Nosocomial COVID-19 Infection in a Long-Term Hospital in Spain: Retrospective Observational Study

• Published in: Medicina (Kaunas, Lithuania) Vol. 58; no. 5; p. 566
• Main Authors: Caro-Martínez, Elena, Abad-Collado, Susana, Escrivá-Cerrudo, Blanca, García-Almarza, Shaila, García-Ródenas, María Del Mar, Gómez-Merino, Elena, Serrano-Mateo, María-Isabel, Ramos-Rincón, Jose-Manuel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 21.04.2022; MDPI
• Subjects: Comorbidity; Coronaviruses; COVID-19; Dementia; Dyspnea; Frailty; Hospitals; Infections; long-term hospital; Medical prognosis; Mortality; nosocomial COVID-19 infection; Nursing; Observational studies; Palliative care; Patients; Pneumonia; Risk factors; Severe acute respiratory syndrome coronavirus 2; Spain; Values; Variables; Spain; mortality; nosocomial COVID-19 infection; long-term hospital; Spain
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina58050566

. The aim of this study is to compare clinical and epidemiological characteristics and outcomes in patients with versus without nosocomial COVID-19 after exposure to SARS-CoV-2 and to analyze the risk factors for severe outcomes of COVID-19 in a long-term hospital in Spain. . This retrospective, single-center observational study included all inpatients in a long-term hospital during a COVID-19 outbreak from 21 January to 15 March 2021. . Of 108 admitted patients, 65 (60.2%) were diagnosed with nosocomial COVID-19 disease ( = 34 women (52.3%), median age 77 years). In the univariable analysis, risk factors associated with nosocomial COVID-19 were dementia (OR 4.98 95% CI 1.58-15.75), dyspnea (OR 5.34 95% CI 1.69-16.82), asthenia (OR 5.10, 95% CI 1.40-18.60) and NECesidades PALiativas (NECPAL) (OR 1.28 95% CI 1.10-1.48). In the multivariable analysis, risk factors independently associated with nosocomial COVID-19 infection were dyspnea (aOR 7.39; 95% CI 1.27-43.11) and NECPAL (aOR 1.25; 95% CI 1.03-1.52). Of the 65 patients diagnosed with nosocomial COVID-19, 29 (44.6%) died, compared to 7/43 (16.2%) non-infected patients (OR 4.14, 95% CI 1.61-10.67). Factors associated with mortality in nosocomial COVID-19 were confusion (aOR 3.83; 95% CI 1.03-14.27) and dyspnea (aOR 7.47; 95% CI 1.87-29.82). The NECPAL tool played an important predictive role in both nosocomial COVID-19 infection and mortality (aOR 1.19, 95% CI: 1.00-1.41). . In a long-term hospital, nosocomial COVID-19 main clinical characteristics associated with infection were dyspnea and NECPAL. Mortality was higher in the group with nosocomial COVID-19; risk factors were confusion and dyspnea. The NECPAL tool may help to predict progression and death in COVID-19.