In UK's 1st wave, 10% of COVID infections were acquired in hospitals

By Suchandrima BhowmikAug 17 2021

Hospital-acquired infections have been one of the common features of the COVID-19 pandemic. Therefore, the prevention of these hospital-acquired infections is considered crucial in the management of COVID-19.

“The number of COVID-19 patients in UK hospitals reached high levels during the first pandemic wave of 2020, and higher levels still in the subsequent winter wave”, says the team of researchers from the United Kingdom.

Their study published in The Lancet journal involved assessing the magnitude of hospital-acquired COVID-19 in the case of acute and long-term National Health Service (NHS) hospital facilities in the UK during the first wave of the pandemic.

Study: Hospital-acquired SARS-CoV-2 infection in the UK's first COVID-19 pandemic wave. Image Credit: Alexander Kirch / Shutterstock

How was the study carried out?

The researchers examined patients with COVID-19 records who were admitted in UK hospitals in n the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK (CCP-UK) study, whose symptom onset was before August 1, 2020.

“We identified patients as having hospital-acquired infections using a combination of their admission date and symptom onset date, and estimates of their infection date based on the known incubation period distribution of SARS-CoV-2”, says the team.

It was estimated that 11.3 percent of individuals with COVID-19 in 314 UK hospitals got infected after getting admitted to the hospital and this proportion increased to 15.8 percent by mid-May 2020. It was also estimated that 14 days after admission 6.8 percent of the patients had a nosocomial infection which peaked at 8.2 percent in mid-May 2020.

What did the study find?

The study showed that hospitals that provided acute and general care had a lower proportion of hospital-acquired infections than mental health hospitals and residential community hospitals.

“We estimated that of 82,624 patients admitted before August 1, 2020, 5,699–11,862 patients were infected during their hospital stay”, says the team.

Also, limited access to early testing, false positive nasopharyngeal swab results, and gastrointestinal symptoms had led to classifying some COVID-19 patients as non-COVID-19 patients who were then admitted to different wards. This has led to the further spread of hospital-acquired infections.

“Enteric features, and the ability of SARS-CoV-2 to persist on surfaces, raise the possibility of fecal-oral transmission in care settings under severe pressure, although the role of this transmission route is uncertain,” adds the team.

What did the authors conclude?

Because SARS-CoV-2 will likely persist in the coming years as an endemic or seasonal virus, it is imperative that we use lessons learned from the pandemic to minimize hospital-acquired infections and to explore new approaches for reducing the burden further.

As a result of this study, changes in the incidence of hospital-acquired infections were identified in different health care settings quickly.

Through regular patient, resident, and staff testing, including point-of-care diagnostics, as recently introduced for NHS staff, and robust hospital infection prevention controls that include the vaccination of staff, appropriate isolation, and environmental disinfection, we have the opportunity to prevent hospital-acquired infections.