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Background and Aim Clostridioides difficile infection (CDI) is the leading cause of hospitalacquired infectious diarrhoea. High bed occupancy rates in acute hospitals correlate with an increased incidence of healthcare-associated CDI (HA-CDI). The COVID-19 pandemic led to changes within our healthcare system, including cessation of elective procedures and reduced presentations for non-COVID-19-related illnesses. Our aim was to determine if improved hand-hygiene, increased use of personal protective equipment (PPE), social distancing and reduced hospital occupancy observed during the first wave of the COVID-19 pandemic also impacted on rates of HA-CDI. Methods: We defined the COVID-19 outbreak period as March to May 2020 and identified newly-acquired HA-CDI cases during the same periods in 2018, 2019 and 2020, using the hospital C. difficile database. HA-CDI was defined as per national case definitions. Electronic records were used to assess patient demographics and biochemical markers. Hospital antimicrobial consumption and hand-hygiene audit data for the study period and corresponding in 2018, 2019 and 2020 were collected. Statistical analysis was performed using STATA. Results Fifty patients with HA-CDI were identified. Chi-squared analysis with Yates correction demonstrated a decrease in newly-acquired HACDI during the first wave of the COVID-19 pandemic period when compared to the same period in 2018 and 2019 (p=0.029);(Table 1). Conclusion During the first wave of the COVID-19 pandemic, static antimicrobial use, reduced hospital occupancy, improved hand hygiene and the use of PPE resulted in a decline in HA-CDI;demonstrating the importance of hospital activity and infection prevention and control measures on HA-CDI during an inpatient stay. (Table presented)
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Introduction: Due to a huge focus of healthcare resources into acute COVID- 19 care during the early phase of the pandemic, endoscopy activity worldwide was significantly reduced. This subsequently led to a reduction in the number of Oesophageal and Gastric cancers diagnosed during this period, resulting in delayed diagnosis, thus posing a risk of diagnosis at an advanced disease stage. The diagnosis of these cancers at an advanced stage, limits the potential of curative therapy. Aims & Methods: The aim was to measure the impact of COVID-19 pandemic on the diagnosis of Oesophageal and Gastric cancers in a single tertiary referral centre. We hypothesised that due to the reduction of endoscopy workload, there will be an increase in the number of patients diagnosed with advanced stage disease. Method: This retrospective study was carried out in a single tertiary centre in Dublin, using our local Upper GI Cancer database. Patients were divided into three groups based on the period of diagnosis. Period A represented October 2019-March 2020, Period B represented April 2020-June 2020, and Period C represented July 2020-October 2020. Patients were then further subdivided based on the stage of the cancer at diagnosis. Results: A total of 153 patients diagnosed with Oesophageal and Gastric cancers between October 2020 and October 2020 were included. 107 patients (69.5%) were male. The mean age was 69.4 (Range 32-94) During period B (April 2020-June 2020), which correlates with the early phase of the pandemic, and reduced endoscopy activity, there was a reduction in the number of cancers diagnosed. 66 patients (43.1%, Monthly average = 11) were diagnosed in Period A, 25 (16.3%, Monthly average = 8) in Period B and 62 (40.5%, Monthly average = 16) in Period C. Furthermore, there was an increase in the number of cancers diagnosed at an advanced/metastatic stage in Period C (July 2020-October 2020) which correlates with the recovery/decelerating phase of the first wave of the pandemic and increased endoscopy activity. In comparison to Period B, where an average of 3.3 patients (41.25%) were diagnosed with advanced/metastatic cancer, an average of 8.1 patients (52.3%) were diagnosed with advanced/metastatic Oesophageal and Gastric cancers in Period C. Conclusion: This study highlights the risk associated with delayed diagnosis as a result of reduced endoscopy activity during the pandemic.
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Late in 2020, two genetically-distinct clusters of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with mutations of biological concern were reported, one in the United Kingdom and one in South Africa. Using a combination of data from routine surveillance, genomic sequencing and international travel we track the international dispersal of lineages B.1.1.7 and B.1.351 (variant 501Y-V2). We account for potential biases in genomic surveillance efforts by including passenger volumes from location of where the lineage was first reported, London and South Africa respectively. Using the software tool grinch (global report investigating novel coronavirus haplotypes), we track the international spread of lineages of concern with automated daily reports, Further, we have built a custom tracking website (cov-lineages.org/global_report.html) which hosts this daily report and will continue to include novel SARS-CoV-2 lineages of concern as they are detected.
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Aims To determine the incidence of COVID-19 transmission following outpatient gastrointestinal (GI) endoscopy duringrising community incidence of COVID-19. Methods This prospective study was conducted in a single tertiary referral centre in Dublin. Consecutive patients whoattended the endoscopy unit for a procedure at time points in June, September, and October 2020 were included. Patientsreceived a COVID-19 triage phone call 48 hours before their procedure. COVID-19 testing was not performed beforeoutpatient endoscopy. Inpatients and any outpatient that failed telephone triage were excluded. Standard surgical masks,FFPs and PPE were used by endoscopy staff for all procedures. Patients were contacted 14 days after the procedure toenquire if they had developed symptoms suggestive of COVID-19. Results 522 patients who had GI endoscopy were enrolled, and 506(96.9 %) were contacted for follow up. 163, 157, and186 patients were included in June, September, and October respectively. The mean age was 55.6(range 16-92). Nationallythere were 558, 7430, and 25476 new cases of COVID-19 in June, September, and October respectively. In the two weeks post endoscopy, 7/506(1.3 %) patients required testing for symptoms suggestive of COVID-19. Allpatients had negative results. No member of our endoscopy personnel contracted COVID-19 during the study period. Conclusions This study highlights that the risk of COVID-19 transmission related to GI endoscopy is negligible despitedramatic escalation in community infection.