Journal Article

Proposed new definition for hospital-acquired SARS-CoV-2 infections: results of a confirmatory factor analysis

Loderstädt, Ulrike, Scheithauer, Simone, Baier, Claas, Dresselhaus, Isabella, Schlüter, Dirk, Eckmanns, Tim, Reinoso Schiller, Nicolás

2024

Overview

The present study aims to develop and discuss an extension of hospital-acquired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections (HA-SIs) definition which goes beyond the use of time parameters alone. A confirmatory factor analysis was carried out to test a suitable definition for HA-SI. A two-center cohort study was carried out at two tertiary public hospitals in the German state of lower Saxony. The study involved a population of 366 laboratory-confirmed SARS-CoV-2-infected inpatients enrolled between March 2020 and August 2023. The proposed model shows adequate fit indices (CFI.scaled = 0.959, RMSEA = 0.049). A descriptive comparison with existing classifications revealed strong features of our model, particularly its adaptability to specific regional outbreaks. The use of the regional incidence as a proxy variable to better define HA-SI cases represents a pragmatic and novel approach. The model aligns well with the latest scientific results in the literature. This work successfully unifies, within a single model, variables which the recent literature described as significant for the onset of HA-SI. Further potential improvements and adaptations of the model and its applications, such as automating the categorization process (in terms of hospital acquisition) or employing a comparable model for hospital-acquired influenza classification, are subjects open for discussion.

• Publisher: Cambridge University Press
• Subject: Adaptability / COVID-19 / Discriminant analysis / Disease transmission / Epidemics / Factor analysis / Hospitalization / Hospitals / Nosocomial infections / Original / Pandemics / Patients / Public health / Severe acute respiratory syndrome coronavirus 2 / Statistical analysis / Variables