Risk of Healthcare-Associated Transmission of Sever Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Hospitalized Cancer Patients. (30th July 2021)

• Record Type: Journal Article
• Authors: Chow, Karin; Aslam, Anoshé; McClure, Tara; Singh, Jessica; Burns, Jacquelyn; McMillen, Tracy; Jani, Krupa; Lucca, Anabella; Bubb, Tania; Robilotti, Elizabeth V; Babady, N Esther; Kamboj, Mini
• Is Part Of: Clinical infectious diseases. Volume 74:Number 9(2022)
• Page Start: 1579
• Page End: 1585
• Publication Date: 2021-07-30
• Subjects: SARS-CoV-2 -- COVID-19 -- hospital-acquired -- cancer; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciab670
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: There is limited information on the risk of hospital-acquired coronavirus disease 2019 (COVID-19) among high-risk hospitalized patients after exposure to an infected patient or healthcare worker (HCW) in a nonoutbreak setting. Methods: This study was conducted at a tertiary care cancer center in New York City from 10 March 2020 until 28 February 2021. In early April 2020, the study institution implemented universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing at admission and retesting every 3 days through the hospital stay. Contact tracing records were reviewed for all exposures to SARS-CoV-2 positive patients and HCWs. Results: From 10 March 2020 to 28 February 2021, 11 348 unique patients who were SARS-CoV-2 polymerase chain reaction (PCR) negative at the time of admission underwent 31 662 postadmission tests during their hospitalization, and 112 tested positive (0.98%). Among these, 49 patients housed in semiprivate rooms during admission resulted in 74 close contacts and 14 secondary infections within 14 days, for an overall attack rate of 18.9%. Among those exposed to a roommate undergoing an aerosol-generating procedure (AGP), the attack rate was 35.7%. Whole genome sequencing (WGS) corroborated transmission in 6/8 evaluated pairs. In addition, three transmission events occurred in 214 patients with significant exposure to 105 COVID-19 positive healthcare workers (1.4%). Conclusions: The overall risk of hospital-acquired COVID-19 is low for hospitalized cancer patients, even during periods of high community prevalence. However, shared occupancy with an unrecognized case is associated with a high secondary attack rate in exposed roommates. Abstract : There was low risk of hospital-acquired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients after direct contact with infected patients or healthcare workers (HCW). There was greater transmission risk during shared room occupancy with exposure to aerosol-generating procedures. Routine testing is not necessary when community rates are low.