ABSTRACT
OBJECTIVE: Hand Hygiene (HH) is the most important measure to prevent healthcare-associated infections. The aim of this study was to determine the impact of the COVID-19 pandemic on the degree of compliance (DC) of HH in an Emergency Department (ED). METHODS: Cross-sectional study. DC of HH in the ED was calculated from 2005 to 2021. We studied the association between DC of HH and different variables (age, sex, status, ED area, time of WHO, etc.) by calculating the Odds Ratio (OR) and its 95% confidence interval (95%CI). To study the impact of the pandemic, we compared the C of HH before and after the onset of the COVID-19 pandemic, calculated the OR and its 95%CI. RESULTS: DC of HH increased to 75.9% (95%CI: 68.6%-83.2%) in the period after pandemic onset from the previous baseline period of 48.9% (95%CI: 43.4%-54.5%) (p<0.001). Factors significantly and independently associated with DC of HH were time period (before or after pandemic), attending training sessions, having alcohol solution in pocket format and WHO moments 3,4 and 5. CONCLUSIONS: DC of HH in the ED has reached the highest value in 17 years of monitoring following the COVID-19 pandemic. This increase reflects a very positive change in the behavior of healthcare personnel with respect to HH.
ABSTRACT
OBJECTIVE: To assess the validity of SARS-CoV-2 Antigen (Ag) detection for the diagnosis of SARS-CoV-2 infection in mildly infected or asymptomatic patients. METHODS: Observational study to evaluate diagnostic tests. Non-hospitalized patients with indication for diagnostic testing for SARS-CoV-2 infection were included. The diagnostic test to be evaluated was the determination of Ag and as a reference standard to determine the presence of viral RNA the RT-PCR was used. RESULTS: A total of 494 patients were included. Of these 71.5% (353/494) had symptoms and 28.5% (141/494) were asymptomatic (presurgery screening (35/494) and confirmed case-contact (106/494). The overall sensitivity of the Ag test was 61.1% and the specificity was 99.7%. The sensitivity and specificity in the asymptomatic group were 40% and 100% respectively, and in the symptomatic group 63.5% and 99.6% respectively. In turn, the sensitivity and specificity in the group of symptomatic patients varied according to the time of symptom evolution: in patients with recent symptoms, they were 71.4% and 99.6% respectively, while in patients with symptoms of more than 5 days of evolution, they were 26.7% and 100% respectively. In all groups studied, the presence of antigen is associated with a high viral load (Ct<30 cycles). CONCLUSIONS: The use of Ag detection test is not indicated for the diagnosis of SARS-CoV-2 infection in asymptomatic patients or with symptoms of more than 5 days of evolution, but it could be useful in patients with symptoms of 1-5 days of evolution.
Subject(s)
COVID-19 , SARS-CoV-2 , False Positive Reactions , Humans , Reference Standards , Sensitivity and SpecificityABSTRACT
This observational study included patients who underwent pre-operative coronavirus disease 2019 (COVID-19) screening in order to preserve patient safety. Reverse transcriptase polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus-2 was performed in 2292 of 8740 surgical procedures, and the incidence of a positive PCR result was 0.0022%. No healthcare-associated infections were detected. There was no difference in overall mortality or length of hospital stay compared with the same period from the previous year. A selective screening strategy to identify patients for PCR testing, based on isolation measures, presurgical clinical-epidemiological assessment and selected major surgeries susceptible to a poor COVID-19-related outcome, is effective and safe for patients and healthcare workers.
Subject(s)
COVID-19 , SARS-CoV-2 , Elective Surgical Procedures , Health Personnel , Humans , Mass ScreeningABSTRACT
Background: A first protective dose of vaccine may allow delaying the second dose in a context of low supply. The objective is to assess the effectiveness of a single dose of vaccine against SARS-CoV-2 (BNT162b2) after twelve days of its administration in healthcare personnel (HCP) of a Health Department. Methods: A case-control study was made. HCP with suspected COVID-19 and HCP close contacts of COVID-19 cases were included between January 27 and February 7, 2021. They were PCR tested for SARS-CoV-2;those with positive PCR were considered cases and those with negative PCR were considered controls. The crude (VE) and adjusted (VEa) vaccine effectiveness to prevent COVID-19 cases and their 95% confidence interval were calculated using the formula VE = (1-Odds ratio) x 100. Results: 268 HCP were included, of which 70 (26.1%) were considered cases and 198 (73.9%) controls. The frequency of vaccine exposure in cases was 55.7% vs. 69.7% in controls (p=0.035). The VEa of the first vaccine dose was 52.6% (95%CI: 1.1-77.3). The VEa in the subgroup of HCP studied for suspected disease was 74.6% (CI95%: 38.4-89.5). Conclusions: One dose of BNT162b2 vaccine against SARS-CoV-2 offers early protection after twelve days of administration. These data could be considered to adapt strategies and consider postponing the second dose in situations of limited vaccine supply in order to achieve the maximum number of people covered with a first dose.
ABSTRACT
OBJECTIVE: A first protective dose of vaccine may allow delaying the second dose in a context of low supply. The objective is to assess the effectiveness of a single dose of vaccine against SARS-CoV-2 (BNT162b2) after twelve days of its administration in healthcare personnel (HCP) of a Health Department. METHODS: A case-control study was made. HCP with suspected COVID-19 and HCP close contacts of COVID-19 cases were included between January 27 and February 7, 2021. They were PCR tested for SARS-CoV-2;those with positive PCR were considered cases and those with negative PCR were considered controls. The crude (VE) and adjusted (VEa) vaccine effectiveness to prevent COVID-19 cases and their 95% confidence interval were calculated using the formula VE = (1-Odds ratio) x 100. RESULTS: 268 HCP were included, of which 70 (26.1%) were considered cases and 198 (73.9%) controls. The frequency of vaccine exposure in cases was 55.7% vs. 69.7% in controls (p=0.035). The VEa of the first vaccine dose was 52.6% (95%CI: 1.1-77.3). The VEa in the subgroup of HCP studied for suspected disease was 74.6% (CI95%: 38.4-89.5). CONCLUSIONS: One dose of BNT162b2 vaccine against SARS-CoV-2 offers early protection after twelve days of administration. These data could be considered to adapt strategies and consider postponing the second dose in situations of limited vaccine supply in order to achieve the maximum number of people covered with a first dose.