ABSTRACT
BackgroundRhinoviruses account for many cases of the "common cold" and infection is often self-limiting. As such, there is a lack of data regarding the inpatient outcomes of individuals hospitalized with rhinovirus infection. Given the generalized poorer prognosis of elderly admitted with respiratory viral infections, we assessed the mortality rate of general medical patients admitted with rhinovirus infection along with the major risk factors associated to mortality. MethodsWe performed a retrospective chart review of patients admitted to our clinical teaching ward from December 2013 to June 2017. ResultsOverall, 12.5% of patients admitted with rhinovirus infection died within 90 days of admission. The median age of admitted patients was 70 years-old. In univariable analysis, age (OR 1.05; 95% confidence interval (CI) 1.01-1.09) and the need for oxygen at presentation (OR 3.23; 95% CI 1.06-9.86) were associated with death while obstructive pulmonary disease or asthma (OR 0.10; 95% CI 0.01-0.81) was associated with survival. In the multivariable model, age (aOR 1.04; 95% CI 1.00-1.09) and obstructive lung disease (aOR 0.09 95%CI 0.01-0.73) remained significant whereas the requirement for oxygen at presentation did not (aOR 2.78; 95% CI 0.84-9.23). ConclusionOur study reveals that rhinovirus is an important cause of both morbidity and mortality in the elderly and further highlights the need for studies of potentially effective treatment options. In the meantime, we suggest that rigorous respiratory hygiene measures and quality older adult care should be practiced when caring for at-risk adults.
ABSTRACT
BackgroundEvidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to SARS-CoV-2. This study evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. MethodsHCWs advised by their Infection Control or Occupational Health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May-September 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0-6 post exposure, followed by standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for i) clinical COVID-19 diagnosis from day 8-14 post exposure, and for ii) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9-10 and 14 post exposure. Interim results are reported in the context of a second wave threatening this essential workforce. ResultsAmong 30 HCWs enrolled to date (age 31{+/-}9 years, 24 [80.0%] female), 3 were diagnosed with COVID-19 by day 14 post exposure (secondary attack rate 10.0%), with all cases detected by the 7-day infection control strategy: NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95%CI: 93.1-100.0%). InterpretationAmong HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. While ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.
