A comparison of characteristics and outcomes of patients with community-acquired and hospital-acquired COVID-19 in the United Kingdom: An observational study

Shiwani, Haaris A.; Bilal, Muhammad; Shahzad, Muhammad Umar; Rodrigues, Alson; Suliman, Jehad A.; Soban, Muhammad; Mirza, Shahzeb; Lotca, N; Ruslan, Mohammed R.; Memon, Danyal; Arshad, Muhammad; Fatima, Kiran; Kamran, Asma; Egom, Emmanuel E.; Aziz, Abdul

doi:10.1016/j.rmed.2021.106314

Cited by 7 publications

(19 citation statements)

References 22 publications

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“…Nosocomial and community-acquired Covid-19 have been frequently compared in the literature. In our study, the patients with nosocomial Covid-19 were older and had a longer hospital stay than the patients with community-acquired Covid-19 as it was previously demonstrated in 2 other studies [4,24]. We identi ed a higher mortality in patients with nosocomial (36%) than in those with community-acquired Covid-19 (21%).…”

Section: Descriptive and Comparative Analysis Of The Case-control Studysupporting

confidence: 77%

“…In total, 281 cases were matched to 441 controls according to the length of stay before diagnosis and the period of admission in hospital. In the literature, the proportion of nosocomial Covid-19 cases was comprised between 0% and 30.5% during the rst wave [4,18]. In our hospital, the rate of nosocomial Covid-19 was low during the rst wave, with 5.4% of nosocomial cases [19].…”

Section: Descriptive and Comparative Analysis Of The Case-control Studymentioning

confidence: 60%

“…Three observational studies found no signi cant difference regarding mortality [4,24,25], and a recent review showed a higher mortality for patients with a community-acquired Covid-19 compared to patients with a nosocomial Covid-19 [26]. An observational study had similar results as ours for mortality of nosocomial cases (32%) but they identi ed a higher proportion of admissions to ICU for the patients with nosocomial compared to the patients with community-acquired Covid-19 [4]. Finally, we did not identify any difference regarding gender as found in the literature [24,27].…”

Section: Descriptive and Comparative Analysis Of The Case-control Studymentioning

confidence: 96%

“…In response to the pandemic, hospitals implemented infection prevention strategies to reduce the risk of nosocomial transmission to a minimum. However, these strategies based on in uenza prevention, did not completely stop the spread of nosocomial Covid-19 [3,4]. Thus, at Grenoble Alpes university hospital (CHUGA), Covid-19 numbers increased sharply during the second wave of the pandemic, between September 2020 and January 2021, and had serious consequences on patient management (units closing, etc…).…”

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confidence: 99%

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Risk factors of nosocomial Covid-19 in a French university hospital: a case- control study

Dinh

Gallouche

Terrisse

et al. 2022

Preprint

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Background: During the Covid-19 pandemic, prevention strategies implemented by hospitals to reduce nosocomial transmission sometimes failed and determining transmission risk factors remains crucial. Our objective was to determine the risk factors of nosocomial Covid-19.Methods: A case-control study was conducted in a French hospital between 09/01/2020 and 01/31/2021. Adult patients hospitalized in medical or surgical units were included. Infants or patients hospitalized in ICU were excluded. Cases were patients with a nosocomial Covid-19 (clinical symptoms and RT-PCR positive for SARS-CoV-2 or RT-PCR positive for SARS-CoV-2 with Ct ≤28 more than five days after admission); controls were patients without infection (RT-PCR negative for SARS-CoV-2 more than 5 days after admission). They were matched according to length of stay before diagnosis and period of admission. Analyses were performed with a conditional logistic regression.Results: A total of 281 cases and 441 controls were included. In the bivariate analysis, cases were older (OR per 10 years: 1.22; CI95% [1.10; 1.36]), had more often shared a room (OR: 1.74; CI95% [1.25; 2.43]), had more often a risk factor of severe Covid-19 (OR: 1.94; CI95% [1.09; 3.45]), were more often hospitalized in medical units [OR: 1.59; CI95% [1.12; 2.25]), had a higher exposure to contagious health care workers (HCW; OR per 1 person.days: 1.12; CI95% [1.08; 1.17]) and contagious patients (OR per 1 person.days: 1.11; CI95% [1.08; 1.14]) than controls. In an adjusted model, risk factors of nosocomial Covid-19 were exposure to contagious HCW (aOR per 1 person.days: 1.08; CI95% [1.03; 1.14]) and exposure to contagious patients (aOR per 1 person.days: 1.10; CI95% [1.07; 1.13]).Conclusions: Exposure to contagious professionals and contagious patients are the main risk factors for nosocomial Covid-19, outweighing all other potential risk factors including the hospitalisation in double room. Prevention strategies need to be adjusted according to these results to decrease the risk of nosocomial COVID-19.Trial registrationStudy ethics approval was obtained retrospectively on 22 December 2021 (CECIC Rhône-Alpes-Auvergne, Clermont-Ferrand, IRB 5891).

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Section: Descriptive and Comparative Analysis Of The Case-control Studysupporting

confidence: 77%

Section: Descriptive and Comparative Analysis Of The Case-control Studymentioning

confidence: 60%

Section: Descriptive and Comparative Analysis Of The Case-control Studymentioning

confidence: 96%

mentioning

confidence: 99%

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Risk factors of nosocomial Covid-19 in a French university hospital: a case- control study

Dinh

Gallouche

Terrisse

et al. 2022

Preprint

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“…Nosocomial COVID prevalence is based on a review undertaken early in the pandemic (considering only studies with a sample >100) [21] and recent information about prevalence with the Omicron variant [22][23][24]. Risks of ICU admission and death reflect a 2021 systematic review [25], which results were supported by later studies [26][27][28][29]. Finally, the impact of healthcare-facility screening is based on simulations in [30] for the high community incidence scenario.…”

Section: Use Case 3: Testing In Health Facilitiesmentioning

confidence: 99%

Is there a role for RDTs as we live with COVID? An assessment of different strategies

Bonnet

Vassall

Jit

2022

Preprint

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Introduction: By 2022, high levels of past COVID-19 infections, combined with substantial levels of vaccination and the development of Omicron have shifted country strategies toward burden reduction policies. SARS-CoV-2 rapid antigen tests (RDTs) could contribute to these policies by helping rapidly detect, isolate and/or treat infections in different settings. However, the evidence to inform RDT policy choices in LMICs is limited. Method: We provide an overview of the potential impact of several RDT use cases (surveillance; testing, tracing and isolation without and with surveillance; hospital-based screening to reduce nosocomial COVID; and testing to enable earlier/expanded treatment) for a range of country settings. We use conceptual models and literature review to identify which use cases are likely to bring benefits and how these may change with outbreak characteristics. Impacts are measured through multiple outcomes related to gaining time, reducing the burden on the health system, and reducing deaths. Results: In an optimal scenario in terms of resources and capacity and with baseline parameters, we find marginal time gains of at least a week through surveillance and testing tracing and isolation with surveillance, a reduction in peak ICU or ICU admissions by 6% or more (hospital-based screening; testing, tracing and isolation), and reductions in COVID deaths by over 6% (hospital-based screening; test and treat). Time gains may be used to strengthen ICU capacity and/or boost vulnerable individuals, though only a small minority of at-risk individuals could be reached in the time available. The impact of RDTs declines with lower country resources and capacity, more transmissible or immune-escaping variants and reduced test sensitivity. Conclusion: RDTs alone are unlikely to dramatically reduce the burden of COVID-19 in LMICs, though they may have an important role alongside other interventions such as vaccination, therapeutic drugs, improved healthcare capacity and non-pharmaceutical measures.

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Risk factors for nosocomial COVID-19 in a French university hospital

Dinh¹,

Gallouche²,

Terrisse³

et al. 2023

Infectious Diseases Now

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A comparison of characteristics and outcomes of patients with community-acquired and hospital-acquired COVID-19 in the United Kingdom: An observational study

Cited by 7 publications

References 22 publications

Risk factors of nosocomial Covid-19 in a French university hospital: a case- control study

Risk factors of nosocomial Covid-19 in a French university hospital: a case- control study

Is there a role for RDTs as we live with COVID? An assessment of different strategies

Risk factors for nosocomial COVID-19 in a French university hospital

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