466 - SARS-CoV-2 Diagnosis And Point Prevalence in a Non-Cohorted Tertiary Care Center

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Presenting Author(s)

Spencer Schrank

Internal Medicine Resident
MedStar Georgetown University Hospital
Washington, District of Columbia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

KM

Katherine McAleese

Resident
MedStar Georgetown University Hospital
Washington, District of Columbia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AS

Amanda B. Spence

Assistant Professor
Georgetown University Medical Center
District of Columbia, District of Columbia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MN

Madhuri Natarajan

Statistician
Medstar Georgetown University Hospital
Washington, DC
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JT

Joseph Timpone

Associate Professor of Medicine Division of Infectious Diseases and Travel Medicine Associate Program Director, Department of Medicine Georgetown University Hospital Associate Dean for Student Research
Medstar Georgetown University Hospital
DC, District of Columbia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JC

Joseph Chang

Fellow
Fellow
Washingon, District of Columbia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GB

Gayle p. Balba

Assoicate Professor of Medicine
Georgetown University School of Medicine
Washington, District of Columbia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Princy N. Kumar

Professor, Medicine; Chief, Division of Infectious Diseases and Travel Medicine
Georgetown University Medical Center, Washington, DC, USA
Washington, District of Columbia
Disclosure: Gilead Sciences Inc. (Scientific Research Study Investigator)

Background: The CDC recommends testing for SARS-CoV-2 in patients who present with symptoms consistent with COVID-19 and to cohort hospitalized patients diagnosed with COVID-19. Up to 35% of persons infected with SARS-CoV-2 are asymptomatic; however, no recommendations exist for universal testing in hospitalized patients. We assessed the point prevalence of SARS-CoV-2 infection amongst hospitalized patients at a tertiary care center during a time when there was a regional surge of cases.

Methods: Nasopharyngeal SARS-CoV-2 PCR testing was performed on inpatients at Georgetown University Hospital on 4/27/20, excluding those who were SARS-CoV-2 positive, tested within 72 hours or admitted to pediatric, psychiatric, labor & delivery or ICUs. Patients within the hospital were not cohorted based on COVID-19 status. Patient demographics and comorbidities were obtained from the EMR and analyzed for significance based on SARS-CoV-2 status.

Results: Hospital census on the testing date was 297; 204/297(68.7%) met inclusion criteria; 78/297(26.3%) were known COVID-19 patients. Within the study group 78/204 (38.2%) had known COVID-19, 21/204 (10.3%) were PUIs (4 of whom tested positive), 31/204 (15.1%) tested negative for COVID-19 within 72 hours and 74/204 (36.3%) met criteria for testing. The median age was 62 years (IQR, 53 to 70), 59%(n=122) were male, 56%(n= 115) were Black, and 90%(n=185) had at least one co-morbidity. 0/74 of those tested on 4/27/20 were positive for SARS-CoV-2, and none were diagnosed with COVID-19 within 28 days. In adjusted analyses, patients who were hospitalized for COVID-19 were more likely to be Black(OR=10.53 95% CI 3.02, 36.68, p=0.0002); male(OR=3.27 95% CI 1.26, 8.47, p=0.0143); reside in group/nursing homes(OR= 11.78 95%CI 3.03, 45.76, p=0.0004); have a history of prior stroke(OR= 6.25 95%CI 1.49, 26.12, p=0.012); but less likely to smoke(OR=0.10 95%CI 0.02, 0.48, p=0.0039), or have active malignancy (OR= 0.11 95%CI 0.01, 0.73, p=0.0223).Risk Factors for SARS-CoV-2 Among Hospitalized Patients at a Tertiary Care Center

Conclusion: The use of CDC testing criteria for PUIs were successful in identifying COVID-19 patients and limiting the need for routine testing in all hospitalized patients during a time when access to testing was limited. Nosocomial transmission did not occur in our institution despite a lack of cohorting.