Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Cotton, S., McHugh, M. P., Dewar, R., Haas, J. G. and Templeton, K. and The COVID-19 Genomics UK (COG-UK) Consortium (2023) Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes. Journal of Hospital Infection, 135. pp. 28-36. ISSN 0195-6701

[thumbnail of 1-s2.0-S0195670123000671-main]
Preview
PDF (1-s2.0-S0195670123000671-main) - Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (455kB) | Preview

Abstract

Background: The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim: To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods: A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings: In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion: The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine.

Item Type: Article
Additional Information: Funding Information: COG-UK is supported by funding from the MRC part of UK Research & Innovation, the National Institute of Health Research (Grant code MC_PC_19027), and Genome Research Limited, operating as the Welcome Sanger Institute. Acknowledgements: Lothian Analytical Services, medicine of the elderly consultants, administrative staff and infection control staff performed clinical review of hospital discharges to care homes. The authors acknowledge use of data generated through the COVID-19 Genomics Programme funded by the Department of Health and Social Care. The views expressed are those of the author and not necessarily those of the Department of Health and Social Care or UKHSA.
Uncontrolled Keywords: care homes,hospital discharge,introduction,sars-cov-2,microbiology (medical),infectious diseases,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2726
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Faculty of Science

Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Science > School of Biological Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine
Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine
Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 03 Jan 2024 03:19
Last Modified: 18 Jul 2024 21:31
URI: https://ueaeprints.uea.ac.uk/id/eprint/94051
DOI: 10.1016/j.jhin.2023.02.010

Downloads

Downloads per month over past year

Actions (login required)

View Item View Item