Contextual Hospital Conditions and the Risk of Nosocomial SARS-CoV-2 Infection: A Matched Case-Control Study with Density Sampling in a Large Portuguese Hospital

Data de publicação:

Autores da FMUP

  • Ana Azevedo Cardoso Oliveira

    Autor

Participantes de fora da FMUP

  • Almeida, Francisco
  • Correia, Sofia
  • Leal, Catia
  • Guedes, Mariana
  • Duro, Raquel
  • Andrade, Paulo
  • Pedrosa, Afonso
  • Rocha-Pereira, Nuno
  • Lima-Alves, Carlos

Unidades de investigação

Abstract

<bold>Objective:</bold> Knowledge of the role of hospital conditions in SARS-CoV-2 transmission should inform strategies for the prevention of nosocomial spread of this pathogen and of similarly transmitted viruses. This study aimed to identify risk factors for nosocomial acquisition of SARS-CoV-2. <bold>Methods:</bold> We ran a nested case-control study with incidence density sampling among adult patients hospitalized for >7 days (August-December 2020). Patients testing positive for SARS-CoV-2 after the 7th day of hospitalization were defined as cases and matched with controls (1:4) by date of admission, hospitalization duration until index date, and type of department. Individual and contextual characteristics were gathered, including admission characteristics and exposures during the risk period. Conditional logistic regression was used to estimate the odds ratios (ORs) with respective 95% confidence intervals (CI) separately for probable (diagnosed on day 8-13) and definitive (diagnosed after day 14) nosocomial sets. <bold>Results:</bold> We identified 65 cases (31 probable; 34 definitive) and 219 controls. No individual characteristic was related to nosocomial acquisition of SARS-CoV-2. Contextual risk factors for nosocomial acquisition were staying in a non-refurbished room (probable nosocomial: OR = 3.6, 1.18-10.87), contact with roommates with newly diagnosed SARS-CoV-2 (probable nosocomial: OR = 9.9, 2.11-46.55; definitive nosocomial: OR = 3.4, 1.09-10.30), and contact with roommates with a first positive test 21-90 days before the beginning of contact (probable nosocomial: OR = 10.7, 1.97-57.7). <bold>Conclusions:</bold> Hospital conditions and contact with recently infected patients modulated nosocomial SARS-CoV-2 transmission. These results alert us to the importance of the physical context and of agile screening procedures to shorten contact with patients with recent infection.

Dados da publicação

ISSN/ISSNe:
2077-0383, 2077-0383

Journal of Clinical Medicine  MDPI AG

Tipo:
Article
Páginas:
-
Link para outro recurso:
www.scopus.com

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Keywords

  • SARS-CoV-2; respiratory transmission; transmission risk factors

Proyectos asociados

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Estudo Clínico Académico . 2022

Understanding the gap between scientific evidence and clinical practice in cardiovascular diseases

Investigador Principal: Ana Azevedo Cardoso Oliveira

Estudo Clínico Académico . 2019

Inequalities in coronary heart disease management and outcomes em Portugal

Investigador Principal: Ana Azevedo Cardoso Oliveira

Estudo Clínico Académico . 2019

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