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Strategies for the Prevention of the Intra-Hospital Transmission of COVID-19: A Retrospective Cohort Study.

ABSTRACT: Coronavirus disease (COVID-19) has spread rapidly worldwide. We aimed to review the strategies used by our university hospital in Daegu (South Korea) to prevent the transmission of COVID-19 within our institution. We also investigated the actual situation at our hospital against the recommended guidelines. We conducted a survey among patients and staff in our hospital. Additionally, patients' electronic medical records were reviewed along with closed-circuit television (CCTV) recordings. Various strategies and guidelines developed by our hospital have been implemented. A total of 303 hospital staff and patients had exposure to 29 confirmed COVID-19 patients. Of them, three tested positive for COVID-19 without further transmission. The intra-hospital infection of the disease occurred when the recommended strategies and guidelines such as wearing a mask and isolating for 2 weeks were not followed. In conclusion, the implementation of robust guidelines for preventing the intra-hospital transmission of COVID-19 is essential.

SUBMITTER: Chang MC

PROVIDER: S-EPMC7551914 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Strategies for the Prevention of the Intra-Hospital Transmission of COVID-19: A Retrospective Cohort Study.

Chang Min Cheol MC Hur Jian J Park Donghwi D

Healthcare (Basel, Switzerland) 20200703 3

Coronavirus disease (COVID-19) has spread rapidly worldwide. We aimed to review the strategies used by our university hospital in Daegu (South Korea) to prevent the transmission of COVID-19 within our institution. We also investigated the actual situation at our hospital against the recommended guidelines. We conducted a survey among patients and staff in our hospital. Additionally, patients' electronic medical records were reviewed along with closed-circuit television (CCTV) recordings. Various ...[more]

PMID: 32635290

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Project description:ObjectiveTo quantify rates of organ specific dysfunction in individuals with covid-19 after discharge from hospital compared with a matched control group from the general population.DesignRetrospective cohort study.SettingNHS hospitals in England.Participants47 780 individuals (mean age 65, 55% men) in hospital with covid-19 and discharged alive by 31 August 2020, exactly matched to controls from a pool of about 50 million people in England for personal and clinical characteristics from 10 years of electronic health records.Main outcome measuresRates of hospital readmission (or any admission for controls), all cause mortality, and diagnoses of respiratory, cardiovascular, metabolic, kidney, and liver diseases until 30 September 2020. Variations in rate ratios by age, sex, and ethnicity.ResultsOver a mean follow-up of 140 days, nearly a third of individuals who were discharged from hospital after acute covid-19 were readmitted (14 060 of 47 780) and more than 1 in 10 (5875) died after discharge, with these events occurring at rates four and eight times greater, respectively, than in the matched control group. Rates of respiratory disease (P<0.001), diabetes (P<0.001), and cardiovascular disease (P<0.001) were also significantly raised in patients with covid-19, with 770 (95% confidence interval 758 to 783), 127 (122 to 132), and 126 (121 to 131) diagnoses per 1000 person years, respectively. Rate ratios were greater for individuals aged less than 70 than for those aged 70 or older, and in ethnic minority groups compared with the white population, with the largest differences seen for respiratory disease (10.5 (95% confidence interval 9.7 to 11.4) for age less than 70 years v 4.6 (4.3 to 4.8) for age ≥70, and 11.4 (9.8 to 13.3) for non-white v 5.2 (5.0 to 5.5) for white individuals).ConclusionsIndividuals discharged from hospital after covid-19 had increased rates of multiorgan dysfunction compared with the expected risk in the general population. The increase in risk was not confined to the elderly and was not uniform across ethnicities. The diagnosis, treatment, and prevention of post-covid syndrome requires integrated rather than organ or disease specific approaches, and urgent research is needed to establish the risk factors.

Project description:BackgroundData from the UK COVID-19 outbreak are emerging, and there are ongoing concerns about a disproportionate effect on ethnic minorities. There is very limited information on COVID-19 in the over-80s, and the rates of hospital-onset infections are unknown.MethodsThis was a retrospective cohort study from electronic case records of the first 450 patients admitted to our hospital with PCR-confirmed COVID-19, 77% of the total inpatient caseload to date. Demographic, clinical and biochemical data were extracted. The primary endpoint was death during the index hospital admission. The characteristics of all patients, those over 80 years of age and those with hospital-onset COVID-19 were examined.ResultsThe median (IQR) age was 72 (56, 83), with 150 (33%) over 80 years old and 60% male. Presenting clinical and biochemical features were consistent with those reported elsewhere. The ethnic breakdown of patients admitted was similar to that of our underlying local population. Inpatient mortality was high at 38%. Patients over 80 presented earlier in their disease course and were significantly less likely to present with the typical features of cough, breathlessness and fever. Cardiac co-morbidity and markers of cardiac dysfunction were more common, but not those of bacterial infection. Mortality was significantly higher in this group (60% vs 28%, p < 0.001). Thirty-one (7%) patients acquired COVID-19 having continuously been in hospital for a median of 20 (14, 36) days. The peak of hospital-onset infections occurred at the same time as the overall peak of admitted infections. Despite being older and more frail than those with community-onset infection, their outcomes were no worse.ConclusionsInpatient mortality was high, especially among the over-80s, who are more likely to present atypically. The ethnic composition of our caseload was similar to the underlying population. While a significant number of patients acquired COVID-19 while already in hospital, their outcomes were no worse.

Dataset Information

Strategies for the Prevention of the Intra-Hospital Transmission of COVID-19: A Retrospective Cohort Study.

Publications

Strategies for the Prevention of the Intra-Hospital Transmission of COVID-19: A Retrospective Cohort Study.

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