Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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In response to reported COVID-19 outbreaks among people experiencing homelessness (PEH) in other U.S. cities, we conducted multiple, proactive, facility-wide testing events for PEH living sheltered and unsheltered and homelessness service staff in Atlanta, Georgia. We describe SARS-CoV-2 prevalence and associated symptoms and review shelter infection prevention and control (IPC) policies. ⋯ PEH living in shelters experienced higher SARS-CoV-2 prevalence compared with PEH living unsheltered. Facility-wide testing in congregate settings allowed for identification and isolation of COVID-19 cases and is an important strategy to interrupt SARS-CoV-2 transmission.
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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19). This study aimed to determine if SARS-CoV-2 RNA in serum at admission correlated with clinical outcome in COVID-19. ⋯ The cohort (N=167) consisted of 106 SARS-CoV-2 RNA serum negative and 61 positive patients. Median sampling time for initial SARS-CoV-2 in serum was 1 (IQR 1-2) day after admission corresponding to day 10 (IQR 8-12) after symptom onset. Median ages were 53 (IQR 44-67) and 63 (IQR 52-74) years for the PCR-negative and positive patients, respectively. In the serum PCR negative and positive groups 3/106 and 15/61 patients died, respectively.The hazard ratios for critical disease and all-cause mortality were 7.2 (95% CI 3.0-17) and 8.6 (95% CI 2.4-30), respectively for patients that were serum PCR positive compared to serum PCR negative.Conclusion: SARS-CoV-2 RNA in serum at hospital admission indicates a high-risk of progression to critical disease and death.
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Population-based literature suggest SARS-CoV-2 infection may disproportionately affect racial/ethnic minorities; however, patient-level observations of hospitalization outcomes by race/ethnicity are limited. The aim of this study was to characterize COVID-19-associated morbidity and in-hospital mortality by race/ethnicity. ⋯ In this multi-center cohort of hospitalized COVID-19 patients in the largest health system in Massachusetts, there was no association between race/ethnicity and clinically relevant hospitalization outcomes, including in-hospital mortality, after controlling for key demographic/clinical characteristics. These findings serve to refute suggestions that certain races/ethnicities may be biologically predisposed to poorer COVID-19 outcomes.
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Treatment of suspected methicillin-resistant Staphylococcus aureus (MRSA) is a cornerstone of many antibiotic regimens; however, there is associated toxicity. The Department of Veterans Affairs (VA) hospitals screen each patient for MRSA nares colonization on admission and transfer. The objective was to determine the negative predictive value (NPV) of MRSA screening in the determination of subsequent positive clinical culture for MRSA. High NPVs with MRSA nares screening may be used as a stewardship tool. ⋯ Given the high NPVs, MRSA nares screening may be a powerful stewardship tool for deescalation and avoidance of empirical anti-MRSA therapy.