ABSTRACT
Animals may be present in healthcare facilities for multiple reasons. Although specific laws regarding the use of service animals in public facilities were established in the United States in 1990, the widespread presence of animals in hospitals, including service animals, animals used to assist in patient therapy, and research animals, has resulted in the increased presence of animals in acute care hospitals and ambulatory medical settings. The role of animals in the transmission of zoonotic pathogens and cross-transmission of human pathogens in these settings remains poorly studied. Until more definitive information is available, healthcare facilities should establish policies and procedures to prioritize patient and healthcare provider safety and to use standard infection prevention and control measures to prevent animal-to-human transmission in healthcare settings. This chapter is based on published consensus recommendations from a panel of experts, representing the Society for Healthcare Epidemiology of America (SHEA), regarding the management of animals in healthcare (AHC) (Murthy et al., Infect Control Hosp Epidemiol 36:495-516, 2015). However, this chapter aims to review the controversies related to animals in healthcare with respect to infection prevention, identify potential steps for mitigation of risks and areas for future study, and provide updated information where available, including the implications of SARS-CoV-2 infection in animals. Any opinions noted beyond the consensus SHEA guidance document reflect the opinions of only the authors of this document. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
ABSTRACT
Introduction: Cavitary lesions are rarely associated with COVID-19 and have been very rarely reported. We conducted a retrospective analysis of the COVID-19 patients admitted in our center in South India and attempted to study the distribution and etiology of cavitary lesions in COVID-19. Material(s) and Method(s): All inpatients in pulmonology department over a period of 14 months who were diagnosed to have COVID-19 and were found to have cavity on thoracic imaging were included in the study. patient with pre existing cavity were excluded. Patient demographics, comorbid conditions, treatment details, length of hospital stay, and outcomes were examined. The details of the cavitary lesions including their number, the time of detection and lobe of involvement, and the etiology of the cavity were described. Result(s): 602 patients with COVID-19 were admitted during the study period. A total of 9 patients were included in this report with an incidence of cavitation in hospitalised COVID-19 patients being 1.5%. 55.5% patients had evidence of Aspergillus infection confirmed by serology or isolation of Aspergillus from respiratory specimen. Two (22.2%) patients had tuberculosis. The mortality rate of COVID-19 patients with Aspergillus lesions was 44.4%. Majority were detected to have cavity in the third week of illness. Left lower lobe was the most common involved site. Result(s): The incidence of cavitary lesions in patients hospitalised with COVID-19 was 1.5% in this study most common etiology of these cavities was fungal followed by TB. These patients had a very high mortality rate of around 45% in this study. Early identification and treatment may improve clinical outcomes in these patients.