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Infectious Diseases

Association of Omicron vs Wild-type SARS-CoV-2 Variants With Hospital-Onset SARS-CoV-2 Infections in a US Regional Hospital System

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: June 15, 2022

Research Letter

Article Information and Disclosures

Michael Klompas, MD, MPH¹;

Michael C. Pandolfi, BS²;

Ansa B. Nisar, BS²;

Meghan A. Baker, MD, ScD¹;

Chanu Rhee, MD, MPH¹

Author Affiliations

¹Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
²Mass General Brigham Digital, Somerville, Massachusetts

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The SARS-CoV-2 Omicron variant is more contagious than prior variants, leading to large increases in community cases. Little is known, however, about the incidence of nosocomial SARS-CoV-2 infections with Omicron vs prior variants.

We retrospectively identified all SARS-CoV-2 cases diagnosed in 12 hospitals within the Mass General Brigham health care system between July 1, 2020, and February 28, 2022. All patients were tested on admission with polymerase chain reaction (PCR) assays, and, starting November 2020, were retested 72 hours after admission to identify cases with virus incubating on admission. Retesting was also required for new symptoms, after possible exposures, before aerosol-generating procedures, and before discharge if requested by destination facilities.

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Article Information

Accepted for Publication: May 21, 2022.

Published Online: June 15, 2022. doi:10.1001/jama.2022.9609

Corresponding Author: Michael Klompas, MD, MPH, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr, Ste 401 E, Boston, MA 02215 (mklompas@bwh.harvard.edu).

Author Contributions: Dr Klompas and Mr Pandolfi had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Klompas, Nisar, Baker, Rhee.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Klompas, Pandolfi.

Critical revision of the manuscript for important intellectual content: Klompas, Nisar, Baker, Rhee.

Statistical analysis: Klompas, Pandolfi, Nisar.

Administrative, technical, or material support: Nisar, Baker.

Supervision: Klompas.

Conflict of Interest Disclosures: Dr Klompas reported receiving grants from the Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality, and royalties from UpToDate outside the submitted work. Dr Baker reported receiving grants from CDC during the conduct of the study. Dr Rhee reported receiving royalties from UpToDate and consulting fees from Cytovance and Pfizer outside the submitted work. No other disclosures were reported.

References

Backer JA , Eggink D , Andeweg SP , et al. Shorter serial intervals in SARS-CoV-2 cases with Omicron BA.1 variant compared with Delta variant, the Netherlands, 13 to 26 December 2021. Euro Surveill. 2022;27(6):2200042. doi:10.2807/1560-7917.ES.2022.27.6.2200042 PubMed Google Scholar Crossref

Rhee C , Baker MA , Kanjilal S , et al. Prospective clinical assessments of hospitalized patients with positive SARS-CoV-2 PCR tests for necessity of isolation. Open Forum Infect Dis. 2021;8(7):ofab194. doi:10.1093/ofid/ofab194 PubMed Google Scholar Crossref

Klompas M , Baker MA , Rhee C , et al. A SARS-CoV-2 cluster in an acute care hospital. Ann Intern Med. 2021;174(6):794-802. doi:10.7326/M20-7567 PubMed Google Scholar Crossref

Lumley SF , Constantinides B , Sanderson N , et al; OUH Microbiology Laboratory; OUH Infection Prevention and Control Team. Epidemiological data and genome sequencing reveals that nosocomial transmission of SARS-CoV-2 is underestimated and mostly mediated by a small number of highly infectious individuals. J Infect. 2021;83(4):473-482. doi:10.1016/j.jinf.2021.07.034 PubMed Google Scholar Crossref

Klompas M , Karan A . Preventing SARS-CoV-2 transmission in health care settings in the context of the Omicron variant. JAMA. 2022;327(7):619-620. doi:10.1001/jama.2022.0262 PubMed Google Scholar Crossref

Baker MA , Rhee C , Tucker R , et al. Rapid control of hospital-based SARS-CoV-2 Omicron clusters through daily testing and universal use of N95 respirators. Clin Infect Dis. Published online February 7, 2022. doi:10.1093/cid/ciac113 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.