COVID-19: A Retrospective Cohort Study of Nosocomial Transmission in a District General Hospital

Background and objectives Since the outbreak of coronavirus disease 2019 (COVID-19) in the UK, there has been concern that a higher proportion of COVID-19 deaths among inpatients were a result of nosocomial infections. We sought to investigate the proportion of nosocomial COVID-19 infections within our hospital and patient outcomes within this category. Methods This was a retrospective cohort study of 616 patients admitted to the hospital and tested positive for SARS-CoV-2 through a polymerase chain reaction test with particular emphasis on 104 patients who were classed as probable or definite hospital-acquired COVID-19. Demographic and clinical data were extracted from the electronic records of patients, and the outcome of their stay was recorded. Results The median (interquartile range) age of inpatients testing positive for SARS-CoV-2 was 76 (62, 84) years, and the ethnic breakdown of patients was similar to that of the local population. Inpatient mortality was similar to other hospitals in the UK at 41%. Patients with a hospital-acquired infection were older, with a median age of 79 (69, 86) years, more likely to be of White ethnicity, and more likely to die in the hospital. Conclusion Older age was associated with a higher risk of healthcare-associated infection, and as a result, patients were more likely to die.