in 277 hemodialysis patients on chronic hemodialysis with a mean age of 68.4 +/- 14.6 years. Thirty-eight (0.9%) rapid antigen tests resulted positive. Only five (13.8%) positive-rapid antigen tests were also positive by RT-PCR testing. During the same period, 219 patients regularly screened by rapid antigen tests bimonthly underwent 442 RT-PCR nasopharyngeal swabs for clinical reasons. RT-PCR testing yielded a positive result in 13 (5.9%) patients. The time elapsed between PCR and the negative-rapid antigen test was 7.7 +/- 4.6 days (range 1.8-13.9 days). At the end of the follow-up, 6.4% of the population on in-center hemodialysis contracted COVID-19, and routine rapid antigen tests detected only 5 out of 18 (27.7%) COVID-19 cases. No outbreaks of COVID-19 were identified within the dialysis unit. Conclusion. Bimonthly rapid antigen screening led to the early diagnosis of COVID-19 in less than one-third of cases. The short incubation period of the new SARS-CoV-2 variants makes bimonthly test screening inadequate for an early diagnosis of COVID-19. More frequent tests are probably necessary to improve the utility of COVID-19 nasal rapid antigen test in patients on hemodialysis.

COVID-19 Rapid Antigen Test Screening in Patients on Hemodialysis / Alfano, Gaetano; Scarmignan, Roberta; Morisi, Niccolò; Fontana, Francesco; Giovanella, Silvia; Ligabue, Giulia; Rofrano, Laura; Gennari, William; Pecorari, Monica; Gregorini, Mariacristina; Cappelli, Gianni; Magistroni, Riccardo; Donati, Gabriele. - In: INTERNATIONAL JOURNAL OF NEPHROLOGY. - ISSN 2090-214X. - 2022:(2022), pp. 1-5. [10.1155/2022/4678717]

COVID-19 Rapid Antigen Test Screening in Patients on Hemodialysis

Alfano, Gaetano;Scarmignan, Roberta;Fontana, Francesco;Giovanella, Silvia;Ligabue, Giulia;Cappelli, Gianni;Magistroni, Riccardo;Donati, Gabriele
2022

Abstract

Introduction. Patients receiving in-center hemodialysis are extremely vulnerable to COVID-19. It is unclear if routine screening of asymptomatic hemodialysis patients is an effective strategy to prevent COVID-19 outbreaks within the dialysis unit. Methods. We conducted a retrospective analysis of in-center hemodialysis patients who underwent bimonthly COVID-19 rapid antigen test screening from February 15(th) to December 26(th), 2021. Nasal rapid antigen testing was performed in all asymptomatic patients. All rapid antigen-positive tests were confirmed by RT-PCR nasopharyngeal swab. Besides universal rapid antigen screening, RT-PCR testing was conducted in all symptomatic patients and contacts of COVID-19 subjects. Results. Overall, 4079 rapid antigen tests were performed in 277 hemodialysis patients on chronic hemodialysis with a mean age of 68.4 +/- 14.6 years. Thirty-eight (0.9%) rapid antigen tests resulted positive. Only five (13.8%) positive-rapid antigen tests were also positive by RT-PCR testing. During the same period, 219 patients regularly screened by rapid antigen tests bimonthly underwent 442 RT-PCR nasopharyngeal swabs for clinical reasons. RT-PCR testing yielded a positive result in 13 (5.9%) patients. The time elapsed between PCR and the negative-rapid antigen test was 7.7 +/- 4.6 days (range 1.8-13.9 days). At the end of the follow-up, 6.4% of the population on in-center hemodialysis contracted COVID-19, and routine rapid antigen tests detected only 5 out of 18 (27.7%) COVID-19 cases. No outbreaks of COVID-19 were identified within the dialysis unit. Conclusion. Bimonthly rapid antigen screening led to the early diagnosis of COVID-19 in less than one-third of cases. The short incubation period of the new SARS-CoV-2 variants makes bimonthly test screening inadequate for an early diagnosis of COVID-19. More frequent tests are probably necessary to improve the utility of COVID-19 nasal rapid antigen test in patients on hemodialysis.
2022
2022
1
5
COVID-19 Rapid Antigen Test Screening in Patients on Hemodialysis / Alfano, Gaetano; Scarmignan, Roberta; Morisi, Niccolò; Fontana, Francesco; Giovanella, Silvia; Ligabue, Giulia; Rofrano, Laura; Gennari, William; Pecorari, Monica; Gregorini, Mariacristina; Cappelli, Gianni; Magistroni, Riccardo; Donati, Gabriele. - In: INTERNATIONAL JOURNAL OF NEPHROLOGY. - ISSN 2090-214X. - 2022:(2022), pp. 1-5. [10.1155/2022/4678717]
Alfano, Gaetano; Scarmignan, Roberta; Morisi, Niccolò; Fontana, Francesco; Giovanella, Silvia; Ligabue, Giulia; Rofrano, Laura; Gennari, William; Peco...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1290105
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