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. 2023 Aug;53(5):104695.
doi: 10.1016/j.idnow.2023.104695. Epub 2023 Mar 22.

Risk factors for nosocomial COVID-19 in a French university hospital

C Dinh  1 , M Gallouche  2 , H Terrisse  1 , K Gam  1 , C Giner  3 , B Nemoz  4 , S Larrat  5 , J Giai  6 , J L Bosson  6 , C Landelle  7
Affiliations

Risk factors for nosocomial COVID-19 in a French university hospital

C Dinh et al. Infect Dis Now. 2023 Aug.

Abstract

Objectives: Prevention strategies implemented by hospitals to reduce nosocomial transmission of SARS-CoV-2 sometimes failed. Our aim was to determine the risk factors for nosocomial COVID-19.

Patients and methods: A case-control study was conducted (September 1, 2020-January 31, 2021) with adult patients hospitalized in medical or surgical units. Infants or patients hospitalized in ICU were excluded. Cases were patients with nosocomial COVID-19 (clinical symptoms and RT-PCR + for SARS-CoV-2 or RT-PCR + for SARS-CoV-2 with Ct ≤ 28 more than 5 days after admission); controls were patients without infection (RT-PCR- for SARS-CoV-2 > 5 days after admission). They were matched according to length of stay before diagnosis and period of admission. Analyses were performed with a conditional logistic regression.

Results: A total of 281 cases and 441 controls were included. In the bivariate analysis, cases were older (OR per 10 years: 1.22; 95%CI [1.10;1.36]), had more often shared a room (OR: 1.74; 95%CI [1.25;2.43]) or a risk factor for severe COVID-19 (OR: 1.94; 95%CI [1.09;3.45]), were more often hospitalized in medical units [OR: 1.59; 95%CI [1.12;2.25]), had higher exposure to contagious health care workers (HCW; OR per 1person-day: 1.12; 95%CI [1.08;1.17]) and patients (OR per 1 person-day: 1.11; 95%CI [1.08;1.14]) than controls. In an adjusted model, risk factors for nosocomial COVID-19 were exposure to contagious HCW (aOR per 1person-day: 1.08; 95%CI [1.03;1.14]) and to contagious patients (aOR per 1person-day: 1.10; 95%CI [1.07;1.13]).

Conclusions: Exposure to contagious professionals and patients are the main risk factors for nosocomial COVID-19.

Keywords: COVID-19; Nosocomial infection; Risk factors; SARS-CoV-2.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of the case-control study. Ct: Cycle threshold.
See this image and copyright information in PMC

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