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The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020

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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.

In: BMC Infectious Diseases, Vol. 22, No. 1, 556, 18.06.2022.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Harvard

Knight, GM, Pham, TM, Stimson, J, Funk, S, Jafari, Y, Pople, D, Evans, S, Yin, M, Brown, CS, Bhattacharya, A, Hope, R, Semple, MG, Read, JM, Cooper, BS & Robotham, JV 2022, 'The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020', BMC Infectious Diseases, vol. 22, no. 1, 556. https://doi.org/10.1186/s12879-022-07490-4

APA

Knight, G. M., Pham, T. M., Stimson, J., Funk, S., Jafari, Y., Pople, D., Evans, S., Yin, M., Brown, C. S., Bhattacharya, A., Hope, R., Semple, M. G., Read, J. M., Cooper, B. S., & Robotham, J. V. (2022). The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020. BMC Infectious Diseases, 22(1), [556]. https://doi.org/10.1186/s12879-022-07490-4

Vancouver

Knight GM, Pham TM, Stimson J, Funk S, Jafari Y, Pople D et al. The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020. BMC Infectious Diseases. 2022 Jun 18;22(1). 556. https://doi.org/10.1186/s12879-022-07490-4

Author

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. / The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020. In: BMC Infectious Diseases. 2022 ; Vol. 22, No. 1.

Bibtex

@article{b988ba57e6ad4e88827383a45dd05b58,
title = "The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020",
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.",
keywords = "Research Article, COVID-19, SARS-CoV-2, Nosocomial transmission, Mathematical modelling",
author = "Knight, {Gwenan M.} and Pham, {Thi Mui} and James Stimson and Sebastian Funk and Yalda Jafari and Diane Pople and Stephanie Evans and Mo Yin and Brown, {Colin S.} and Alex Bhattacharya and Russell Hope and Semple, {Malcolm G.} and Read, {Jonathan M.} and Cooper, {Ben S.} and Robotham, {Julie V.}",
year = "2022",
month = jun,
day = "18",
doi = "10.1186/s12879-022-07490-4",
language = "English",
volume = "22",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020

AU - Knight, Gwenan M.

AU - Pham, Thi Mui

AU - Stimson, James

AU - Funk, Sebastian

AU - Jafari, Yalda

AU - Pople, Diane

AU - Evans, Stephanie

AU - Yin, Mo

AU - Brown, Colin S.

AU - Bhattacharya, Alex

AU - Hope, Russell

AU - Semple, Malcolm G.

AU - Read, Jonathan M.

AU - Cooper, Ben S.

AU - Robotham, Julie V.

PY - 2022/6/18

Y1 - 2022/6/18

N2 - 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.

AB - 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.

KW - Research Article

KW - COVID-19

KW - SARS-CoV-2

KW - Nosocomial transmission

KW - Mathematical modelling

U2 - 10.1186/s12879-022-07490-4

DO - 10.1186/s12879-022-07490-4

M3 - Journal article

VL - 22

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

SN - 1471-2334

IS - 1

M1 - 556

ER -