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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.
Affiliation
  • Alfano G; Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy.
  • Scarmignan R; Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Via Del Pozzo 71, Modena 41124, Italy.
  • Morisi N; Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Via Del Pozzo 71, Modena 41124, Italy.
  • Fontana F; Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy.
  • Giovanella S; Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Via Del Pozzo 71, Modena 41124, Italy.
  • Ligabue G; Clinical and Experimental Medicine Program, University of Modena and Reggio Emilia, Via Del Pozzo 71, Modena 41124, Italy.
  • Rofrano L; Surgical, Medical and Dental Department of Morphological Sciences, Section of Nephrology, University of Modena and Reggio Emilia, Via Del Pozzo 71, Modena 41124, Italy.
  • Gennari W; Clinical Microbiology Unit, University Hospital of Modena, Modena, Italy.
  • Pecorari M; Molecular Microbiology and Virology Unit, Department of Laboratory Medicine and Pathological Anatomy, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
  • Gregorini M; Molecular Microbiology and Virology Unit, Department of Laboratory Medicine and Pathological Anatomy, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
  • Cappelli G; Nephrology and Dialysis, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
  • Magistroni R; Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy.
  • Donati G; Nephrology, Dialysis and Transplant Unit, University Hospital of Modena, Modena, Italy.
Int J Nephrol ; 2022: 4678717, 2022.
Article in En | MEDLINE | ID: mdl-36160837
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 15th to December 26th, 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.

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Screening_studies Language: En Journal: Int J Nephrol Year: 2022 Document type: Article Affiliation country: Italy Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Screening_studies Language: En Journal: Int J Nephrol Year: 2022 Document type: Article Affiliation country: Italy Country of publication: United States