SARS-CoV-2 Screening in Dialysis Facilities: Building an Optimal Strategy to Protect a High Risk Population

This study planned to offer SARS-CoV-2 screening tests at selected dialysis facilities in order to: reduce transmission, and detect early cases and prevent serious illness among patients receiving dialysis. Patients receiving dialysis have an 8-fold higher risk for hospitalization and 15-fold higher risk for death from COVID-19 compared with the general population. Patients receiving dialysis also disproportionately belong to racial/ethnic minority and economically disadvantaged groups. Thus, the goals of this project were to increase availability of highly sensitive and specific testing for SARS-CoV-2 infection in a medically vulnerable and disadvantaged population. The study planned to perform a pragmatic cluster (facility-level) randomized study to test the patient level acceptability of two strategies for offering test-based screening offered at the dialysis facility. This study offered anterior nares, rtPCR tests at a static frequency (aim 1) versus a dynamic frequency anchored to county COVID-19 spread (aim 2). After a pilot in four facilities, this study planned to scale up the study to 62 dialysis facilities within US Renal Care. After a 3-month period of testing, the study assessed the following outcomes: Patient level test acceptability (primary outcome), Facility level Deaths, and Facility level Hospitalization. The overall goal was to identify a highly acceptable universal testing strategy for patients receiving dialysis, and prevent serious complications from SARS-CoV-2 by identifying cases early.