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Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence.
Khonyongwa, K; Taori, S K; Soares, A; Desai, N; Sudhanva, M; Bernal, W; Schelenz, S; Curran, L A.
  • Khonyongwa K; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
  • Taori SK; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK; School of Immunology and Microbial Sciences, Kings College London, London, UK. Electronic address: surabhi.taori@nhslothian.scot.nhs.uk.
  • Soares A; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
  • Desai N; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
  • Sudhanva M; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK; South London Specialist Virology Centre, VIAPATH, Denmark Hill, London, UK.
  • Bernal W; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK; School of Immunology and Microbial Sciences, Kings College London, London, UK.
  • Schelenz S; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
  • Curran LA; Kings College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
J Hosp Infect ; 106(4): 663-672, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-856859
Preprint
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ABSTRACT

BACKGROUND:

The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV-2 pandemic of 2020 led to onward transmissions among vulnerable inpatients.

AIMS:

This study was performed to evaluate the prevalence and clinical outcomes of healthcare-associated COVID-19 infections (HA-COVID-19) during the 2020 epidemic and study factors which may promote or correlate with its incidence and transmission in a Teaching Hospital NHS Trust in London, UK.

METHODS:

Electronic laboratory, patient and staff self-reported sickness records were interrogated from 1st March to 18th April 2020. HA-COVID-19 was defined as COVID-19 with symptom onset within >14 days of admission. Test performance of a single combined throat and nose swab (CTNS) for patient placement was calculated. The effect of delayed RNA positivity (DRP, defined as >48 h delay), staff self-reported COVID-19 sickness absence, hospital bed occupancy, and community incidence of COVID-19 was compared for HA-COVID-19. The incidence of other significant hospital-acquired bacterial infections (HAB) was compared with previous years.

RESULTS:

Fifty-eight HA-COVID-19 (7.1%) cases were identified. When compared with community-acquired admitted cases (CA-COVID-19), significant differences were observed in age (P=0.018), ethnicity (P<0.001) and comorbidity burden (P<0.001) but not in 30-day mortality. CTNS-negative predictive value was 60.3%. DRP was associated with greater mortality (P=0.034) and incidence of HA-COVID-19 correlated positively with DRP (R = 0.7108) and staff sickness absence (R = 0.7815). For the study period HAB rates were similar to the previous 2 years.

CONCLUSIONS:

Early diagnosis and isolation of COVID-19 patients would help to reduce transmission. A single CTNS has limited value in segregating patients into positive and negative pathways.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / Delayed Diagnosis / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: J Hosp Infect Year: 2020 Document Type: Article Affiliation country: J.jhin.2020.10.006

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / Delayed Diagnosis / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: J Hosp Infect Year: 2020 Document Type: Article Affiliation country: J.jhin.2020.10.006