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Protocol for the COG-UK hospital-onset COVID-19 infection (HOCI) multicentre interventional clinical study: evaluating the efficacy of rapid genome sequencing of SARS-CoV-2 in limiting the spread of COVID-19 in UK NHS hospitals.
Blackstone, James; Stirrup, Oliver; Mapp, Fiona; Panca, Monica; Copas, Andrew; Flowers, Paul; Hockey, Leanne; Price, James; Partridge, David; Peters, Christine; de Silva, Thushan; Nebbia, Gaia; Snell, Luke B; McComish, Rachel; Breuer, Judith.
  • Blackstone J; Comprehensive Clinical Trials Unit, University College London, London, UK.
  • Stirrup O; Institute for Global Health, University College London, London, UK.
  • Mapp F; Institute for Global Health, University College London, London, UK.
  • Panca M; Comprehensive Clinical Trials Unit, University College London, London, UK.
  • Copas A; Institute for Global Health, University College London, London, UK.
  • Flowers P; School of Psychology & Health, University of Strathclyde, Glasgow, UK.
  • Hockey L; Comprehensive Clinical Trials Unit, University College London, London, UK.
  • Price J; Department of Infectious Disease, Imperial College London, London, UK.
  • Partridge D; Department of Virology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Peters C; Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK.
  • de Silva T; Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK.
  • Nebbia G; Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK.
  • Snell LB; Department of Infectious Diseases, Guy's and St Thomas' NHS Foundation Trust, London, UK.
  • McComish R; Comprehensive Clinical Trials Unit, University College London, London, UK.
  • Breuer J; Institute of Child Health, University College London, London, UK j.breuer@ucl.ac.uk.
BMJ Open ; 12(4): e052514, 2022 04 19.
Article in English | MEDLINE | ID: covidwho-1962188
ABSTRACT

OBJECTIVES:

Nosocomial transmission of SARS-CoV-2 has been a significant cause of mortality in National Health Service (NHS) hospitals during the COVID-19 pandemic. The COG-UK Consortium Hospital-Onset COVID-19 Infections (COG-UK HOCI) study aims to evaluate whether the use of rapid whole-genome sequencing of SARS-CoV-2, supported by a novel probabilistic reporting methodology, can inform infection prevention and control (IPC) practice within NHS hospital settings.

DESIGN:

Multicentre, prospective, interventional, superiority study.

SETTING:

14 participating NHS hospitals over winter-spring 2020/2021 in the UK.

PARTICIPANTS:

Eligible patients must be admitted to hospital with first-confirmed SARS-CoV-2 PCR-positive test result >48 hour from time of admission, where COVID-19 diagnosis not suspected on admission. The projected sample size is 2380 patients. INTERVENTION The intervention is the return of a sequence report, within 48 hours in one phase (rapid local lab processing) and within 5-10 days in a second phase (mimicking central lab), comparing the viral genome from an eligible study participant with others within and outside the hospital site. PRIMARY AND SECONDARY OUTCOME

MEASURES:

The primary outcomes are incidence of Public Health England (PHE)/IPC-defined SARS-CoV-2 hospital-acquired infection during the baseline and two interventional phases, and proportion of hospital-onset cases with genomic evidence of transmission linkage following implementation of the intervention where such linkage was not suspected by initial IPC investigation. Secondary outcomes include incidence of hospital outbreaks, with and without sequencing data; actual and desirable changes to IPC actions; periods of healthcare worker (HCW) absence. Health economic analysis will be conducted to determine cost benefit of the intervention. A process evaluation using qualitative interviews with HCWs will be conducted alongside the study. TRIAL REGISTRATION NUMBER ISRCTN50212645. Pre-results stage. This manuscript is based on protocol V.6.0. 2 September 2021.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-052514

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-052514