Two outbreaks of SARS-CoV-2 in department of surgery in a Wuhan hospital

Gao, Shicheng; Yuan, Yufeng; Xiong, Yong; Zhang, Yongxi; Deng, Liping; Chen, Tielong; Ke, Hengning; Wang, Xinghuan

doi:10.1016/j.infpip.2020.100065

Cited by 9 publications

(20 citation statements)

References 5 publications

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“…Since patients can present at any stage of the illness, one CTNS would seem insufficient to prevent onward transmission if the decision to segregate patients is based on this result alone. Gao et al (5) have described two nosocomial outbreaks in Wuhan where the index was a misdiagnosed case of CA-COVID-19. Our results also suggest that 34.5% of all HA-COVID-19 and late indeterminate infections could be traced back to cases where the acquisition was in the community but an RNA based diagnosis could not be made within 48h of admission (table 5).…”

Section: Discussionmentioning

confidence: 99%

“…Recent publications have identified advanced age, comorbidities and male gender among as major risk factors for severity and mortality in COVID-19 (2, 3) and the impact of ethnicity is being explored (4). Healthcare associated COVID-19 infections (HA-COVID-19) have been reported in other studies (5) but the literature on epidemiology, risk factors and outcomes of healthcare acquisition of COVID-19 among healthcare inpatients is lacking.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence

Khonyongwa

Taori

Soares

et al. 2020

Preprint

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Background: The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV2 pandemic of 2020 has 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 London Teaching Hospital Trust. Methods: Electronic laboratory, patient and staff self-reported sickness records were interrogated for the period 1st March to 18th April 2020. HA-COVID-19 was defined as symptom onset >14d of admission. Test performance of a single combined throat and nose swab (CTNS) for patient placement and the effect of delayed RNA positivity (DRP, defined as >48h delay) on patient outcomes was evaluated. The incidence of staff self-reported COVID-19 sickness absence, hospital bed occupancy, community incidence and DRP was compared HA-COVID-19. The incidence of other significant hospital-acquired bacterial infections (OHAI) was compared to previous years. Results: 58 HA-COVID-19 (7.1%) cases were identified. As compared to community-acquired cases, significant differences were observed in age (p=0.018), ethnicity (p<0.001) and comorbidity burden (p<0.001) but not in 30d mortality. CTNS negative predictive value was 60.3%. DRP was associated with greater mortality (p=0.034) and 34.5% HA-COVID-19 cases could be traced to delayed diagnosis in CA-COVID-19. Incidence of HA-COVID-19 correlated positively with DRP (R=0.7108) and staff sickness absence (R=0.7815). OHAI rates were similar to previous 2 years. Conclusion: Early diagnosis and isolation of COVID-19 would help reduce transmission. A single CTNS has limited value in segregating patients into positive and negative pathways.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence

Khonyongwa

Taori

Soares

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Since patients can present at any stage of the illness, we conclude one CTNS is insufficient to prevent onward transmission, if the decision to segregate patients is based on this result alone. Gao et al ( 5 ) have described two nosocomial outbreaks in Wuhan where the index was a misdiagnosed case of CA-COVID-19. Our results also suggest that 34.5% of all HA-COVID-19 and late indeterminate infections could be traced back to cases where the acquisition was from a community case but an RNA based diagnosis could not be made within 48h of admission ( Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Recent publications have identified advanced age, comorbidities and male gender as major risk factors for severity and mortality in COVID-19 ( 2 , 3 ) and the impact of ethnicity is being explored ( 4 ). Healthcare-associated COVID-19 infections (HA-COVID-19) have been reported in other studies ( 5 ) but the literature on epidemiology, risk factors and outcomes of acquisition is lacking.…”

Section: Introductionmentioning

confidence: 99%

Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence

Khonyongwa

Taori

Soares

et al. 2020

Journal of Hospital Infection

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Background The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV2 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, England. Methods Electronic laboratory, patient and staff self-reported sickness records were interrogated from 1 st March to 18 th April 2020. HA-COVID-19 was defined as COVID-19 with symptom onset >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 >48h 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 to previous years. Results 58 HA-COVID-19 (7.1%) cases were identified. When compared to 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 d 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 previous 2 years. Conclusion Early diagnosis and isolation of COVID-19 patients would help reduce transmission. A single CTNS has limited value in segregating patients into positive and negative pathways.

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“…Previous experience suggests a high risk of transmission of coronaviruses in hospitals (Bin et al, 2015;Chowell et al, 2015). For SARS-CoV-2, the risk of transmission in hospitals is high, as evidenced by outbreaks in various medical institutions around the world (Gao et al, 2020;Heinzerling et al, 2020;Komissarov et al, 2020;Sommerstein et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Aerosol and Surface Contamination in Health Care Settings: The Moscow Pilot Study

Pochtovyi

Bacalin

Kuznetsova

et al. 2021

Aerosol Air Qual. Res.

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The ongoing worldwide COVID-19 pandemic caused by SARS-CoV-2 has had serious impacts on not only the health care system but also all sectors of the economy. Thanks to the adoption of various epidemiological measures, a significant reduction in new cases of infection has been achieved. However, there are still "hotspots", such as healthcare settings focused on treating patients with COVID-19, which are characterized by the risk of nosocomial transmission among health care workers, patients, and visitors. The proper monitoring and timely detection of pathogens in a hospital environment will help prevent further spread of coronavirus infection. In this study, we collected samples from the air and surface swabs at the First Moscow Infectious Diseases Hospital to study the spread of the SARS-CoV-2 in various hospital locations. More than 130 aerosol and surface samples were collected and analysed by RT-PCR. We detected viral contamination of the air in the intensive care unit (ICU) but not in the respiratory infection department where less severe patients are treated. The concentration of SARS-CoV-2 RNA was low, consisting of less than one copy per litre of air. The contact surfaces in both departments were contaminated with SARS-CoV-2. Considering the possible transmission of SARS-CoV-2 through fomites, these results indicate the need to strictly follow personal hygiene rules as well as wear personal protective equipment to prevent disease spread.

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Two outbreaks of SARS-CoV-2 in department of surgery in a Wuhan hospital

Cited by 9 publications

References 5 publications

Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence

Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence

Incidence and outcomes of healthcare-associated COVID-19 infections: significance of delayed diagnosis and correlation with staff absence

SARS-CoV-2 Aerosol and Surface Contamination in Health Care Settings: The Moscow Pilot Study

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