Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence
The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV-2 pandemic of 2020 led to onward transmissions among vulnerable inpatients. This study was performed to evaluate the prevalence and clinical outcomes of healthcare-associated COVID-19 infections (HA-COVID-19) during the 2020...
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| Veröffentlicht in: | The Journal of hospital infection 2020-12, Vol.106 (4), p.663-672 |
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| container_title | The Journal of hospital infection |
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| creator | Khonyongwa, K. Taori, S.K. Soares, A. Desai, N. Sudhanva, M. Bernal, W. Schelenz, S. Curran, L.A. |
| description | The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV-2 pandemic of 2020 led to onward transmissions among vulnerable inpatients.
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.
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.
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 |
| doi_str_mv | 10.1016/j.jhin.2020.10.006 |
| format | Article |
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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.
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.
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.
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.</description><identifier>ISSN: 0195-6701</identifier><identifier>EISSN: 1532-2939</identifier><identifier>DOI: 10.1016/j.jhin.2020.10.006</identifier><identifier>PMID: 33065193</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Absenteeism ; Aged ; Aged, 80 and over ; Case-Control Studies ; Comorbidity ; Coronavirus ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 - transmission ; COVID-19 - virology ; Cross Infection - epidemiology ; Cross Infection - prevention & control ; Cross Infection - virology ; Delayed Diagnosis - adverse effects ; Female ; Global Burden of Disease - statistics & numerical data ; HCW infections ; Humans ; Incidence ; London - epidemiology ; Male ; Nosocomial infections ; Predictive Value of Tests ; Prevalence ; Risk Factors ; SARS-CoV-2 - genetics ; Self Report</subject><ispartof>The Journal of hospital infection, 2020-12, Vol.106 (4), p.663-672</ispartof><rights>2020 The Healthcare Infection Society</rights><rights>Copyright © 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.</rights><rights>2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. 2020 The Healthcare Infection Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-af2bc8bd5c36d9ce96f5920a10ba641e73a694434cfd6d4485e7ccfa9eb090493</citedby><cites>FETCH-LOGICAL-c455t-af2bc8bd5c36d9ce96f5920a10ba641e73a694434cfd6d4485e7ccfa9eb090493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhin.2020.10.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33065193$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khonyongwa, K.</creatorcontrib><creatorcontrib>Taori, S.K.</creatorcontrib><creatorcontrib>Soares, A.</creatorcontrib><creatorcontrib>Desai, N.</creatorcontrib><creatorcontrib>Sudhanva, M.</creatorcontrib><creatorcontrib>Bernal, W.</creatorcontrib><creatorcontrib>Schelenz, S.</creatorcontrib><creatorcontrib>Curran, L.A.</creatorcontrib><title>Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence</title><title>The Journal of hospital infection</title><addtitle>J Hosp Infect</addtitle><description>The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV-2 pandemic of 2020 led to onward transmissions among vulnerable inpatients.
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.
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.
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.
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.</description><subject>Absenteeism</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Case-Control Studies</subject><subject>Comorbidity</subject><subject>Coronavirus</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - transmission</subject><subject>COVID-19 - virology</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - prevention & control</subject><subject>Cross Infection - virology</subject><subject>Delayed Diagnosis - adverse effects</subject><subject>Female</subject><subject>Global Burden of Disease - statistics & numerical data</subject><subject>HCW infections</subject><subject>Humans</subject><subject>Incidence</subject><subject>London - epidemiology</subject><subject>Male</subject><subject>Nosocomial infections</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Risk Factors</subject><subject>SARS-CoV-2 - genetics</subject><subject>Self Report</subject><issn>0195-6701</issn><issn>1532-2939</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS1ERbeFP8AB-cglix3HyRohJLQUWKlSL4WrNbHHG6-ydrGzRf0J_GsctlT00pOlN--9seYj5DVnS854-2633A0-LGtWz8KSsfYZWXAp6qpWQj0nC8aVrNqO8VNylvOOMVZ0-YKcCsFayZVYkN-bYLzFYJBCsDQeJhP3mGl0dEAYp8FAwgpyjsbDhJaur35sPldcUR8cmsnHkN_T7LfBO29g7ilRiyPcFbP1sA0x-_y33MSUymDO0F9-GmiewDkKfZ73vyQnDsaMr-7fc_L9y8X1-lt1efV1s_50WZlGyqkCV_dm1VtpRGuVQdU6qWoGnPXQNhw7Aa1qGtEYZ1vbNCuJnTEOFPZMsUaJc_Lx2Htz6PdoDYYpwahvkt9DutMRvH48CX7Q23irOykFZ6IUvL0vSPHnAfOk9z4bHEcIGA9Z143kq7JYdMVaH60mxZwTuoc1nOmZod7pmaGeGc5aYVhCb_7_4EPkH7Ri-HA0YDnTrceks_HzCa1PBYm20T_V_wdmzbEv</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Khonyongwa, K.</creator><creator>Taori, S.K.</creator><creator>Soares, A.</creator><creator>Desai, N.</creator><creator>Sudhanva, M.</creator><creator>Bernal, W.</creator><creator>Schelenz, S.</creator><creator>Curran, L.A.</creator><general>Elsevier Ltd</general><general>The Healthcare Infection Society. 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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.
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.
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.
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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33065193</pmid><doi>10.1016/j.jhin.2020.10.006</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Absenteeism Aged Aged, 80 and over Case-Control Studies Comorbidity Coronavirus COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - transmission COVID-19 - virology Cross Infection - epidemiology Cross Infection - prevention & control Cross Infection - virology Delayed Diagnosis - adverse effects Female Global Burden of Disease - statistics & numerical data HCW infections Humans Incidence London - epidemiology Male Nosocomial infections Predictive Value of Tests Prevalence Risk Factors SARS-CoV-2 - genetics Self Report |
| title | Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence |
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