Hospital-onset SARS-CoV-2 infection associated with significant morbidity and mortality during Omicron era
Abstract: https://www.acpjournals.org/doi/10.7326/M24-0199
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A retrospective matched cohort study found that SARS-CoV-2 infections acquired while in the hospital continue to be associated with significant morbidity and mortality, even during the Omicron era. These findings suggest that hospitals should take measures to prevent in-hospital SARS-CoV-2 infections, particularly when community SARS-CoV-2 rates are elevated. The findings are published in Annals of Internal Medicine.
Researchers from Harvard Medical School and Harvard Pilgrim Health Care Institute retrospectively analyzed adult patients admitted to 5 Massachusetts hospitals affiliated with the Mass General Brigham System between December 1, 2020 and April 30, 2023 to estimate the impact of hospital-onset SARS-CoV-2 on patients’ outcomes during the pre-Omicron and Omicron periods. Hospital-onset SARS-CoV-2 was defined as a positive test on hospital day 5 or later after negative admission tests. Infected patients were matched to control patients by hospital, service, demographics, comorbidities, and severity of illness, and assessed for hospital mortality, time to discharge, and other outcomes. The researchers found that during the pre-Omicron period, hospital-onset SARS-CoV-2 infection was associated with significantly greater risk for ICU admission, greater need for high-flow oxygen by nasal cannula, and higher risk of hospital death. During the Omicron period, hospital-onset infections continued to be associated with increased risk for ICU admission, as well as higher risk for mechanical ventilation. The impact of hospital-onset SARS-CoV-2 on hospital death was attenuated but still significant.
According to the study authors, hospitals should continue to take precautions to protect patients from hospital-acquired SARS-CoV-2 infection. Possible measures include masking during patient interactions, surveillance testing, instituting policies to encourage employees to stay home when sick and encouraging vaccination. The authors acknowledge that some of these measures are burdensome on staff and hospitals. They suggest that one-way hospitals can balance their ethical obligation to protect patients against the burden of protective measures is to institute these measures just when SARS-CoV-2 rates are elevated.
Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with the corresponding author, Michael Klompas, MD, MPH, please email Haley Bridger at hbridger@mgb.org.
