Prognostic value of the initial chest computerised tomography scan at one year following infection in an ethnically diverse cohort of patients admitted to hospital for COVID-19

P130 Figure 1Features of COVID-19 on the CT were very common in hospitalised patients and were related to all-cause mortality one year following hospitalisation[Figure omitted. See PDF]ConclusionEvidence of COVID-19 pneumonia on CTT is more common and severe in patients from ethnic minority groups and is independently associated with worse prognosis following hospitalisation.

Infection control policies during the COVID-19 pandemic were effective in limiting morbidity and mortality associated with nosocomial viral transmission at a large NHS respiratory department

IntroductionPrevention of nosocomial transmission was a priority for NHS hospital teams during the SARS-COV-2 pandemic. However, infection control policies were developed in the face of uncertainty about duration of infectivity, routes of transmission, and safety of shared admission spaces. We retrospectively reviewed all hospital admissions to the University Hospitals of Leicester (UHL) respiratory department, which managed more than 30% of UHL patients with a diagnosis of COVID-19 between March 2020 and March 2021to determine the proportion of cases with laboratory evidence of healthcare associated infection (HCAI) and mortality within 28 days of PCR conversionMethodsThis was a retrospective cohort study performed using a bespoke database collating COVID-19 throat swab (TS) PCR results for UHL (COVTRACK). Nosocomial transmission was identified by demonstrating PCR conversions during admission and categorized into definite (conversion time > 14 days) or probable (conversion time 8–14 days). In depth records based analysis was undertaken for patients admitted to respiratory medicine (RM) and deceased within 28 days after conversion.ResultsOut of 10485 patients admitted to the Respiratory Department at UHL, 2054 (19.6%) were COVID-19 spell positive, including 57 with probable (41) or definite HCAI (16). 23 patients (7 with definite HCAI) died within 28 days of PCR conversion (0.22%, of total admitted, 1.1% of COVID19 positive), with 21 (91%) deaths in the 2nd wave. Compared with non-COVID admissions not acquiring nosocomial infection, HCAI was significantly associated with older age (mean difference (95%CI) 11.5 (7.5–15.5) years), length of stay (median LOS 18 Vs 1 day) and multiple ward occupancy (median 3 vs 1 ward);all analyses p<0.001.DiscussionOur analysis suggests HCAI with SARS-COV-2 contributed a very small fraction of COVID-19 related morbidity and mortality at our department and in the majority the trajectory of care was not changed. Despite the high numbers of highly infectious cases during the 1st and 2nd wave, we successfully implemented a suite of infection control measures that effectively mitigated risk. High throughput in admission areas, multiple ward moves, and prolonged hospital stay were significant risk factors associated with HCAI.

Impact of National Lockdown for Sars-Cov-2 Pandemic on Incident Tuberculosis and Transmission

Introduction The nationwide lockdown for COVID-19 and ongoing mitigation measures are having a significant impact on healthcare delivery for other disease including tuberculosis (TB). Leicester has faced a particularly prolonged period of disruption after imposition of local lockdown measures within 7 weeks of the national lockdown. Objectives To evaluate the impact of the national lockdown and post-lockdown periods on tuberculosis presentation and transmission in Leicester, UK. Methods We performed retrospective analysis of all notified tuberculosis cases and their contacts comparing the pre-lockdown period (January 2019-March 2020) with lockdown and post-lockdown periods (April-Sept 2020). AFB smear status, Xpert DNA load, culture status, time to culture positivity, CXR severity scores, hospital admission rate and proportion of screened contacts identified with latent tuberculosis infection (LTBI) were reviewed. Data was extracted from hospital systems. Statistical analyses used SPSS (v.26). Results 307 index cases (146 pulmonary) and 460 family contacts of pulmonary TB were included for analysis. Overall, TB incidence in 2020 has been lower than 2019 (144 vs. 129 cases from Jan-Sept). There has been a marked fall in cases during the lockdown with no comparable rebound increase Introduction The nationwide lockdown for COVID-19 and ongoing mitigation measures are having a significant impact on healthcare delivery for other disease including tuberculosis (TB). Leicester has faced a particularly prolonged period of disruption after imposition of local lockdown measures within 7 weeks of the national lockdown. Objectives To evaluate the impact of the national lockdown and post-lockdown periods on tuberculosis presentation and transmission in Leicester, UK. Methods We performed retrospective analysis of all notified tuberculosis cases and their contacts comparing the pre-lockdown period (January 2019-March 2020) with lockdown and post-lockdown periods (April-Sept 2020). AFB smear status, Xpert DNA load, culture status, time to culture positivity, CXR severity scores, hospital admission rate and proportion of screened contacts identified with latent tuberculosis infection (LTBI) were reviewed. Data was extracted from hospital systems. Statistical analyses used SPSS (v.26). Results 307 index cases (146 pulmonary) and 460 family contacts of pulmonary TB were included for analysis. Overall, TB incidence in 2020 has been lower than 2019 (144 vs. 129 cases from Jan-Sept). There has been a marked fall in cases during the lockdown with no comparable rebound increase.