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

• Published in: Asian Pacific Journal of Tropical Medicine
• Main Authors: 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 Çıirak, 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
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wolters Kluwer Medknow Publications 2023
• Subjects: covid-19; nosocomial infection; vaccination; intensive care unit; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.4103/1995-7645.383912; https://doaj.org/article/b7ea1548375b453cb9d037050a85148f

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% Cl 1.11-2.74 and OR 1.60, 95% Cl 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 (OR 0.25, 95% Cl 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.