Risk of SARS-CoV-2 in a Pediatric Dialysis Unit

There is great concern about transmission of SARS-CoV-2 infection within dialysis units. In this report from a single pediatric dialysis unit in Indiana, researchers followed 13 patients and 25 healthcare workers (physicians, nurses, and staff) for 21 days after admission of a symptomatic patient who tested positive for SARS-CoV-2 by reverse transcriptase–polymerase chain reaction (PCR) assay. All patients and healthcare workers at the unit wore masks and were screened for fever and symptoms before and after dialysis shifts. The patient was isolated on day 0.

Serum IgM and IgG antibodies were measured weekly, and results were confirmed by an independent laboratory. By day 7, two healthcare workers had upper respiratory symptoms; however, neither had a positive PCR test for SARS-CoV-2 during that time. No other patients or workers had symptoms during the 21-day study. By day 21, 23% of patients and 44% of healthcare workers had developed SARS-CoV-2 antibodies. One patient and four healthcare workers had IgM seroconversion. None of the healthcare workers who directly cared for the symptomatic SARS-CoV-2-positive patient seroconverted. Two of 11 healthcare workers seroconverted after caring for two asymptomatic patients who had seroconverted. One of these healthcare workers had a positive nasopharyngeal PCR test after seroconversion.