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Comparison between healthcare-associated and community-acquired hospitalised COVID-19 cases from the Swiss prospective COVID-19 cohort
Antimicrobial Resistance and Infection Control ; 10(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1448316
ABSTRACT

Introduction:

Numerous reports of healthcare-associated COVID- 19 (HA-COVID-19) outbreaks have highlighted that hospitals can be a platform for SARS-CoV-2 transmission. Uncertainty remains with regards to clinical outcomes of patients who contracted SARS-CoV-2 in healthcare facilities compared to those hospitalized after community acquisition (CA-COVID-19).

Objectives:

The objective of this study was to describe and compare characteristics and clinical outcomes of patients with HA-COVID-19 versus CA-COVID-19.

Methods:

We used data from 16 hospitals included in the prospective national surveillance on COVID-19 in Switzerland. We included all hospitalized COVID-19 adult cases with a laboratory confirmed infection. HA-COVID-19 cases were defined as those detected > 5 days after hospital admission. Only the first hospital stay after diagnosis for CACOVID- 19 cases, and during diagnosis for HA-COVID-19 cases, were considered. Cases with no information on place of acquisition were excluded.

Results:

Between February and December 2020, 1'389 HA-COVID-19 cases and 9'139 CA-COVID-19 were included. HA-COVID-19 patients were older than CA-COVID-19 (median [IQR] age 79 [70-86] versus 70 [57-80], predominantly female (48.2% versus 39.6%), and were more likely to have a Charlson comorbidity index > 4 (78.2% versus 54.9%). At the time of diagnosis, HA-COVID cases were most frequently hospitalized in general medical (570, 41%) and Geriatric/Rehabilitation wards (409, 29.4%). Length of stay was shorter for CA-COVID-19 cases (median 15, IQR [10-23] days from admission) than for HA-COVID-19 (17 [9-30] days from COVID-19 diagnosis). Fewer HA-COVID-19 patients stayed in intermediate or intensive care units (ICU) (223 [16.1%] versus 2'031 [22%] of CA-COVID-19 cases) (p < 0.001), and fewer HA-COVID-19 cases experienced any COVID-19 complications (770 (65.7%) versus 6665 (83.5%), p < 0.001). Overally, 350 (26.6%) HA-COVID-19 and 1225 (13.9%) CA-COVID-19 died.

Conclusion:

Patients who acquired COVID-19 within the hospital were older and more comorbid. They were less frequently transferred to the intermediate or ICU and experienced fewer COVID-19 complications, but suffered from higher rates of hospital mortality.

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Antimicrobial Resistance and Infection Control Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Antimicrobial Resistance and Infection Control Year: 2021 Document Type: Article