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Coronavirus disease 2019 (COVID-19) admission screening and assessment of infectiousness at an academic medical center in Iowa, 2020

Published online by Cambridge University Press:  24 June 2021

Mohammed A. Alsuhaibani*
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States Department of Pediatrics, College of Medicine, Qassim University, Qassim, Saudi Arabia
Takaaki Kobayashi
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Alexandra Trannel
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Stephanie Holley
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Oluchi J. Abosi
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Kyle E. Jenn
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Holly Meacham
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Lorinda Sheeler
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
William Etienne
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Angelique Dains
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Mary E. Kukla
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Emily Ward
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Bradley Ford
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Michael B. Edmond
Affiliation:
Department of Medicine, West Virginia University School of Medicine, Morgantown, West Virginia, United States
Melanie Wellington
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Daniel J. Diekema
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
Jorge L. Salinas*
Affiliation:
University of Iowa Hospitals & Clinics, Iowa City, Iowa, United States
*
Author for correspondence: Mohammed A. Alsuhaibani, E-mail: moa.alsuhaibani@qu.edu.sa Or Jorge L. Salinas, E-mail: Jorge-salinas@uiowa.edu
Author for correspondence: Mohammed A. Alsuhaibani, E-mail: moa.alsuhaibani@qu.edu.sa Or Jorge L. Salinas, E-mail: Jorge-salinas@uiowa.edu

Abstract

Objective:

Patients admitted to the hospital may unknowingly carry severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and hospitals have implemented SARS-CoV-2 admission screening. However, because SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) assays may remain positive for months after infection, positive results may represent active or past infection. We determined the prevalence and infectiousness of patients who were admitted for reasons unrelated to COVID-19 but tested positive for SARS-CoV-2 on admission screening.

Methods:

We conducted an observational study at the University of Iowa Hospitals & Clinics from July 7 to October 25, 2020. All patients admitted without suspicion of COVID-19 were included, and medical records of those with a positive admission screening test were reviewed. Infectiousness was determined using patient history, PCR cycle threshold (Ct) value, and serology.

Results:

In total, 5,913 patients were screened and admitted for reasons unrelated to COVID-19. Of these, 101 had positive admission RT-PCR results; 36 of these patients were excluded because they had respiratory signs/symptoms on admission on chart review. Also, 65 patients (1.1%) did not have respiratory symptoms. Finally, 55 patients had Ct values available and were included in this analysis. The median age of the final cohort was 56 years and 51% were male. Our assessment revealed that 23 patients (42%) were likely infectious. The median duration of in-hospital isolation was 5 days for those likely infectious and 2 days for those deemed noninfectious.

Conclusions:

SARS-CoV-2 was infrequent among patients admitted for reasons unrelated to COVID-19. An assessment of the likelihood of infectiousness using clinical history, RT-PCR Ct values, and serology may help in making the determination to discontinue isolation and conserve resources.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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