Dear Editor,
The first case of COVID-19 was identified in Wuhan, China, in 2019. Most probably, the disease was transmitted to humans from animals. The new infectious agent that is known as “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)” is readily transmitted between humans; thus, it rapidly spread in China and other parts of the world and turned into a pandemic. The severe form of the syndrome can lead to pneumonia and even death (1-3). Patients with underlying conditions are vulnerable to develop the severe form of the disorder, so that most deaths occur in people with underlying conditions and the elderly (4). The symptoms of COVID-19 include pain, fever, chills, cough, nausea, and vomiting (3, 5). One of the vulnerable groups is dialysis patients. Compared to other patients, this group of patients is more vulnerable to infections, with higher mortality rates (6).
Given the high prevalence of COVID-19 in Iran, currently, most hospitals admit COVID-19 patients; therefore, other groups of patients who are admitted to hospitals are at a high risk of contracting the virus. Dialysis patients are a group of patients who need to go frequently to hospitals. According to Iran’s Ministry of Health, about half of transmissions of COVID-19 occur in medical settings; as a result, dialysis patients who go to medical centers are at a high risk of contracting COVID-19, and this risk needs to be prevented or reduced using proper strategies. According to the clinical governance law in Iran’s health system, experienced nurses are in charge of infection prevention and control, and they can help in the prevention of COVID-19 in dialysis patients. They should develop plans to clean and disinfect dialysis units, train the personnel, provide both personnel and patients with protective equipment such as surgical masks, ensure the proper distance between dialysis chairs, make a timetable to avoid the gathering of several patients in one place at the same time, and educate patients on preventive measures outside the hospital environment. Dialysis patients must be informed that they are more vulnerable to COVID-19 than are normal people because they have a weaker immune system (3). In addition, given that COVID-19 stays in the environment for a long time, hospital administrators should provide separate entrances for dialysis patients and COVID-19 patients. Moreover, it is suggested that the shifts of nurses in dialysis units be limited to one per day. These strategies can have an important role in reducing the risk of COVID-19 in dialysis patients.
Acknowledgements
References
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Deng Y, Wares JR, Lawson B, Shemin D, D’Agata EM. Evaluating Infection Prevention Strategies in Out-Patient Dialysis Units Using Agent-Based Modeling. Plos One. 2016;11(5). e0153820. https://doi.org/10.1371/journal.pone.0153820.