The burden and dynamics of hospital-acquired SARS-CoV-2 in England.

Autor: Cooper BS; NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK. ben.cooper@ndm.ox.ac.uk.; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. ben.cooper@ndm.ox.ac.uk., Evans S; HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK., Jafari Y; Centre for Mathematical Modelling of Infectious Diseases, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK., Pham TM; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Mo Y; NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.; Division of Infectious Disease, Department of Medicine, National University Hospital, Singapore, Singapore.; Department of Medicine, National University of Singapore, Singapore, Singapore., Lim C; NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand., Pritchard MG; NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Pople D; HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK., Hall V; HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK., Stimson J; HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK., Eyre DW; Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.; Oxford University Hospitals NHS Foundation Trust, Oxford, UK.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with UKHSA, Oxford, UK., Read JM; Lancaster Medical School, Lancaster University, Lancaster, UK., Donnelly CA; Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Department of Statistics, University of Oxford, Oxford, UK.; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK., Horby P; Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Watson C; Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Funk S; Centre for Mathematical Modelling of Infectious Diseases, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK., Robotham JV; HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK.; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with UKHSA, Oxford, UK., Knight GM; Centre for Mathematical Modelling of Infectious Diseases, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK.; AMR Centre, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK.
Jazyk: angličtina
Zdroj: Nature [Nature] 2023 Nov; Vol. 623 (7985), pp. 132-138. Date of Electronic Publication: 2023 Oct 18.
DOI: 10.1038/s41586-023-06634-z
Abstrakt: Hospital-based transmission had a dominant role in Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV) epidemics 1,2 , but large-scale studies of its role in the SARS-CoV-2 pandemic are lacking. Such transmission risks spreading the virus to the most vulnerable individuals and can have wider-scale impacts through hospital-community interactions. Using data from acute hospitals in England, we quantify within-hospital transmission, evaluate likely pathways of spread and factors associated with heightened transmission risk, and explore the wider dynamical consequences. We estimate that between June 2020 and March 2021 between 95,000 and 167,000 inpatients acquired SARS-CoV-2 in hospitals (1% to 2% of all hospital admissions in this period). Analysis of time series data provided evidence that patients who themselves acquired SARS-CoV-2 infection in hospital were the main sources of transmission to other patients. Increased transmission to inpatients was associated with hospitals having fewer single rooms and lower heated volume per bed. Moreover, we show that reducing hospital transmission could substantially enhance the efficiency of punctuated lockdown measures in suppressing community transmission. These findings reveal the previously unrecognized scale of hospital transmission, have direct implications for targeting of hospital control measures and highlight the need to design hospitals better equipped to limit the transmission of future high-consequence pathogens.
(© 2023. The Author(s).)
Databáze: MEDLINE
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