COVID-19: a nursing overview from the front line. The experience of dialysis units in Lombardy, Italy

COVID-19 is a new crown virus of the beta coronavirus genus that originated in bats The virus first emerged in China in December 2019 and has since spread rapidly to other areas of the world;in Italy the region most affected was Lombardy The infection caused by the virus manifests itself in most cases as an infection of the lower respiratory tract that leads to fever, cough and dyspnoea, while more serious cases can lead to respiratory failure and/or multi-organ failure Patients undergoing renal replacement therapy have a fragility related to the overlap of multiple pathologies, and the sharing of the same microclimate during dialysis sessions significantly increases the risk of transmission and spread of the infection among patients and among healthcare professionals The frequency of exposure of dialysis patients to infectious diseases also increases the risk of poor nutrition in a vicious circle of malnutrition-infection-malnutrition Therefore, prevention, protection, screening and isolation measures can minimise the risk of transmission for patients and for healthcare professionals Working together on the further development of tools such as telemedicine, robotics, video communications, international protocols and best practice sharing can improve the efficiency and maybe the weapons the world needs to combat coronavirus