Public Health Agency of Canada (Mitchell, Choi, Pelude, Rudnick); Children's Hospital of Eastern Ontario (Thampi), Ottawa, Ont.; University of Alberta Hospital (Taylor [deceased]), Edmonton, Alta.
CMAJ Open. 2021 Mar 2;9(1):E149-E156. doi: 10.9778/cmajo.20200246. Print 2021 Jan-Mar.
Information on the epidemiology of patients in hospital with laboratory-confirmed coronavirus disease 2019 (COVID-19) in Canadian acute care hospitals is needed to inform infection prevention and control strategies and public health measures. The aim of this surveillance was to describe the epidemiology of patients in hospital with laboratory-confirmed COVID-19 in a network of Canadian acute care hospitals between Mar. 1 and Aug. 31, 2020.
Through prospective surveillance, we identified adult and pediatric patients in hospital with laboratory-confirmed COVID-19 using a standard definition between Mar. 1 and Aug. 31, 2020, through the Canadian Nosocomial Infection Surveillance Program (CNISP), a network of 78 hospitals. Patient demographic and clinical characteristics and data on treatment, interventions and outcomes were reviewed and described.
As of Aug. 31, 2020, the CNISP had received data for 1906 patients in hospital with COVID-19 in 49 sentinel hospitals in 9 provinces. The majority of patients in hospital with COVID-19 were older (median age 71 yr) and had underlying medical conditions (85.8%). Few children with COVID-19 were admitted to a participating hospital ( = 37, 1.9%). Acquisition of COVID-19 in hospitals was infrequent (6.4% of all cases). A total of 32.8% of patients were admitted from a long-term care facility or retirement home. Health care workers constituted 10.6% of adult patients aged 18-65 years in hospital with COVID-19. Thirty-day attributable mortality was 16.2%. Hospital admission rates peaked in mid-April and were highest in Ontario and Quebec.
Surveillance findings indicate that a high proportion of Canadian patients in hospital with COVID-19 during the first 6 months of the pandemic were older adults with underlying medical conditions. Active surveillance of patients in hospital with COVID-19 is critical to enhancing our knowledge of the epidemiology of COVID-19 and to identifying populations at risk for severe outcomes, which will help guide Canada's response in the coming months.
需要了解加拿大急性护理医院中经实验室确诊的 2019 年冠状病毒病（COVID-19）患者的流行病学信息，以为感染预防和控制策略及公共卫生措施提供依据。本监测的目的是描述 2020 年 3 月 1 日至 8 月 31 日期间加拿大急性护理医院网络中经实验室确诊 COVID-19 的患者的流行病学特征。
通过前瞻性监测，我们使用加拿大医院感染监测计划（CNISP）的标准定义，通过该计划在 2020 年 3 月 1 日至 8 月 31 日期间在 78 家医院网络中识别出患有经实验室确诊 COVID-19 的成年和儿科患者。回顾并描述患者的人口统计学和临床特征以及治疗、干预和结局数据。
截至 2020 年 8 月 31 日，CNISP 已收到来自 9 个省的 49 家监测医院中患有 COVID-19 的 1906 名患者的数据。COVID-19 住院患者多数年龄较大（中位数年龄 71 岁），且有基础疾病（85.8%）。少数患有 COVID-19 的儿童被收入参与医院（=37，1.9%）。医院内获得性 COVID-19 感染的情况很少见（所有病例的 6.4%）。共有 32.8%的患者是从长期护理院或退休之家转入。在医院治疗的 18-65 岁成年 COVID-19 患者中，医护人员占 10.6%。30 天归因死亡率为 16.2%。医院入院率在 4 月中旬达到峰值，安大略省和魁北克省最高。
监测结果表明，在大流行的前 6 个月中，加拿大 COVID-19 住院患者中很大一部分是年龄较大且有基础疾病的成年人。对 COVID-19 住院患者进行主动监测对于增强我们对 COVID-19 流行病学的认识以及确定有严重后果风险的人群至关重要，这将有助于指导加拿大未来几个月的应对工作。
