The reported incidence of many healthcare–associated infections (HAIs) increased during the COVID-19 pandemic; however, it is unclear whether this is due to increased patient risk or to increased pressure on the healthcare system. Sands, et al. (2023) sought to assess HAI occurrence among patients admitted to hospitals with and without COVID-19. A cross-sectional retrospective analysis of inpatients discharged both with and without laboratory-confirmed COVID-19 infection was conducted. Data were obtained between Jan. 1, 2019, and March 31, 2022, from community hospitals affiliated with a large healthcare system in the US.

Among nearly 5 million hospitalizations in 182 hospitals between 2020 and 2022, the occurrence of healthcare–associated infections (HAIs) was high among the 313,200 COVID-19 inpatients (median [SD] age, 57 [27.3] years; 56.0% women). Incidence per 100,000 patient-days showed higher HAIs among those with COVID-19 compared with those without. For CLABSI, the incidence for the full 9 quarters of the study was nearly 4-fold higher among the COVID-19 population than the non–COVID-19 population (25.4 vs 6.9). For CAUTI, the incidence in the COVID-19 population was 2.7-fold higher in the COVID-19 population (16.5 vs 6.1), and for MRSA, 3.0-fold higher (11.2 vs 3.7). Quarterly trends were compared with the same quarter in 2019. The greatest increase in the incidence of HAI in comparison with the same quarter in 2019 for the entire population occurred in quarter 3 of 2020 for CLABSI (11.0 vs 7.3), quarter 4 of 2021 for CAUTI (7.8 vs 6.8), and quarter 3 of 2021 for MRSA (5.2 vs 3.9). When limited to the non–COVID-19 population, the increase in CLABSI incidence vs the 2019 incidence was eliminated, and the quarterly rates of MRSA and CAUTI were lower vs the prepandemic 2019 comparator quarter.

In this cross-sectional study of hospitals during the pandemic, HAI occurrence among inpatients without COVID-19 was similar to that during 2019 despite additional pressures for infection control and healthcare professionals.The findings suggest that patients with COVID-19 may be more susceptible to HAIs and may require additional prevention measures.

Reference: Sands KE, et al. Healthcare–Associated Infections Among Hospitalized Patients With COVID-19, March 2020-March 2022. JAMA Netw Open. 2023;6(4):e238059. doi:10.1001/jamanetworkopen.2023.8059