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Clinical Outcome and Prognosis of a Nosocomial Outbreak of COVID-19. J Clin Med 2023; 12:jcm12062279. [PMID: 36983280 PMCID: PMC10056618 DOI: 10.3390/jcm12062279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023] Open
Abstract
Nosocomial coronavirus disease 2019 (COVID-19) outbreaks have been reported despite widespread quarantine methods to prevent COVID-19 in society and hospitals. Our study was performed to investigate the clinical outcome and prognosis of a nosocomial outbreak of COVID-19. We retrospectively analyzed the medical records of patients diagnosed with nosocomial COVID-19 of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) at a university teaching hospital between 1 November 2021 and 31 April 2022. Nosocomial COVID-19 was defined as a positive SARS-CoV-2 polymerase chain reaction (PCR) test result 4 or more days after admission in asymptomatic patients who had a negative SARS-CoV-2 PCR test on admission. In this study, 167 patients were diagnosed with nosocomial COVID-19 (1.14%) among a total of 14,667 patients admitted to hospital during the study period. A total of 153 patients (91.6%) survived, but 14 patients (8.4%) died. The median time between admission and COVID-19 diagnosis was 11 days, and the median duration of hospital stay was 24 days. After adjusting for other factors, no vaccination (adjusted HR = 5.944, 95% CI = 1.626–21.733, p = 0.007) and chronic kidney disease (adjusted HR = 6.963, 95% CI = 1.182–41.014, p = 0.032) were found to increase mortality risk. Despite strict quarantine, a significant number of nosocomial COVID-19 cases with a relatively high mortality rate were reported. As unvaccinated status or chronic kidney disease were associated with poor outcomes of nosocomial COVID-19, more active preventive strategies and treatments for patients with these risk factors are needed.
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Kim Y, Shin JM, Yoo SH, Keam B. Challenges in Care for Non-COVID-19 Patients with Severe Chronic Illnesses during COVID-19 Pandemic: A Qualitative Study of Healthcare Providers Working around Acute Care Hospitals in South Korea. Healthcare (Basel) 2023; 11:healthcare11040611. [PMID: 36833145 PMCID: PMC9957023 DOI: 10.3390/healthcare11040611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND The COVID-19 epidemic has afflicted patients with severe chronic illnesses who need continuous care between home and hospitals. This qualitative study examines the experiences and challenges of healthcare providers around acute care hospitals who have cared for patients with severe chronic illness in non-COVID-19 situations during the pandemic. METHODS Eight healthcare providers, who work in various healthcare settings around acute care hospitals and frequently care for non-COVID-19 patients with severe chronic illnesses, were recruited using purposive sampling from September to October 2021 in South Korea. The interviews were subjected to thematic analysis. RESULTS Four overarching themes were identified: (1) deterioration in the quality of care at various settings; (2) new emerging systemic problems; (3) healthcare providers holding on but reaching their limit; and (4) a decline in the quality of life of patients at the end of their lives, and their caregivers. CONCLUSION Healthcare providers of non-COVID-19 patients with severe chronic illnesses reported that the quality of care was declining due to the structural problems of the healthcare system and policies centered solely on the prevention and control of COVID-19. Systematic solutions are needed for appropriate and seamless care for non-infected patients with severe chronic illness in the pandemic.
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Affiliation(s)
- Yejin Kim
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jeong Mi Shin
- Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Shin Hye Yoo
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Correspondence: (S.H.Y.); (B.K.); Tel.: +82-2-2072-1589 (S.H.Y.); +82-2-2072-7215 (B.K.); Fax: +82-2-2072-0754 (S.H.Y.); +82-2-2072-7379 (B.K.)
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Correspondence: (S.H.Y.); (B.K.); Tel.: +82-2-2072-1589 (S.H.Y.); +82-2-2072-7215 (B.K.); Fax: +82-2-2072-0754 (S.H.Y.); +82-2-2072-7379 (B.K.)
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Lee HJ, Lee HK, Kim YR. The impact of caregivers on nosocomial transmission during a COVID-19 outbreak in a community-based hospital in South Korea. PLoS One 2022; 17:e0277816. [PMID: 36409747 PMCID: PMC9678252 DOI: 10.1371/journal.pone.0277816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/03/2022] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic becomes a cause of concern for hospital transmission. Caregivers may play an important role as vectors for nosocomial infections; however, infection control for caregivers often is neglected. A nosocomial COVID-19 outbreak occurred in a 768-bed hospital from March 20, 2020, to April 14, 2020. We conducted a retrospective chart review and epidemiologic investigation on all cases. A total of 54 cases of laboratory-confirmed COVID-19 occurred in the community-based hospital. They included 26 (48.1%) patients, 21 (38.9%) caregivers, and 7 (13.0%) healthcare workers. These 21 caregivers cared for 18 patients, and of these, 9 were positive for COVID-19, 6 were negative, and 3 died before testing. Of the 6 negative patients, 3 had no exposure because the caregiver began to show symptoms at least 5 days after their discharge. Of the 9 positive patients, 4 cases of transmission took place from patient to caregiver (one patient transmitted COVID-19 to two caregivers), and 6 cases of transmission occurred from caregiver to patient. Of the 54 hospital-acquired cases, 38 occurred in the 8th-floor ward and 8 occurred in the 4th-floor ward. The index case of each ward was a caregiver. Counting the number of cases where transmission occurred only between patients and their own caregivers, 9 patients were suspected of having exposure to COVID-19 from their own caregivers. Six patients (66.7%) were infected by COVID-19-confirmed caregivers, and 3 patients were uninfected. Fewer patients among the infected were able to perform independent activities compared to uninfected patients. Not only patients and healthcare workers but also caregivers groups may be vulnerable to COVID-19 and be transmission sources of nosocomial outbreaks. Therefore, infection control programs for caregivers in addition to patients and healthcare workers can be equally important.
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Affiliation(s)
- Hyo-Jin Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yang Ree Kim
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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The difference in strategies for prevention of COVID-19 transmission in hospitals: A nationwide survey results in the Republic of Korea. J Hosp Infect 2022; 129:22-30. [PMID: 35998837 PMCID: PMC9391228 DOI: 10.1016/j.jhin.2022.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Hospital infection control measures against coronavirus disease 2019 (COVID-19) are often based on expert discretion due to the lack of detailed guidelines. AIM To survey the current strategies for preventing COVID-19 spread in medical institutions. METHODS Thirteen key issues related to COVID-19 transmission prevention within medical institutions were selected via discussion among infectious diseases specialists, and related critical questions were subsequently obtained following a review of national-level guidelines in government databases. Six hospitals had an open survey between 11th and 25th August 2020 to provide responses to these topics. An online questionnaire developed from these data was sent to infection control teams of 46 South Korean hospitals between 31st January 2021 and 20th February 2021. FINDINGS All 46 hospitals responded to the survey. All operated screening clinics, but 89.1% (41/46) allowed symptomatic patients without COVID-19-associated symptoms to visit the general outpatient clinics. Most hospitals (87.2%; 34/39) conducted PCR tests for all hospitalised patients. Of 35/46 (76.1%) hospitals with preemptive isolation policies for hospitalised patients, 31 (88.6%) released patients from isolation after a single negative PCR test while most (76.9%; 20/26) allowed shared-room accommodation for patients meeting the national criteria for release from isolation despite positive PCR results with above cycle threshold values (34.6%; 9/26) or after a certain period that satisfied the national criteria (26.9%; 7/26). CONCLUSION Individual hospitals in South Korea are currently relying on experience to frame relevant guidelines and responded differently to some infection control issues on hospital settings during the COVID-19 pandemic.
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Tuakli-Wosornu YA, Pandiyan U, Stratton C, Hwang Y, Hajjioui A, Muñoz-Velasco LP, Fourtassi M, Cooper R, Balikuddembe JK, Peterson M, Krassioukov A, Palomba A, Tripathi DR, Hong BY. Perceived Physical and Mental Health and Healthy Eating Habits During the COVID-19 Pandemic in Korea. J Korean Med Sci 2022; 37:e118. [PMID: 35437966 PMCID: PMC9015897 DOI: 10.3346/jkms.2022.37.e118] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/21/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted the lives of people around the world since 2020. This study aims to reveal perceived impact of the coronavirus pandemic on physical and mental health and eating behaviors among people with disabilities and without disabilities in South Korea, as compared to other countries. METHODS A secondary analysis of a prospective cross-sectional study which was conducted with a web-based global survey. RESULTS Among the 3,550 responses from 65 countries, 2,621 responses with nation information were set as full data, 189 for South Korea and 2,432 for other countries. In Korea, there was no significant difference in healthy lifestyle behaviors between people with and without disabilities before the COVID-19 pandemic. Perceived physical and mental health and changes in eating habits during the COVID-19 pandemic showed no significant difference between people with and without disabilities in Korea. There were significant differences in physical health and dietary habits, but no differences in its effect on mental health between people living in Korea and other countries in both people with and without disabilities groups. In other words, more than 60% of people in all groups (disability vs. non-disability, Korea vs. non-Korea) reported worse mental health than before the COVID-19 pandemic. CONCLUSION In Korea and other countries, mental health showed a tendency to deteriorate regardless of the presence or absence of disability during the COVID-19 pandemic. In terms of healthy eating habits, Koreans were relatively less affected than people from other countries.
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Affiliation(s)
- Yetsa A Tuakli-Wosornu
- Department of Chronic Disease and Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Uma Pandiyan
- Qatar Rehabilitation Institute, Hamad Medical Corporation, Doha, Qatar
| | - Catherine Stratton
- Department of Chronic Disease and Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Youngdeok Hwang
- Paul H. Chook Department of Information Systems and Statistics, Baruch College, City University of New York, New York, NY, USA
| | - Abderrazak Hajjioui
- Department of Physical and Rehabilitation Medicine, University Hospital Hassan II of Fez, Fez, Morocco
- University Sidi Mohammed Ben Abdellah, Fes, Morocco
| | | | - Maryam Fourtassi
- Department of Physical Medicine and Rehabilitation, Université Abdelmalek Essaâdi, Tétouan, Morocco
| | - Rory Cooper
- Human Engineering Research Laboratories (HERL), US Department of Veteran Affairs, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph K Balikuddembe
- Department of Disaster Health Sciences, Institute for Disaster Management and Reconstruction, Sichuan University and Hong Kong Polytechnic University, Chengdu, China
| | - Mark Peterson
- Department of Physical Medicine and Rehabilitation, Michigan Medicine Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
| | - Andrei Krassioukov
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, Canada
- G.F. Strong Rehabilitation Centre, Vancouver, Canada
| | - Angela Palomba
- Multidisciplinary Department of Medicine for Surgery and Orthodontics, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Deo Rishi Tripathi
- Dr. Ram Manohar Lohia Hospital & Post Graduate Institute of Medical Education and Research (PGIMER), New Delhi, India
| | - Bo Young Hong
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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