Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
Department of Laboratory Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
J Korean Med Sci. 2021 Jan 25;36(4):e38. doi: 10.3346/jkms.2021.36.e38.
Coronavirus disease 2019 (COVID-19) outbreaks emerged at two university-affiliated hospitals in Seoul (hospital A) and Uijeongbu City (hospital S) in the metropolitan Seoul area in March 2020. The aim of this study was to investigate epidemiological links between the outbreaks using whole genome sequencing (WGS) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Fifteen patients were enrolled in the study, including four non-outbreak (A1-A4) and three outbreak cases (A5-A7) in hospital A and eight cases (S1-S8) in hospital S. Patients' hospital stays, COVID-19 symptoms, and transfer history were reviewed. RNA samples were submitted for WGS and genome-wide single nucleotide variants and phylogenetic relationships were analyzed.
The index patient (A5) in hospital A was transferred from hospital S on 26 March. Patients A6 and A7 were the family caregiver and sister, respectively, of the patient who shared a room with A5 for 4 days. Prior to transfer, A5 was at the next bed to S8 in the emergency room on 25 March. Patient S6, a professional caregiver, took care of the patient in the room next to S8's room for 5 days until 22 March and then S5 for another 3 days. WGS revealed that SARS-CoV-2 in A2, A3, and A4 belong to clades V/B.2, S/A, and G/B.1, respectively, whereas that of A5-A7 and S1-S5 are of the V/B.2.1 clade and closely clustered. In particular, SARS-CoV-2 in patients A5 and S5 showed perfect identity.
WGS is a useful tool to understand epidemiology of SARS-CoV-2. It is the first study to elucidate the role of patient transfer and caregivers as links of nosocomial outbreaks of COVID-19 in multiple hospitals.
2020 年 3 月，2019 年冠状病毒病（COVID-19）疫情在首尔市（医院 A）和议政府市（医院 S）的两所大学附属医院爆发。本研究旨在通过对严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的全基因组测序（WGS）调查疫情爆发之间的流行病学联系。
共纳入 15 例患者，包括医院 A 的 4 例非暴发（A1-A4）和 3 例暴发（A5-A7）病例以及医院 S 的 8 例病例（S1-S8）。回顾患者住院期间、COVID-19 症状和转移史。提交 RNA 样本进行 WGS，分析全基因组单核苷酸变异和系统发育关系。
医院 A 的索引病例（A5）于 3 月 26 日从医院 S 转来。A6 和 A7 分别是与 A5 同住 4 天的患者的家庭照顾者和妹妹。在转院之前，A5 于 3 月 25 日在急诊室与 S8 隔壁的床位上。专业护理人员 S6 在 3 月 22 日至 25 日期间在 S8 隔壁的房间照顾患者，然后在 3 月 25 日至 28 日期间在 S5 隔壁的房间照顾患者。WGS 显示，A2、A3 和 A4 的 SARS-CoV-2 分别属于 V/B.2、S/A 和 G/B.1 分支，而 A5-A7 和 S1-S5 的则属于 V/B.2.1 分支，且聚类紧密。特别是，患者 A5 和 S5 的 SARS-CoV-2 完全相同。
WGS 是了解 SARS-CoV-2 流行病学的有用工具。这是第一项阐明患者转移和护理人员在多家医院 COVID-19 医院感染暴发中的作用的研究。
Zotero 插件
