• Ana Rubia Guedes, Bruno de Melo Tavares, AssisDenise Brandão deDB0000-0003-0875-6745Divisao de Infeccoes Hospitares, Centro de Vigilancia Epidemiologica "Prof. Alexandre Vranjac", Centro de Controle de Doencas, Secretaria de Estado da Saude, Sao Paulo, SP, BR., Maristela Pinheiro Freire, Geraldine Madalosso, Anna S Levin, Lauro Vieira Perdigão Neto, and Maura Salaroli de Oliveira.
• Departamento de Controle de Infeccao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
• Clinics (Sao Paulo). 2021 Jan 1; 76: e3299.

ObjectiveThis study aimed to evaluate the occurrence of coronavirus disease 2019 (COVID-19) in hemodialysis facilities and the occurrence of and risk factors for clustering of COVID-19 cases.MethodsWe conducted a cross-sectional online survey between March and July 2020, in all dialysis facilities in São Paulo state, using Google Forms. The online questionnaire contained questions addressing specific components of infection prevention and control practices and the number of cases during the COVID-19 pandemic.ResultsA total of 1,093 (5%) COVID-19 cases were reported among 20,984 patients; approximately 56% of the facilities had ≥1 cluster. Most facilities implemented various measures (such as allocation of dedicated COVID-19 areas/shifts, symptom screening, environmental disinfection, and maintenance of adequate ventilation) to prevent the transmission of severe acute respiratory syndrome coronavirus 2. Clustering of COVID-19 cases was suspected in only 7% of dialysis facilities. The only variable associated with this event was the performance of aerosol-generating procedures (odds ratio: 4.74; 95% confidence interval: 1.75-12.86).ConclusionAttention should be paid to avoiding the performance of aerosol-generating procedures in dialysis facilities and monitoring the clustering of cases.

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