HOW CAN WE DO BETTER? DEATHS FROM HEALTHCARE-ASSOCIATED COVID-19 IN A REGIONAL HOSPITAL

HOW CAN WE DO BETTER? DEATHS FROM HEALTHCARE-ASSOCIATED COVID-19 IN A REGIONAL HOSPITAL

Caroline Bartolo^1,2,3, Alison McKenzie¹, Muhammad Akhtar Hussain², Michael Muleme², Bridgette J McNamara², Laura Brown², Eugene Athan^1,2,3, Daniel P O’Brien^1,2,3,4, ,

¹Department of Infectious Diseases Barwon Health, Geelong, Victoria, Australia
²Barwon South West Public Health Unit, Geelong, Victoria, Australia
³Deakin University, Geelong, Victoria, Australia
⁴Department of Medicine and Infectious Diseases Royal Melbourne Hospital, Melbourne, Victoria, Australia
Background
Healthcare-associated (HA) COVID-19 infections make up only a small proportion of the total number of infections but they affect vulnerable members of the community and the impacts on health services are significant.

Method
We conducted an audit on all deaths that occurred in University Hospital Geelong (UHG) during the period 1st August 2020 to 31st January 2023 in those with HA COVID-19 infection using individual patient records. Demographic data, vaccination status, readmission rates, diagnosis, treatment and outcomes were collected, as was the area where exposure occurred.

Results
There were 14 deaths out of 147 HA infections (mortality rate= 9.5%). Median age of the deceased was 75.5 years and 64% were male, five (36%) were overseas-born, and 10 (71%) had received three or more doses of a COVID-19 vaccine. More than three-quarters (79%) had ≥3 chronic diseases and six (43%) had a previous admission to UHG within 30 days before the index admission. Half of the deceased were asymptomatic at diagnosis and more than a third (36%) had symptoms for more than 24 hours before being tested. Nine patients received antivirals but only three commenced treatment within 24 hours of diagnosis. The majority of patients acquired infection from shared room spaces with an unrecognised COVID-19 patient. The average length of stay was 27.9 days.

Conclusion
We identified areas that could improve outcomes in the management of HA COVID-19 infection including earlier diagnosis and treatment, improved access to single rooms and improved ventilation in multiple bed bays.

Biography

Dr Caroline Bartolo is an Infectious Diseases Physician and Medical Lead of Infection Prevention and Control at Barwon Health.