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The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020.
Knight, Gwenan M; Pham, Thi Mui; Stimson, James; Funk, Sebastian; Jafari, Yalda; Pople, Diane; Evans, Stephanie; Yin, Mo; Brown, Colin S; Bhattacharya, Alex; Hope, Russell; Semple, Malcolm G; Read, Jonathan M; Cooper, Ben S; Robotham, Julie V.
  • Knight GM; Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. gwen.knight@lshtm.ac.uk.
  • Pham TM; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Stimson J; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
  • Funk S; Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, Colindale, London, UK.
  • Jafari Y; Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
  • Pople D; Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
  • Evans S; Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, Colindale, London, UK.
  • Yin M; Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, Colindale, London, UK.
  • Brown CS; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
  • Bhattacharya A; National University of Singapore Department of Medicine, Singapore, Singapore.
  • Hope R; Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, Colindale, London, UK.
  • Semple MG; Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, Colindale, London, UK.
  • Read JM; Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
BMC Infect Dis ; 22(1): 556, 2022 Jun 18.
Article in English | MEDLINE | ID: covidwho-1962756
ABSTRACT

BACKGROUND:

SARS-CoV-2 is known to transmit in hospital settings, but the contribution of infections acquired in hospitals to the epidemic at a national scale is unknown.

METHODS:

We used comprehensive national English datasets to determine the number of COVID-19 patients with identified hospital-acquired infections (with symptom onset > 7 days after admission and before discharge) in acute English hospitals up to August 2020. As patients may leave the hospital prior to detection of infection or have rapid symptom onset, we combined measures of the length of stay and the incubation period distribution to estimate how many hospital-acquired infections may have been missed. We used simulations to estimate the total number (identified and unidentified) of symptomatic hospital-acquired infections, as well as infections due to onward community transmission from missed hospital-acquired infections, to 31st July 2020.

RESULTS:

In our dataset of hospitalised COVID-19 patients in acute English hospitals with a recorded symptom onset date (n = 65,028), 7% were classified as hospital-acquired. We estimated that only 30% (range across weeks and 200 simulations 20-41%) of symptomatic hospital-acquired infections would be identified, with up to 15% (mean, 95% range over 200 simulations 14.1-15.8%) of cases currently classified as community-acquired COVID-19 potentially linked to hospital transmission. We estimated that 26,600 (25,900 to 27,700) individuals acquired a symptomatic SARS-CoV-2 infection in an acute Trust in England before 31st July 2020, resulting in 15,900 (15,200-16,400) or 20.1% (19.2-20.7%) of all identified hospitalised COVID-19 cases.

CONCLUSIONS:

Transmission of SARS-CoV-2 to hospitalised patients likely caused approximately a fifth of identified cases of hospitalised COVID-19 in the "first wave" in England, but less than 1% of all infections in England. Using time to symptom onset from admission for inpatients as a detection method likely misses a substantial proportion (> 60%) of hospital-acquired infections.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07490-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / COVID-19 Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: S12879-022-07490-4