EFFECT OF COVID – 19 ON DIALYSIS PATIENTS
INTRODUCTION:
Dialysis patients should NOT stop their treatments during the COVID-19 outbreak. To protect dialysis patients from the coronavirus, which causes the disease, COVID-19, the health care Centers have given dialysis centers new information to stop the virus from spreading. Dialysis patients are at high risk for serious complications, even death, from the virus.
Coronavirus disease 2019 (COVID-19), a pandemic sweeping the world’s population, is particularly threatening to patients on dialysis.
The challenge of COVID-19 is very different: as the disease spreads in a community, many patients on dialysis in the same geographic area are likely to become infected and require continued dialysis treatments. Thrice-weekly dialysis poses the risk of infection spread among patients and staff. Early in this pandemic, patients on dialysis who are symptomatic may be referred to hospital for diagnosis and management. Outpatient dialysis facilities must anticipate and prepare for dialyzing their patients infected with COVID-19 at their facility, or clustered in designated outpatient facility.
Patients who undergo dialysis treatment are at a higher risk for infection because the process of Hemodialysis requires frequent use of catheters or insertion of needles to access the bloodstream.
Hemodialysis patients are known to have weakened immune systems, which poses greater risk for infection, in addition, they require frequent hospitalizations and surgery where they might acquire an infection.
CKD-5 patients on dialysis are the most vulnerable group because of their existing comorbidities, repeated unavoidable exposure to hospital environment and immunosuppressed state. Therefore, these patients are not only more prone to acquire infection but also at a higher risk to develop severe diseases as compared to general population.
The team has participated in discussions with chief medical officers of dialysis companies, sponsored webinars for dialysis staff, participated in webinars for patients on dialysis, and created awareness posters for dialysis facilities.
The guidelines stressed that patients on regular dialysis should adhere to prescribed schedule and not miss their dialysis sessions to avoid any emergency dialysis such as pulmonary edema and electrolytes imbalances.
Yet, as more and more patients admitted in the hospital, appearing to have positive symptoms of COVID-19, the chances of dialysis patients acquiring COVID-19 is highly likely to be possible. As social distancing is one of the main preventions for COVID-19, home Hemodialysis is the best prevention for dialysis patients at risk.
This is what your dialysis center should do to protect you:
Check and follow all patients, including home dialysis patients, staff, and visitors who may have had contact with the coronavirus, or with people who have symptoms of COVID-19. For example, the centers should:
- Check you for fever or any breathing or respiratory (lung) symptoms
- Ask if you live in an area where people have COVID-19
- Ask if you have had contact with someone who is being checked for COVID-19, or if you have recently been in another country where COVID-19 has spread.
- Centers should take patients’ temperatures at check-in.
Dialysis centers should identify patients with signs and symptoms of respiratory infections before they enter and do the following:
- Give a mask to patients with respiratory symptoms. These patients should wear the mask from check-in and until after they leave the center.
- Tell patients to call ahead to report respiratory symptoms.
- Put signs at the entrance to let patients know they should tell the staff if they have respiratory symptoms.
- Give patients and staff information about hand hygiene (how to keep hands clean) and other ways to stay safe. Patients should get this information in the language they know best. Centers should also have tissues, hand sanitizer, and trash bins with foot pedals.
- Don’t allow visitors with signs/symptoms of infection to enter the dialysis center.
- Give sick time to staff with respiratory symptoms or other signs of illness. It’s not safe for them to be around patients.
- Make separate waiting areas for sick patients that are at least six feet from other patients. Healthy patients can wait outside or in their cars until it’s their turn to be seen.
- Separate healthy and sick patients by no less than six feet in all directions. Ideally, sick patients will be dialyzed in a separate room.
- Group, multiple dialyzing patients suspected or confirmed for having COVID-19, along with the staff caring for them, in the same unit or on the same shift.
- Use cleaning procedures that kill the coronavirus, along with all routine cleaning and disinfection procedures.
- Transfer any patient too sick to be treated in a dialysis unit. The transport service and receiving facility should be told about the patient’s condition.
- Monitor home dialysis patients monthly.
VACCINATION FOLLOW UP’S:
- Scientists around the world are working on potential treatments and vaccines for the new coronavirus disease known as COVID-19.
- Several companies are working on antiviral drugs, some of which are already in use against other illnesses, to treat people who already have COVID-19.
- Other companies are working on vaccines that could be used as a preventive measure against the disease.
The World Health Organization (WHO) officials welcomed efforts to develop a vaccine to counter COVID-19 in different parts of the world while urging equitable distribution once they are approved.
HYDROXYCHLOROQUINE AND CHLOROQUINE:
A few days later, the FDA issued an emergency use declaration for the anti-malaria drugs hydroxychloroquine and chloroquine.
The medications can be distributed and prescribed by doctors for adults and teens hospitalized with COVID-19 when a clinical trial isn’t available.
In late April, the FDA issued a warning Trusted Source against the use of both hydroxychloroquine and chloroquine outside of medical facilities. The agency stated there were “serious and potentially life-threatening heart rhythm problems” connected with the drugs.
Even though technological advances allow us to do certain things more quickly,” “we still have to rely on social distancing, contact tracing, self-isolation, and other measures.”
There are 120 projects around the world centered on the development of a vaccine. Here look at the some of the projects:
Moscow: The head of a top Russian research centre told President Vladimir Putin on Tuesday that his lab was ready to start human trials of experimental coronavirus vaccines in June.
The vaccine is a recombinant protein on the basis of epitopes of the SARS-CoV-2 surface S-protein.
University of Queensland in Australia. Researchers are developing a vaccine by growing viral proteins in cell cultures. They began preclinical testing stages in early April.
University of Oxford in England. A clinical trial with more than 500 participants began in late April. Oxford officials said the potential vaccine has an 80 percent chance for success and could be available as early as September. The vaccine uses a modified virus to trigger the immune system.
Pharmaceutical companies. Johnson & Johnson and Sanofi are both working on a vaccine of their own. Pfizer has also teamed up with a German company to develop a vaccine. Their initial clinical trial with 200 participants was given the green light in late April. The two companies began human testing in the United States in early May.
An Italian coronavirus vaccine developed in a Rome lab has antibodies generated in mice that work on human cells, a report on ANSA stated on Tuesday.
In an official statement, Bennet claimed that the “monoclonal neutralising antibody” developed by the Israel Institute for Biological Research (IIBR) “attacks the virus and neutralizes it” inside the virus carrier’s body.
The World Health Organization has been coordinating the global response to the virus and has endorsed the study of interferon beta as a potential treatment.
The US, China, and many other countries have been rushing to develop treatments for the virus. More than 100 other remedies are currently being explored worldwide.
A drug called Remdesivir, which was developed as an Ebola treatment, has generated particular excitement.
US officials have said there is “clear-cut” evidence that it helps people recover from COVID-19.