One in ten Covid patients infected in hospital in first UK wave: Lancet study

London, August 13  

Over one in ten Covid-19 patients in 314 UK hospitals were infected with the SARS-CoV-2 virus during their stay in hospital in the first wave of the pandemic, according to a study published in The Lancet journal.

The researchers from Lancaster University and colleagues from other UK universities examined records of Covid-19 patients in hospitals, who became ill before August 1, 2020.

They found that at least 11.1 per cent of Covid-19 patients in 314 UK hospitals were infected after admission.

The study shows that the proportion of Covid-19 patients infected in hospital also rose to between 16 and 20 per cent in mid-May 2020, long after the peak of admissions in the first wave.

The research team estimates between 5,699 and 11,862 patients admitted in the first wave were infected during their stay in hospital.

“This is, unfortunately, likely to be an underestimate, as we did not include patients who may have been infected but discharged before they could be diagnosed,” said Jonathan Read, study lead author from Lancaster University.

“Controlling viruses like SARS-CoV-2 has been difficult in the past, so the situation could have been much worse. However, infection control should remain a priority in hospitals and care facilities,” Read said.

The researchers noted that there are likely to be a number of reasons why many patients were infected in these care settings.

These reasons include the large numbers of patients admitted to hospitals with limited facilities for case isolation and less access to rapid and reliable diagnostic testing in the early stages of the outbreak.

There were “challenges around access to and best use of PPE, our understanding of when patients are most infectious in their illness, some misclassification of cases due to presentation with atypical symptoms, and an under-appreciation of the role of airborne transmission,” said Chris Green from the University of Birmingham.

According to the researchers, there were marked differences in the numbers of patients infected in hospital according to the type of care provided.

Hospitals providing acute and general care had lower proportions of hospital acquired infections (9.7 per cent) than residential community care hospitals (61.9 per cent) and mental health hospitals (67.5 per cent), which reflects the outbreaks seen in care-homes.

“The reasons for the variation between settings that provide the same type of care requires urgent investigation to identify and promote best infection control practice,” said Professor Calum Semple from the University of Liverpool.

“Research has now been commissioned to find out what was done well and what lessons need to be learned to improve patient safety,” Semple said.

The researchers noted that the underlying reasons for these high rates of transmission in hospitals at the peak of the first wave must be investigated, so that we can improve safety and outcomes for our patients. PTI