| Title: |
Comparison of clinical outcomes over time of inpatients with healthcare-associated or community-acquired coronavirus disease 2019 (COVID-19): A multicenter, prospective cohort study. |
| Authors: |
Grant, Rebecca L; Sauser, Julien; Atkinson, Andrew; D'Incau, Stéphanie; Buetti, Niccolò; Zanella, Marie-Céline; Harbarth, Stephan; Marschall, Jonas; Catho, Gaud |
| Source: |
Grant, Rebecca L; Sauser, Julien; Atkinson, Andrew; D'Incau, Stéphanie; Buetti, Niccolò; Zanella, Marie-Céline; Harbarth, Stephan; Marschall, Jonas; Catho, Gaud (2024). Comparison of clinical outcomes over time of inpatients with healthcare-associated or community-acquired coronavirus disease 2019 (COVID-19): A multicenter, prospective cohort study. Infection control and hospital epidemiology, 45(1), pp. 75-81. Cambridge University Press 10.1017/ice.2023.143 |
| Publisher Information: |
Cambridge University Press |
| Publication Year: |
2024 |
| Collection: |
BORIS (Bern Open Repository and Information System, University of Bern) |
| Subject Terms: |
610 Medicine & health |
| Description: |
OBJECTIVE To compare clinical outcomes over time of inpatients with healthcare-associated coronavirus disease 2019 (HA-COVID-19) versus community-acquired COVID-19 (CA-COVID-19). DESIGN We conducted a multicenter, prospective observational cohort study of inpatients with COVID-19. SETTING The study was conducted across 16 acute-care hospitals in Switzerland. PARTICIPANTS AND METHODS We compared HA-COVID-19 cases, defined as patients with a positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) test > 5 days after hospital admission, with hospitalized CA-COVID-19 cases, defined as those who tested positive within 5 days of admission. The composite primary outcome was patient transfer to an intensive care unit (ICU) or an intermediate care unit (IMCU) and/or all-cause in-hospital mortality. We used cause-specific Cox regression and Fine-Gray regression to model the time to the composite clinical outcome, adjusting for confounders and accounting for the competing event of discharge from hospital. We compared our results to those from a conventional approach using an adjusted logistic regression model where time-varying effects and competitive risk were ignored. RESULTS Between February 19, 2020, and December 31, 2020, we included 1,337 HA-COVID-19 cases and 9,068 CA-COVID-19 cases. HA-COVID-19 patients were significantly older: median, 80 (interquartile range [IQR], 71-87) versus median 70 (IQR, 57-80) (P < .001). A greater proportion of HA-COVID-19 patients had a Charlson comorbidity index ≥ 5 (79% vs 55%; P < .001) than did CA-COVID-19 patients. In time-varying analyses, between day 0 and 8, HA-COVID-19 cases had a decreased risk of death or ICU or IMCU transfer compared to CA-COVID-19 cases (cause-specific hazard ratio [csHR], 0.43; 95% confidence interval [CI], 0.33-0.56). In contrast, from day 8 to 30, HA-COVID-19 cases had an increased risk of death or ICU or IMCU transfer (csHR, 1.49; 95% CI, 1.20-1.85), with no significant effect on the rate of discharge (csHR, 0.83; 95% CI, 0.61-1.14). ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://boris.unibe.ch/185184/ |
| Availability: |
https://boris.unibe.ch/185184/1/comparison-of-clinical-outcomes-over-time-of-inpatients-with-healthcare-associated-or-community-acquired-coronavirus-disease-2019-covid-19-a-multicenter-prospective-cohort-study.pdf; https://boris.unibe.ch/185184/ |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.240E0D69 |
| Database: |
BASE |