PDF(Pubmed)
Abstract：
The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site. This observational study was performed at the University Hospital Basel, Switzerland, from 03/20 - 11/20. Secondary attack rates were compared between patients hospitalized in multiple-bed rooms and exposed to individuals subjected to on-site isolation precautions (on-site isolation group), and patients exposed to individuals initially not identified as having COVID-19, and not placed under isolation precautions until the diagnosis was suspected (control group). Transmission events were confirmed by whole-genome sequencing. Among 1,218 patients with suspected COVID-19, 67 (5.5%) tested positive for SARS-CoV-2. Of these, 21 were isolated on-site potentially exposing 27 patients sharing the same room. Median contact time was 12 h (interquartile range 7-18 h). SARS-CoV-2 transmission was identified in none of the patients in the on-site isolation group vs. 10/63 (15.9%) in the control group (p = 0.03). Isolation on-site of suspected COVID-19-patients in multiple-bed rooms avoided single-room occupancy and subsequent in-hospital relocation for many patients without confirmed SARS-CoV-2-infection. The absence of secondary transmission among the exposed patients in the on-site isolation group allows for assessment of the risk/benefit ratio of this strategy given the limitation of a small sample size.
摘要：
对疑似2019年冠状病毒病（COVID-19）患者实施隔离预防措施和待检测结果是资源密集型的。由于我们机构的单床房供应有限，在获得SARS-CoV-2检测结果之前,我们将疑似COVID-19的患者和非疑似COVID-19的患者现场隔离在多床房.我们评估了SARS-CoV-2传播给与现场隔离的患者共享房间的个人的可能性。这项观察性研究是在巴塞尔大学医院进行的，瑞士,从03/20-11/20。比较了在多床房住院并暴露于接受现场隔离预防措施的患者（现场隔离组）之间的二次发作率，和暴露于最初未被鉴定为患有COVID-19的个体的患者，并且在怀疑诊断之前没有采取隔离预防措施（对照组）。通过全基因组测序证实了传播事件。在1218例疑似COVID-19患者中，67例（5.5%）SARS-CoV-2检测呈阳性。其中,21人被隔离在现场，可能暴露27名患者共享同一房间。中位接触时间为12小时(四分位距7-18小时)。在现场隔离组中没有发现SARS-CoV-2传播对照组10/63(15.9%)(p=0.03)。在多床房中对疑似COVID-19患者进行现场隔离，避免了许多未确诊SARS-CoV-2感染的患者的单室入住和随后的院内搬迁。鉴于样本量较小，现场隔离组中暴露患者之间没有二次传播，因此可以评估该策略的风险/收益比。
