Patient and ward related risk factors in a multi-ward nosocomial outbreak of COVID-19: Outbreak investigation and matched case–control study

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dc.contributor.authorLeal, Jenine
dc.contributor.authorO’Grady, Heidi M.
dc.contributor.authorArmstrong, Logan
dc.contributor.authorDixit, Devika
dc.contributor.authorKhawaja, Zoha
dc.contributor.authorSnedeker, Kate
dc.contributor.authorEllison, Jennifer
dc.contributor.authorErebor, Joyce
dc.contributor.authorJamieson, Peter
dc.contributor.authorWeiss, Amanda
dc.contributor.authorSalcedo, Daniel
dc.contributor.authorRoberts, Kimberley
dc.contributor.authorWiens, Karen
dc.contributor.authorCroxen, Matthew A.
dc.contributor.authorBerenger, Byron M.
dc.contributor.authorPabbaraju, Kanti
dc.contributor.authorLin, Yi-Chan
dc.contributor.authorEvans, David
dc.contributor.authorConly, John M.
dc.date.accessioned2023-03-26T01:03:21Z
dc.date.available2023-03-26T01:03:21Z
dc.date.issued2023-03-22
dc.date.updated2023-03-26T01:03:21Z
dc.description.abstractAbstract Background Risk factors for nosocomial COVID-19 outbreaks continue to evolve. The aim of this study was to investigate a multi-ward nosocomial outbreak of COVID-19 between 1st September and 15th November 2020, occurring in a setting without vaccination for any healthcare workers or patients. Methods Outbreak report and retrospective, matched case–control study using incidence density sampling in three cardiac wards in an 1100-bed tertiary teaching hospital in Calgary, Alberta, Canada. Patients were confirmed/probable COVID-19 cases and contemporaneous control patients without COVID-19. COVID-19 outbreak definitions were based on Public Health guidelines. Clinical and environmental specimens were tested by RT-PCR and as applicable quantitative viral cultures and whole genome sequencing were conducted. Controls were inpatients on the cardiac wards during the study period confirmed to be without COVID-19, matched to outbreak cases by time of symptom onset dates, age within ± 15 years and were admitted in hospital for at least 2 days. Demographics, Braden Score, baseline medications, laboratory measures, co-morbidities, and hospitalization characteristics were collected on cases and controls. Univariate and multivariate conditional logistical regression was used to identify independent risk factors for nosocomial COVID-19. Results The outbreak involved 42 healthcare workers and 39 patients. The strongest independent risk factor for nosocomial COVID-19 (IRR 3.21, 95% CI 1.47–7.02) was exposure in a multi-bedded room. Of 45 strains successfully sequenced, 44 (97.8%) were B.1.128 and differed from the most common circulating community lineages. SARS-CoV-2 positive cultures were detected in 56.7% (34/60) of clinical and environmental specimens. The multidisciplinary outbreak team observed eleven contributing events to transmission during the outbreak. Conclusions Transmission routes of SARS-CoV-2 in hospital outbreaks are complex; however multi-bedded rooms play a significant role in the transmission of SARS-CoV-2.
dc.identifier.citationAntimicrobial Resistance & Infection Control. 2023 Mar 22;12(1):21
dc.identifier.doihttps://doi.org/10.1186/s13756-023-01215-1
dc.identifier.urihttp://hdl.handle.net/1880/115960
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titlePatient and ward related risk factors in a multi-ward nosocomial outbreak of COVID-19: Outbreak investigation and matched case–control study
dc.typeJournal Article
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