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Epidemiologic Linkage of COVID-19 Outbreaks at Two University-affiliated Hospitals in the Seoul Metropolitan Area in March 2020

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Abstract
Background: Coronavirus disease 2019 (COVID-19) outbreaks emerged at two universityaffiliated 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).

Methods: 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.

Results: 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.

Conclusion: 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.
Author(s)
김미나김성한박근열성흥섭윤석현이기현이재웅이진아이해경전종식정지원허규화Mauricio Chalita
Issued Date
2021
Type
Article
Keyword
AdolescentAdultAged 80 and overChildChildPreschoolCladeContact TracingCOVID-19COVID-19 - epidemiologyCross Infection - epidemiologyCross Infection - virologyDisease OutbreaksDNAViral - geneticsElectronic Health RecordsFemaleGenomeViralHospitalsHospitalsUniversityHumansLineageMaleMiddle AgedNosocomial OutbreakOriginalPolymorphismSingle NucleotideSARS-CoV-2SARS-CoV-2 - geneticsSeoul - epidemiologyWhole Genome SequencingYoung Adult의학일반
DOI
10.3346/jkms.2021.36.e38
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8579
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9699835&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Epidemiologic%20Linkage%20of%20COVID-19%20Outbreaks%20at%20Two%20University-affiliated%20Hospitals%20in%20the%20Seoul%20Metropolitan%20Area%20in%20March%202020&offset=0&pcAvailability=true
Publisher
JOURNAL OF KOREAN MEDICAL SCIENCE
Location
대한민국
Language
한국어
ISSN
1011-8934
Citation Volume
36
Citation Number
4
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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