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Review
. 2022 Feb 23:43:1604572.
doi: 10.3389/phrs.2022.1604572. eCollection 2022.

Mitigating SARS-CoV-2 Transmission in Hospitals: A Systematic Literature Review

Chester Yan Hao Ng  1 , Nicole-Ann Lim  1 , Lena X Y Bao  1 , Amy M L Quek  1 , Raymond C S Seet  1   2
Affiliations
Review

Mitigating SARS-CoV-2 Transmission in Hospitals: A Systematic Literature Review

Chester Yan Hao Ng et al. Public Health Rev. .

Abstract

Objectives: Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in hospitals and identify potential vulnerabilities to mitigate the risk of infection. Methods: Three electronic databases (PubMed, Embase and Scopus) were searched from inception to July 27, 2021 for publications reporting SARS-CoV-2 outbreaks in hospital. Relevant articles and grey literature reports were hand-searched. Results: Twenty-seven articles that described 35 SARS-CoV-2 outbreaks were included. Despite epidemiological investigations, the primary case could not be identified in 37% of outbreaks. Healthcare workers accounted for 40% of primary cases (doctors 17%, followed by ancillary staff 11%). Mortality among infected patients was approximately 15%. By contrast, none of the infected HCWs died. Several concerning patterns were identified, including infections involving ancillary staff and healthcare worker infections from the community and household contacts. Conclusion: Continuous efforts to train-retrain and enforce correct personal protective equipment use and regular routine screening tests (especially among ancillary staff) are necessary to stem future hospital outbreaks of SARS-CoV-2.

Keywords: COVID-19; SARS-CoV-2; hospital outbreaks; infection control; nosocomial spread.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Preferred reporting items of Systematic Reviews and Meta-Analyses diagram of study selection (Singapore, 2021).
FIGURE 2
FIGURE 2
Distribution of primary cases according to healthcare workers, patients and others (Singapore, 2021).
FIGURE 3
FIGURE 3
Distribution of infected patients and healthcare workers (Singapore, 2021).
FIGURE 4
FIGURE 4
Summary of identified vulnerabilities control leading to severe acute respiratory syndrome coronavirus 2 hospital outbreaks (Singapore, 2021).
See this image and copyright information in PMC

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