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. 2022 Oct 18;24(10):e41395.
doi: 10.2196/41395.

The Potential Role of an Adjunctive Real-Time Locating System in Preventing Secondary Transmission of SARS-CoV-2 in a Hospital Environment: Retrospective Case-Control Study

Min Hyung Kim  1 , Un Hyoung Ryu  2 , Seok-Jae Heo  3 , Yong Chan Kim  1 , Yoon Soo Park  1
Affiliations

The Potential Role of an Adjunctive Real-Time Locating System in Preventing Secondary Transmission of SARS-CoV-2 in a Hospital Environment: Retrospective Case-Control Study

Min Hyung Kim et al. J Med Internet Res. .

Abstract

Background: There has been an increasing demand for new technologies regarding infection control in hospital settings to reduce the burden of contact tracing.

Objective: This study aimed to compare the validity of a real-time locating system (RTLS) with that of the conventional contact tracing method for identifying high-risk contact cases associated with the secondary transmission of SARS-CoV-2.

Methods: A retrospective case-control study involving in-hospital contact cases of confirmed COVID-19 patients, who were diagnosed from January 23 to March 25, 2022, was conducted at a university hospital in South Korea. Contact cases were identified using either the conventional method or the RTLS. The primary endpoint of this study was secondary transmission of SARS-CoV-2 among contact cases. Univariate and multivariable logistic regression analysis comparing test positive and versus negative contact cases were performed.

Results: Overall, 509 and 653 cases were confirmed by the conventional method and the RTLS, respectively. Only 74 contact cases were identified by both methods, which could be attributed to the limitations of each method. Sensitivity was higher for the RTLS tracing method (653/1088, 60.0%) than the conventional tracing method (509/1088, 46.8%) considering all contact cases identified by both methods. The secondary transmission rate in the RTLS model was 8.1%, while that in the conventional model was 5.3%. The multivariable logistic regression model revealed that the RTLS was more capable of detecting secondary transmission than the conventional method (adjusted odds ratio 6.15, 95% CI 1.92-28.69; P=.007).

Conclusions: This study showed that the RTLS is beneficial when used as an adjunctive approach to the conventional method for contact tracing associated with secondary transmission. However, the RTLS cannot completely replace traditional contact tracing.

Keywords: COVID-19; SARS-CoV-2; contact tracing; real-time locating system; secondary transmission.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Study flow of enrollment. PCR: polymerase chain reaction; RTLS: real-time locating system.
Figure 2
Figure 2
Secondary transmission rate calculated against contacts identified by each method according to the date of diagnosis. The secondary transmission rate was defined as cases of secondary transmission against contacts according to the date of index patients' confirmation. The average secondary transmission rate calculated against contacts identified exclusively by the RTLS was 10.6%, while that calculated against contacts identified exclusively by the conventional method was 7%. "Both" denotes cases identified by both the RTLS and conventional method. RTLS: real-time locating system.
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