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Abstract
Introduction: In addition to the consequences of SARS-CoV-2 infection in renal patients, maintaining dialysis activity during the pandemic has been a significant challenge due to staff shortages resulting from illness-related absences.
Objective: To analyze the incidence of COVID-19 infections among hemodialysis professionals, their characteristics, and their impact on work absences during different waves of the pandemic.
Material and Method: Longitudinal observational study conducted from March 3, 2020, to April 23, 2022 (776 days), involving an average of 406 healthcare and non-healthcare professionals from 18 dialysis units and two administrative support units of the Iñigo Álvarez de Toledo Renal Foundation. Data collection was carried out through communication from various supervisors to the human resources department.
Results: During the study period, 179 professionals out of an average of 406 (44.1%) became infected. Among these, 52% were nurses, 25% were nursing assistants, 11% were nephrologists, and 12% were other professionals. 40.2% of cases exhibited symptoms. A total of 160 infected individuals were absent from work due to illness (89.3%), with an average duration of 15.9 ± 14.3 days. In 71.6% of cases, close contacts were identified outside the dialysis units, and this contact identification increased with each wave of the pandemic, rising from 6.7% in the 1st wave to 40% in the 6th wave (p=0.016).
Conclusions: The symptoms have generally been mild, with absences from work lasting at least two weeks. Close contacts were mainly identified within the community, and there were no recorded infections transmitted through renal patients in the units.
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Copyright (c) 2023 David Hernán-Gascueña, María Dolores Arenas-Jiménez, Mónica Pereira-García, Cristina Ledesma-Torre, Adriana Iglesias-González, Dolores Piña-Simón
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References
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- Aylward R, Bieber B, Guedes M, Pisoni R, Koranteng E, Dreyer G et al. The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey. Kidney Int Rep. 2022;7(3):397-409.
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- Paulus AB. Exploring the Evidence: Considerations for the Dialysis Practice Setting Approach to Staffing. Nephrol Nurs J 2022;49(4):369-83.
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- Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA 2020;323(15):1439-40.
- Guerrero-Rodríguez E, Hernán-Gascueña D, Miranda-Serrano MB, Arenas-Jiménez L, Pereira-Feijoo C, Sanjuan-Miguelsanz M. Reactogenicidad e inmunogenicidad tras la inoculación de vacuna frente a SAR-CoV-2 en personal de diálisis: Array. Enferm Nefrol 2021;24(3):262-70.
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- Wańkowicz P, Szylińska A, Rotter I. Assessment of Mental Health Factors among Health Professionals Depending on Their Contact with COVID-19 Patients. Int J Environ Res Public Health. 2020 [consultado 13 Sep 2023];17(16):5849. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459704/pdf/ijerph-17-05849.pdf.
- Casaux-Huertas A, Ochando-García A, Limón-Cáceres E, Andreu-Périz D. “Del miedo a la resiliencia”. Estudio fenomenológico sobre el impacto de la pandemia por COVID-19 en cuidadoras de pacientes dependientes en hemodiálisis. Enferm Nefrol 2021;24(3):250-6.
References
Alocución de apertura del Director General de la OMS en la rueda de prensa sobre la COVID-19 celebrada el 11 de marzo de 2020 [consultado 13 Sep 2023]. Disponible en: https://www.who.int/es/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
Instituto de Salud Carlos III, CNE, & RENAVE. (2020). Informe sobre la situación deCOVID-19 en personal sanitario en España a 14 de mayo de 2020. Ministerio de Ciencia e Innovación. 2020 [consultado 13 Sep 2023]. Disponible en: https://xurl.es/hlqg5.
Quiroga B, Ortiz A, Cabezas-Reina CJ, Ruiz Fuentes MC, López Jiménez V, Zárraga Larrondo S, et al. Evolving spectrum but persistent high mortality of COVID-19 among patients on kidney replacement therapy in the vaccine era: the Spanish COVID-19 KRT Registry, Clin Kidney J 2022;15(9):1685-97.
Albalate M, Arribas P, Torres E, Cintra M, Alcázar R, Puerta M et al. High prevalence of asymptomatic COVID-19 in haemodialysis: learning day by day in the first month of the COVID-19 pandemic. Alta prevalencia de COVID-19 asintomático en hemodiálisis. Aprendiendo día a día el primer mes de pandemia de COVID-19. Nefrología (Engl Ed) 2020;40(3):279-86.
Aylward R, Bieber B, Guedes M, Pisoni R, Koranteng E, Dreyer G et al. The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey. Kidney Int Rep. 2022;7(3):397-409.
Andreu-Periz D, Ochando-García A, Limón-Cáceres E. Experiencias de vida y soporte percibido por las enfermeras de las unidades de hemodiálisis hospitalaria durante la pandemia de COVID- 19 en España: Array. Enferm Nefrol [Internet]. 2020 [consultado 12 Sep 2022];23(2):148-59. Disponible en: https://www.enfermerianefrologica.com/revista/article/view/3536.
Ruiz-Fernández MD, Ramos-Pichardo JD, Ibáñez-Masero O, Cabrera-Troya J, Carmona-Rega MI, Ortega-Galán AM. Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. J Clin Nurs 2020;29(21-22):4321-30.
Sagherian K, Steege LM, Cobb SJ, Cho H. Insomnia, fatigue and psychosocial well-being during COVID-19 pandemic: A cross-sectional survey of hospital nursing staff in the United States. J Clin Nurs 2023;32(15-16):5382-95.
Paulus AB. Exploring the Evidence: Considerations for the Dialysis Practice Setting Approach to Staffing. Nephrol Nurs J 2022;49(4):369-83.
Informes Epidemiológico COVID-19 Comunidad de Madrid [consultado 13 sep 2023]. Disponible en: https://www.comunidad.madrid/servicios/salud/coronavirus.
Situación y evolución de la pandemia de COVID-19 en España. Centro nacional de epidemiología [consultado 13 Sep 2023]. Disponible en: https://cnecovid.isciii.es/covid19/#evoluci%C3%B3n-pandemia.
Situación de COVID-19 en España a 26 de abril de 2022. Equipo COVID-19. RENAVE. CNE. CNM (ISCIII) [consultado 13 Sep 2023]. Disponible en: https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE.
Martín-Grau C, Benavent-Bofill C, Picó-Plana E, Recio-Comí G, Terrón-Puig M, Bastón Paz N, et al. Use of predictive tools in the management of COVID-19 patients: a key role of clinical laboratories. Adv Lab Med 2020;2(2):237-52.
Zurriaga-Carda R, Aginagalde-Llorente AH, Álvarez-Vaca D, Epidemiología de campo en tiempos de COVID-19: retos para los servicios de salud pública. Informe SESPAS 2022. Gac Sanit 2022;36(S1):S76-81.
Varma PP. COVID-19 Infection among Dialysis Patients and Staff. Indian J Nephrol 2022;32(3):193-4.
Arenas MD, Villar J, González C, Cao H, Collado S, Barbosa F et al. Protection of nephrology health professionals during the COVID-19 pandemic. Protección de los profesionales sanitarios en nefrología ante la pandemia por COVID-19. Nefrologia (Engl Ed) 2020;40(4):395-402.
Huh S. How to train the health personnel for protectingthemselves from novel coronavirus (COVID-19) infectionduring their patient or suspected case care. J Educ Eval Health Prof 2020;17:10,
Smith JD, MacDougall CC, Jhonstone J, Copes RA, Schwartz B, Garber GE. Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis. CMAJ 2016;188(8):567-74.
Recomendaciones para el manejo, prevención y control de COVID19 en Unidades de Diálisis Versión de 25 de Mar 2020. Ministerio de Sanidad [consultado 13 Sep 2023]. Disponible en: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/COVID19-hemodialisis.pdf.
Estrategia de Vacunación COVID-19 en España. [consultado 13 Sep 2023]. Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/vacunaCovid19.htm.
Actualización 11. Estrategia de vacunación frente a COVID-19 en España [consultado 13 Sep 2023]. Disponible en: https://www.sanidad.gob.es/areas/promocionPrevencion/vacunaciones/covid19/Actualizaciones_Estrategia_Vacunacion/docs/COVID-19_Actualizacion11_EstrategiaVacunacion.pdf.
Variantes de SARS-CoV-2 en España: linajes BA.2.12.1, BA.4 y BA.5 de Ómicron. Evaluación rápida de riesgo. Centro de coordinación de alertas y emergencias sanitarias del Ministerio de Sanidad. 11ª actualización, 28 de junio de 2022 [consultado 13 Sep 2023]. Disponible en: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/20220628-ERR.pdf.
Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA 2020;323(15):1439-40.
Guerrero-Rodríguez E, Hernán-Gascueña D, Miranda-Serrano MB, Arenas-Jiménez L, Pereira-Feijoo C, Sanjuan-Miguelsanz M. Reactogenicidad e inmunogenicidad tras la inoculación de vacuna frente a SAR-CoV-2 en personal de diálisis: Array. Enferm Nefrol 2021;24(3):262-70.
Estrategia de vigilancia y control frente a covid-19 tras la fase aguda de la pandemia. Actualizado a 3 de junio de 2022. Instituto de Salud Carlos III. Ministerio de Sanidad [consultado 13 Sep 2023]. Disponible en: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/Nueva_estrategia_vigilancia_y_control.pdf.
Centers for Disease Control and Prevention (CDC). Return to Work Criteria for HCP with SARS-CoV-2 Infection. [consultado 13 Sep 2023]. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html.
Ali S, Maguire S, Marks E, Doyle M, Sheehy C. Psychological impact of the COVID-19 pandemic on healthcare workers at acute hospital settings in the South-East of Ireland: an observational cohort multicentre study. BMJ open 2020 [consultado 12 Sep 2023]18;10(12):e042930. Disponible en:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750872/pdf/bmjopen-2020-042930.pdf.
Que J, Shi L, Deng J, Liu J, Zhang L, Suying W et al. Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China. Gen Psychiatr. 2020 [consultado 12 Sep 2023];33(3):e100259. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299004/pdf/gpsych-2020-100259.pdf.
Wańkowicz P, Szylińska A, Rotter I. Assessment of Mental Health Factors among Health Professionals Depending on Their Contact with COVID-19 Patients. Int J Environ Res Public Health. 2020 [consultado 13 Sep 2023];17(16):5849. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459704/pdf/ijerph-17-05849.pdf.
Casaux-Huertas A, Ochando-García A, Limón-Cáceres E, Andreu-Périz D. “Del miedo a la resiliencia”. Estudio fenomenológico sobre el impacto de la pandemia por COVID-19 en cuidadoras de pacientes dependientes en hemodiálisis. Enferm Nefrol 2021;24(3):250-6.