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SARS-CoV-2/COVID-19

Coronavirus Collection - Over 1.3m downloads
Contents

Page 18 of 30

Letter to the Editor

Original Article

  • Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among hospital workers in a severely affected institution in Madrid, Spain: A surveillance cross-sectional study

  • Part of:
  • Felipe Pérez-García, Aurora Pérez-Zapata, Naroa Arcos, Manuel De la Mata, María Ortiz, Encarnación Simón, Irene Hervás Fernández, Victoria González Ventosa, Mario Muñoz Monte, Javier González Arroyo, Ramón Pérez-Tanoira, Juan Cuadros-González
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 42 / Issue 7 / July 2021
    Published online by Cambridge University Press:
    29 October 2020, pp. 803-809
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  • Objective:

    To analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic in workers of a hospital located in one of the most affected areas in Spain.

    Design, settings, and patients:

    Cross-sectional study performed between March and May 2020 over all workers of a secondary hospital in Madrid, Spain.

    Methods:

    We employed polymerase chain reaction (PCR, for symptomatic individuals) and serology (for both PCR-negative symptomatic workers and asymptomatic workers) as diagnostic tests for severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We analyzed the prevalence of the virus in healthcare workers (HCWs) and nonhealthcare workers (nHCWs). We also collected information about the use of personal protective equipment (PPEs) and possible contacts prior to infection.

    Results:

    In total, 2,963 workers were included: 1,092 were symptomatic, and of these, 539 were positive by PCR (49.4% of symptomatic workers). From the remaining symptomatic workers, 197 (35.6%) were positive by serology. Regarding asymptomatic workers, 345 were positive by serology (31.9% of infected workers). In total, 1,081 (36.5%) presented a positive diagnostic test for SARS-CoV-2. Infection rates were different between HCWs (37.4%) and nHCWs (29.8%) (P = .006). In the multivariate logistic regression analysis, the use of PPE (protective: OR, 0.56; 95% CI, 0.44–0.72; P < .001) and previous contact with COVID-19 patients (risk factor: OR, 1.69; 95% CI, 1.28–2.24; P < .001) were independent factors that were associated with SAS-CoV-2 infection.

    Conclusions:

    Overall, >36% of our workers became infected with SARS-CoV-2, and the rate of asymptomatic infections accounted for almost 32% of all SARS-CoV-2 infections. We detected differences in the rates of infection between HCWs and nHCWs. The use of PPE and previous contact with COVID-19 patients were associated with SARS-CoV-2 infection.

Concise Communication

Letter to the Editor

Original Article

  • Changes in antimicrobial utilization during the coronavirus disease 2019 (COVID-19) pandemic after implementation of a multispecialty clinical guidance team

  • Part of:
  • Milner B. Staub, Ronald M. Beaulieu, John Graves, George E. Nelson
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 42 / Issue 7 / July 2021
    Published online by Cambridge University Press:
    26 October 2020, pp. 810-816
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  • Objective:

    Evaluate changes in antimicrobial use during COVID-19 and after implementation of a multispecialty COVID-19 clinical guidance team compared to pre–COVID-19 antimicrobial use.

    Design:

    Retrospective observational study.

    Setting:

    Tertiary-care academic medical center.

    Participants:

    Internal medicine and medical intensive care unit (MICU) provider teams and hospitalized COVID-19 patients.

    Methods:

    Difference-in-differences analyses of antibiotic days of therapy per 1,000 patient days present (DOT) for internal medicine and MICU teams treating COVID-19 patients versus teams that did not were performed for 3 periods: before COVID-19, initial COVID-19 period, and after implementation of a multispecialty COVID-19 clinical guidance team which included daily, patient-specific antimicrobial stewardship recommendations. Patient characteristics associated with antibiotic DOT were evaluated using multivariable Poisson regression.

    Results:

    In the initial COVID-19 period, compared to the pre–COVID-19 period, internal medicine and MICU teams increased weekly antimicrobial use by 145.3 DOT (95% CI, 35.1–255.5) and 204.0 DOT (95% CI, −16.9 to 424.8), respectively, compared to non–COVID-19 teams. In the intervention period, internal medicine and MICU COVID-19 teams both had significant weekly decreases of 362.3 DOT (95% CI, −443.3 to −281.2) and 226.3 DOT (95% CI, −381.2 to –71.3). Of 131 patients hospitalized with COVID-19, 86 (65.6%) received antibiotics; no specific patient factors were significantly associated with an expected change in antibiotic days.

    Conclusions:

    Antimicrobial use initially increased for COVID-19 patient care teams compared to pre–COVID-19 levels but significantly decreased after implementation of a multispecialty clinical guidance team, which may be an effective strategy to reduce unnecessary antimicrobial use.

Review

  • Coronavirus disease 2019 (COVID-19) in long-term care facilities: A review of epidemiology, clinical presentations, and containment interventions

  • Part of:
  • Cameron G. Gmehlin, L. Silvia Munoz-Price
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 43 / Issue 4 / April 2022
    Published online by Cambridge University Press:
    26 October 2020, pp. 504-509
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  • Long-term care facilities (LTCFs) and their populations have been greatly affected by the coronavirus disease 2019 (COVID-19) pandemic. In this review, we summarize the literature to describe the current epidemiology of COVID-19 in LTCFs, clinical presentations and outcomes in the LTCF population with COVID-19, containment interventions, and the role of healthcare workers in SARS-CoV-2 transmission in these facilities.

Research Brief

Letter to the Editor

Original Article

  • Healthcare personnel absenteeism, presenteeism, and staffing challenges during epidemics

  • Part of:
  • Douglas W. Challener, Laura E. Breeher, JoEllen Frain, Melanie D. Swift, Pritish K. Tosh, John O’Horo
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 42 / Issue 4 / 2021
    Published online by Cambridge University Press:
    26 October 2020, pp. 388-391
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  • Objective:

    Presenteeism is an expensive and challenging problem in the healthcare industry. In anticipation of the staffing challenges expected with the COVID-19 pandemic, we examined a decade of payroll data for a healthcare workforce. We aimed to determine the effect of seasonal influenza-like illness (ILI) on absences to support COVID-19 staffing plans.

    Design:

    Retrospective cohort study.

    Setting:

    Large academic medical center in the United States.

    Participants:

    Employees of the academic medical center who were on payroll between the years of 2009 and 2019.

    Methods:

    Biweekly institutional payroll data was evaluated for unscheduled absences as a marker for acute illness-related work absences. Linear regression models, stratified by payroll status (salaried vs hourly employees) were developed for unscheduled absences as a function of local ILI.

    Results:

    Both hours worked and unscheduled absences were significantly related to the community prevalence of influenza-like illness in our cohort. These effects were stronger in hourly employees.

    Conclusions:

    Organizations should target their messaging at encouraging salaried staff to stay home when ill.

Letter to the Editor

Original Article

  • Environmental contamination in a coronavirus disease 2019 (COVID-19) intensive care unit—What is the risk?

  • Part of:
  • Sean Wei Xiang Ong, Pei Hua Lee, Yian Kim Tan, Li Min Ling, Benjamin Choon Heng Ho, Ching Ging Ng, Dong Ling Wang, Boon Huan Tan, Yee-Sin Leo, Oon-Tek Ng, Michelle Su Yen Wong, Kalisvar Marimuthu
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 42 / Issue 6 / June 2021
    Published online by Cambridge University Press:
    21 October 2020, pp. 669-677
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  • Background:

    The risk of environmental contamination by severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in the intensive care unit (ICU) is unclear. We evaluated the extent of environmental contamination in the ICU and correlated this with patient and disease factors, including the impact of different ventilatory modalities.

    Methods:

    In this observational study, surface environmental samples collected from ICU patient rooms and common areas were tested for SARS-CoV-2 by polymerase chain reaction (PCR). Select samples from the common area were tested by cell culture. Clinical data were collected and correlated to the presence of environmental contamination. Results were compared to historical data from a previous study in general wards.

    Results:

    In total, 200 samples from 20 patient rooms and 75 samples from common areas and the staff pantry were tested. The results showed that 14 rooms had at least 1 site contaminated, with an overall contamination rate of 14% (28 of 200 samples). Environmental contamination was not associated with day of illness, ventilatory mode, aerosol-generating procedures, or viral load. The frequency of environmental contamination was lower in the ICU than in general ward rooms. Eight samples from the common area were positive, though all were negative on cell culture.

    Conclusion:

    Environmental contamination in the ICU was lower than in the general wards. The use of mechanical ventilation or high-flow nasal oxygen was not associated with greater surface contamination, supporting their use and safety from an infection control perspective. Transmission risk via environmental surfaces in the ICUs is likely to be low. Nonetheless, infection control practices should be strictly reinforced, and transmission risk via droplet or airborne spread remains.

Concise Communication

Letter to the Editor

Research Brief

Concise Communication

State of the Pandemic Commentary

Letter to the Editor

Original Article

  • Understanding viral shedding of severe acute respiratory coronavirus virus 2 (SARS-CoV-2): Review of current literature

  • Part of:
  • Lauren M. Fontana, Angela Holly Villamagna, Monica K. Sikka, Jessina C. McGregor
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 42 / Issue 6 / June 2021
    Published online by Cambridge University Press:
    20 October 2020, pp. 659-668
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  • Objective:

    Transmission of SARS-CoV-2 has significant implications for hospital infection prevention and control, discharge management, and public health. We reviewed available literature to reach an evidenced-based consensus on the expected duration of viral shedding.

    Design:

    We queried 4 scholarly repositories and search engines for studies reporting SARS-CoV-2 viral shedding dynamics by PCR and/or culture available through September 8, 2020. We calculated the pooled median duration of viral RNA shedding from respiratory and fecal sources.

    Results:

    The review included 77 studies on SARS-CoV-2. All studies reported PCR-based testing and 12 also included viral culture data. Among 28 studies, the overall pooled median duration of RNA shedding from respiratory sources was 18.4 days (95% CI, 15.5–21.3; I2 = 98.87%; P < .01). When stratified by disease severity, the pooled median duration of viral RNA shedding from respiratory sources was 19.8 days (95% CI, 16.2–23.5; I2 = 96.42%; P < .01) among severely ill patients and 17.2 days (95% CI, 14.0–20.5; I2 = 95.64%; P < .01) in mild-to-moderate illness. Viral RNA was detected up to 92 days after symptom onset. Viable virus was isolated by culture from −6 to 20 days relative to symptom onset.

    Conclusions:

    SARS-COV-2 RNA shedding can be prolonged, yet high heterogeneity exists. Detection of viral RNA may not correlate with infectivity since available viral culture data suggests shorter durations of shedding of viable virus. Additional data are needed to determine the duration of shedding of viable virus and the implications for risk of transmission.

Page 18 of 30