10 Sep Large US Academic Medical Center Study Finds Low Risk Of COVID-19 Transmission to Patients Within Hospital
MedicalResearch.com Interview with:
Chanu Rhee MD MPH
Associate Hospital Epidemiologist
Attending Physician, Infectious Diseases and Critical Care Medicine
Assistant Professor of Medicine
Brigham and Women’s Hospital
MedicalResearch.com: What is the background for this study?
Response: Many patients have been avoiding essential care during the COVID-19 pandemic due to fear of contracting SARS-CoV-2 in healthcare settings. Little is known, however about the adequacy of infection control practices in preventing nosocomial COVID-19 in U.S. acute care hospitals.
We therefore conducted this observational study to determine the incidence of nosocomial COVID-19 in patients hospitalized at a large academic medical center in Boston (Brigham and Women’s Hospital) during the first 12 weeks of the surge in Massachusetts.
MedicalResearch.com: What are the main findings?
Response: Between March 7 and May 30, our hospital admitted nearly 700 patients with COVID-19 and over 8,000 without COVID-19, with a peak inpatient COVID-19 census of over 170 patients in late April. A multifaceted infection control program, informed by U.S. CDC guidance, was implemented and evolved during this time, eventually encompassing universal masking of all patients, staff and visitors; dedicated COVID-19 units with airborne infection isolation rooms; N95 respirators, eye protection, gown, and gloves for all patients with suspected or confirmed COVID-19; a restricted visitor policy; daily symptom screening for employees and patients; and PCR testing of all patients being admitted to the hospital and liberal testing of hospitalized patients for any suspicion of COVID-19.
We reviewed the medical records of all patients who first tested positive for SARS-CoV-2 by PCR on hospital day 3 or later or within 14 days of hospital discharge to determine whether cases were likely acquired in the hospital or in the community.
We found that only two patients likely acquired COVID-19 within the hospital, including one who likely acquired it from his visiting spouse prior to universal masking and restriction of visitors, and one patient with no clear exposures within or outside the hospital.
MedicalResearch.com: What should readers take away from your report?
Response: Our study demonstrates that a multifaceted infection control program based on U.S. CDC guidance can successfully minimize the risk of nosocomial transmission of SARS-CoV-2 to hospitalized patients. These findings, especially if replicated at other hospitals, should provide reassurance to patients as some healthcare systems re-open services and others continue to face COVID-19 surges.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Additional research should focus on determining the generalizability of our results, in particular whether the exceedingly low incidence of nosocomial COVID-19 we observed in our hospital was seen across most U.S. hospitals. Future studies should also evaluate which infection control measures are most critical to preventing nosocomial spread of COVID-19.
MedicalResearch.com: Is there anything else you would like to add?
Response: One important limitation of our study is that we did not examine COVID-19 infections among health care workers. We believe that this important topic warrants a separate, detailed analysis. In terms of disclosures, this study was funded by the CDC Prevention Epicenters Program.
Rhee C, Baker M, Vaidya V, et al. Incidence of Nosocomial COVID-19 in Patients Hospitalized at a Large US Academic Medical Center. JAMA Netw Open. 2020;3(9):e2020498. doi:10.1001/jamanetworkopen.2020.20498
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