Clinical characteristics and outcomes of nosocomial COVID-19 in Turkey: A retrospective multicenter study

Süleyman Yıldırım; Celalettin Yılmaz; Gülru Polat; Serap Argun Baris; İlknur Başyiğit; İlknur Kaya; Ceyda Anar; Mihriban Bozkurt; Hüsnü Baykal; Hulya Dirol; Gamzenur Ozbey; Emine Ozsari; Emel Cireli; Ali Kadri Çırak; Dursun Tatar; Mine Gayaf; Selen Karaoglanoglu; Yener Aydin; Atilla Eroglu; Yıldız Olçar; Berna Botan Yıldırım; Bengül Gürsoy; Deniz Demir Yılmaz; Elif Yelda Ozgun Niksarlioglu; Ramazan Eren; Ayşegül Tomruk Erdem; Müge Meltem Tor; Fusun Fakili; Mustafa Çolak; Merve Erçelik; Ali Tabaru; Özlem Ediboglu

doi:10.4103/1995-7645.383912

Asian Pacific Journal of Tropical Medicine ›› 2023, Vol. 16 ›› Issue (8) :347 -353. DOI: 10.4103/1995-7645.383912

Original Article

research-article

Clinical characteristics and outcomes of nosocomial COVID-19 in Turkey: A retrospective multicenter study

Author information +

¹ Intensive Care Unit, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, University of Health Sciences Turkey , İzmir, Turkey

² Department of Pulmonology, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, University of Health Sciences Turkey , İzmir, Turkey

³ Department of Pulmonary Medicine, School of Medicine, Kocaeli University , Kocaeli, Turkey

⁴ Department of Pulmonology, Kütahya Health Sciences University , Kütahya, Turkey

⁵ Department of Pulmonology, Atatürk Training and Research Hospital, İzmir Katip Çelebi University , İzmir, Turkey

⁶ Department of Pulmonology, Ankara Atatürk Sanatory Training and Research Hospital, University of Health Sciences , Ankara, Turkey

⁷ Department of Pulmonology, Faculty of Medicine, Akdeniz University , Antalya, Turkey

⁸ Department of Pulmonology, Bolu Abant İzzet Baysal University Training and Research Hospital , Bolu, Turkey

⁹ Department of Pulmonology, Ordu University Training and Research Hospital , Ordu, Turkey

¹⁰ Department of Thoracic Surgery, Medical Faculty, Erzurum, Ataturk University , Turkey

¹¹ Department of Infectious Disease and Clinical Microbiology, Kastamonu Training and Research Hospital , Kastamonu, Turkey

¹² Department of Pulmonology, Başkent University Hospital Konya , Konya, Turkey

¹³ Department of Pulmonology, İstanbul Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital , İstanbul, Turkey

¹⁴ Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Health Science University , İstanbul, Turkey

¹⁵ Department of Pulmonology, Faculty of Medicine, Zonguldak Bülent Ecevit University , Zonguldak, Turkey

¹⁶Department of Pulmonary Medicine, Gaziantep, Faculty of Medicine, Şahinbey Research Hospital, Gaziantep University , Turkey

¹⁷Department of Pulmonology, Balıkesir, Health Practice and Research Hospital, Balıkesir University , Turkey

¹⁸ Department of Pulmonology, Afyonkarahisar Dinar State Hospital , Afyon, Turkey

¹⁹ Department of Pulmonology, Söke Fehime Faik Kocagöz State Hospital , Aydın, Turkey

To whom correspondence may be addressed. E-mail:deu.syldrm@gmail.com

Show less

History +

PDF (370KB)

Abstract

Objective: To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey. Methods: COVID-19 patients followed in the pandemic services across Turkey between January 1, 2021, and March 31, 2022 were investigated retrospectively. Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19 ≥5 days after hospital admission. The primary outcome of this study was in-hospital mortality; demographic features and vaccination status was compared between survivors and non-survivors. Results: During the study period, 15 573 COVID-19 patients were followed in 18 centers and 543 (3.5%) patients were nosocomial COVID-19. Most patients with nosocomial COVID-19 (80.4%) were transferred from medical wards. 162 (29.8%) of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138 (25.4%) of the patients died during hospital stay. Advanced age (≥65 years) and number of comorbid diseases (≥2) was found to be associated with mortality in nosocomial COVID-19 (OR 1.74, 95% CI 1.11-2.74 and OR 1.60, 95% CI 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 (OR 0.25, 95% CI 0.16-0.38). Conclusions: Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate. Vaccination can decrease the in-hospital mortality rate.

Keywords

COVID-19 / Nosocomial infection / Vaccination / Intensive care unit

Cite this article

Download citation ▾

Süleyman Yıldırım, Celalettin Yılmaz, Gülru Polat, Serap Argun Baris, İlknur Başyiğit, İlknur Kaya, Ceyda Anar, Mihriban Bozkurt, Hüsnü Baykal, Hulya Dirol, Gamzenur Ozbey, Emine Ozsari, Emel Cireli, Ali Kadri Çırak, Dursun Tatar, Mine Gayaf, Selen Karaoglanoglu, Yener Aydin, Atilla Eroglu, Yıldız Olçar, Berna Botan Yıldırım, Bengül Gürsoy, Deniz Demir Yılmaz, Elif Yelda Ozgun Niksarlioglu, Ramazan Eren, Ayşegül Tomruk Erdem, Müge Meltem Tor, Fusun Fakili, Mustafa Çolak, Merve Erçelik, Ali Tabaru, Özlem Ediboglu. Clinical characteristics and outcomes of nosocomial COVID-19 in Turkey: A retrospective multicenter study. Asian Pacific Journal of Tropical Medicine, 2023, 16 (8) : 347-353 DOI:10.4103/1995-7645.383912

登录浏览全文

4963

注册一个新账户忘记密码

References

Publishing order | Descend order by publishing year | Descend order by cited within

[1]	Oluwaseun A, Oluwole O. Coronavirus disease 2019 (COVID-19) transmission, risk cactors, prevention and control: A mini-review. J Infect Dis Epidemiol 2020; 6(4). doi:10.23937/2474-3658/1510145.

[2]	Ponsford MJ, Jefferies R, Davies C, Farewell D, Humphreys IR, Jolles S, et al. Burden of nosocomial COVID-19 in Wales: Results from a multicentre retrospective observational study of 2 508 hospitalised adults. Thorax 2021; 76(12):1246.

[3]	Carter B, Collins JT, Barlow-Pay F, Rickard F, Bruce E, Verduri A, et al. Nosocomial COVID-19 infection: Examining the risk of mortality. The COPE-nosocomial study (COVID in older PEople). J Hosp Infect 2020; 106(2):376.

[4]	Rhee C, Baker M, Vaidya V, Tucker R, Resnick A, Morris CA, et al. Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center. JAMA Netw Open 2020; 3(9): e2020498-e2020498.

[5]	Mazzoleni L, Ghafari C, Mestrez F, Sava R, Bivoleanu E, Delmotte P, et al. COVID-19 outbreak in a hemodialysis center: A retrospective monocentric case series. Can J kidney Heal Dis 2020; 7. doi:10.1177/2054358120944298.

[6]	Ngandu NK, Mmotsa TM, Dassaye R, Thabetha A, Odendaal W, Langdown N, et al. Hospital acquired COVID-19 infections amongst patients before the rollout of COVID-19 vaccinations, a scoping review. BMC Infect Dis 2022; 22(1):1-12.

[7]	Ponsford MJ, Ward TJC, Stoneham SM, Dallimore CM, Sham D, Osman K, et al. A systematic review and meta-analysis of inpatient mortality associated with nosocomial and community COVID-19 exposes the vulnerability of immunosuppressed adults. Front Immunol 2021; 12:744696.

[8]	Lee JY, Kim HA, Huh K, Hyun M, Rhee JY, Jang S, et al. Risk factors for mortality and respiratory support in elderly patients hospitalized with COVID-19 in Korea. J Korean Med Sci 2020; 35(23). doi:10.3346/JKMS.2020.35.E223.

[9]	Elkrief A, Desilets A, Papneja N, Cvetkovic L, Groleau C, Lakehal YA, et al. High mortality among hospital-acquired COVID-19 infection in patients with cancer: A multicentre observational cohort study. Eur J Cancer 2020; 139:181.

[10]	Romics L, Doughty J, Stallard S, Mansell J, Blackhall V, Lannigan A, et al. A prospective cohort study of the safety of breast cancer surgery during COVID-19 pandemic in the West of Scotland. Breast 2021; 55:1-6.

[11]	Read JM, Green CA, Harrison EM, Docherty AB, Funk S, Harrison J, et al. Hospital-acquired SARS-CoV-2 infection in the UK’s first COVID-19 pandemic wave. Lancet 2021; 398(10305):1037-1038.

[12]	Axiotakis LG, Youngerman BE, Casals RK, Cooke TS, Winston GM, Chang CL, et al. Risk of acquiring perioperative COVID-19 during the initial pandemic peak: A retrospective cohort study. Ann Surg 2021; 273(1):41.

[13]	Khonyongwa K, Taori SK, Soares A, Desai N, Sudhanva M, Bernal W, et al. Incidence and outcomes of healthcare-associated COVID-19 infections: Significance of delayed diagnosis and correlation with staff absence. J Hosp Infect 2020; 106(4):663-672.

[14]	Lakhani K, Minguell J, Guerra-Farfán E, Lara Y, Jambrina U, Pijoan J, et al. Nosocomial infection with SARS-CoV-2 and main outcomes after surgery within an orthopaedic surgery department in a tertiary trauma centre in Spain. Int Orthop 2020; 44(12):2505-2513.

[15]	Khan KS, Reed-Embleton H, Lewis J, Saldanha J, Mahmud S. Does nosocomial COVID-19 result in increased 30-day mortality? A multi-centre observational study to identify risk factors for worse outcomes in patients with COVID-19. J Hosp Infect 2021; 107:91-94.

[16]	Türker F, Ahbab S, Türker BÇ, Esra Ataoglu H, Öztürk S, Çavuşoğlu B, et al. Clinical characteristics and outcomes of hospitalized COVID-19 patients with diabetes: A multi-center, retrospective study in Turkey. Cumhur Med J 2021; 43(4):384-395.

[17]	Turan O, Arpınar Yigitbas B, Turan PA, Mirici A. Clinical characteristics and outcomes of hospitalized COVID-19 patients with COPD. Expert Rev Respir Med 2021; 15(8):1.

[18]	Kokturk N, Babayigit C, Kul S, Duru Cetinkaya P, Atis Nayci S, Argun Baris S, et al. The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients. Respir Med 2021; 183:106433.

[19]	Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5 279 people with coronavirus disease 2019 in New York City: Prospective cohort study. BMJ 2020; doi:10.1136/bmj.m1966.

[20]	Grasselli G, Zanella A, Carlesso E, Florio G, Canakoglu A, Bellani G, et al. Association of COVID-19 vaccinations with intensive care unit admissions and outcome of critically ill patients with COVID-19 pneumonia in Lombardy, Italy. JAMA Netw Open 2022; 5(10):e2238871.

[21]	Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med 2020. doi:10.1056/nejmoa2034577.

[22]	Dagan N, Barda N, Kepten E, Miron O, Perchik S, Katz MA, et al. BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting. N Engl J Med 2021; 384(15):1412-1423.

[23]	Tanriover MD, Doğanay HL, Akova M, Güner HR, Azap A, Akhan S, et al. Efficacy and safety of an inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac): Interim results of a double-blind, randomised, placebo-controlled, phase 3 trial in Turkey. Lancet 2021; 398(10296):213-222.

[24]	Jara A, Undurraga EA, González C, Paredes F, Fontecilla T, Jara G, et al. Effectiveness of an inactivated SARS-CoV-2 vaccine in Chile. N Engl J Med 2021; 385(10):875-884.

[25]

Whittaker R, Bråthen Kristofferson A, Valcarcel Salamanca B, Seppälä E, Golestani K, Kvåle R, et al. Length of hospital stay and risk of intensive care admission and in-hospital death among COVID-19 patients in Norway: A register-based cohort study comparing patients fully vaccinated with an mRNA vaccine to unvaccinated patients. Clin Microbiol Infect 2022; 28(6):871-878.

[26]	Baker TB, Bolt DM, Smith SS, Piasecki TM, Conner KL, Bernstein SL, et al. The relationship of COVID-19 vaccination with mortality among 86 732 hospitalized patients: Subpopulations, patient factors, and changes over time. J Gen Intern Med 2023; 38(5):1248.

[27]	Huespe IA, Ferraris A, Lalueza A, Valdez PR, Peroni ML, Cayetti LA, et al. COVID-19 vaccines reduce mortality in hospitalized patients with oxygen requirements: Differences between vaccine subtypes. A multicontinental cohort study. J Med Virol 2023; 95(5):e28786.

[28]

Danza P, Koo TH, Haddix M, Fisher R, Traub E, OYong K, et al. SARS-CoV-2 infection and hospitalization among adults aged ≥18 years, by vaccination status, before and during SARS-CoV-2 B.1.1.529 (Omicron) variant predominance-Los Angeles County, California, November 7, 2021-January 8, 2022. Morb Mortal Wkly Rep 2022; 71(5):177.