Impact of Nosocomial COVID-19 Infection Among Hospitalized Patients with Respiratory Diseases

Abstract

Objective: There are very few studies concerning the frequency and course of nosocomial Coronavirus disease-2019 (COVID-19) infection among patients hospitalized having diseases other than COVID-19. In our study, patients who were admitted to the pulmonology inpatient clinic from the emergency room due to non-COVID-19 diseases and later diagnosed with COVID-19 (index cases) and the nosocomial transmission caused by these patients and the clinical outcomes were analyzed. Method: This study was carried out on 44 inpatients without COVID-19 at a pulmonology inpatient clinic during the first wave of COVID-19 pandemic. Oro-nasopharyngeal swab samples were taken at the time of hospitalization to detect COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) test. The test results of four patients were found to be positive. Due to the risk of nosocomial transmission, the remaining patients were re-evaluated for COVID-19 disease by clinical, radiological, and RT-PCR tests (1 to 3 times, and/or if symptoms developed). All patients were followed up for 30 days after discharge. Results: Thirty-six males (81%) and 8 females (19%) with a mean age of 65.6±13.6 (31-93) years were included in the study. Twenty-five of these patients had cancer, six had chronic obstructive pulmonary disease exacerbation, four had an aggravation of idiopathic pulmonary fibrosis, three had infected bronchiectasis, two had pulmonary embolisms, and four had other disorders. The RT-PCR test results were found positive in 4 patients. In about two weeks, COVID-19 infection emerged in 16 of the remaining 40 patients, and 10 of them (63% of the infected) died. The RT-PCR test results of patients with COVID-19 infection were found to be positive on day 8.2 averagely (6-13). Conclusion: Nosocomial transmission of COVID-19 may create a risk of severe illness and death among vulnerable patients. It is crucial to take necessary measures in order to reduce the risk of COVID-19 transmission in hospitals.

Keywords

• covid-19
• hospitalized patients
• mortality
• nosocomial infection
• pulmonary disease