key: cord-293564-6xtg8uqt
authors: Hara, Tasuku; Yamamoto, Chie; Sawada, Ryo; Ohara, Tomoya; Oka, Kohei; Iwai, Naoto; Inada, Yutaka; Tsuji, Toshifumi; Okuda, Takashi; Komaki, Toshiyuki; Kagawa, Keizo
title: Infection risk in a gastroenterological ward during a nosocomial COVID‐19 infection event
date: 2020-04-22
journal: J Med Virol
DOI: 10.1002/jmv.25853
sha: 
doc_id: 293564
cord_uid: 6xtg8uqt

The coronavirus disease (COVID‐19) first emerged in Wuhan, China, in December 2019 and rapidly infected a large number of individuals, and disease clusters have spread worldwide. A case of presumably nosocomial COVID‐19 was detected in the gastroenterological ward; however, appropriate precautions against contact and droplet prevented a subsequent infection cluster. This article is protected by copyright. All rights reserved.

To assess the risk of COVID-19 infection, the exposure-risk category and underlying conditions and their relationship with a positive PCR result were examined.

Exposure-risk categories, which is based on whether patients and healthcare professionals use personal protective equipment, were assessed using Interim U.S. Guidance for Risk The basic reproduction number (R0: the number of people a single patient is expected to infect) for COVID-19 is estimated at 2.2 (1.4-3.9). 4 In the present study, low rates of SARS-CoV-2 infection were observed among patients. During the peri-infection period, because the study centre was in an influenza-endemic area, healthcare professionals at the hospital were obligated to wear a surgical mask and instructed to be diligent with handwashing. Surgical masks are reported to prevent transmission of coronaviruses. 5 These measures to prevent contact and droplet transmission were considered to have been practised adequately and were relatively successful at preventing nosocomial infection.

The CCI 3 is used as a prognostic indicator and to determine treatment strategies for gastroenterological diseases. 6,7 Therefore, the CCI was used in this study to assess the risk conferred by underlying diseases for COVID-19. The patient who tested positive for SARS-CoV-2 was given a high CCI of 8. Elderly patients and patients with many comorbidities are considered at risk of SARS-CoV-2 infection.

No patient in the low-exposure risk category or with high-risk underlying conditions was infected with SARS-CoV-2 at this hospital. Therefore, appropriate implementation of measures against contact and droplet transmission appear adequate to minimise nosocomial spread are of utmost importance in preventing COVID-19 transmission. 

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The authors thank all members of the Department of Gastroenterology and Hepatology, Fukuchiyama City Hospital. The authors also thank all members of the ICT, Fukuchiyama