Hospital-Associated Respiratory Virus Infections: Molecular Epidemiology, Clinical Outcomes, and Cost-Effectiveness of Interventions - COVID-19 Administrative Supplement

PROJECT SUMMARY / Abstract: The COVID-19 pandemic has strained hospital capacity and led to shortages in personal protective equipmentand testing supplies. This is particularly concerning because the SARS-CoV-2 virus that causes COVID-19 hasresulted in notable healthcare associated outbreaks, as have other novel coronaviruses such as SARS andMERS. Past studies have shown that these outbreaks are preventable with prompt diagnosis of cases andappropriate use of personal protective equipment. In the face of shortages, hospitals must make rapiddecisions on strategies to room patients, assign infection control precautions, ration personal protectiveequipment, and maintain adequate staffing. Accurate data and projections are needed to inform thesedecisions and evaluating their success is critical to managing the ongoing outbreak and informing futureresponse. This need can be met by applying the existing aims of K01AI141579 to hospital-associated SARS-CoV-2 infection. The overall objective of the existing K01 project is to support Josh Petrie, PhD in thedevelopment of expertise in healthcare epidemiology, state-of-the-art molecular methods, and advancedmodeling techniques. Completion of this objective is in progress through focused training and careerdevelopment activities in healthcare epidemiology, next generation sequencing, bioinformatics, cost-effectiveness analysis, and mathematical modeling that is overseen by an excellent team of mentors. The skillsthat are being developed by the training and career development objectives are strengthened by mentoredresearch to accomplish the following Specific Aims: (1) Define the epidemiology and burden of community-acquired and hospital-associated respiratory virus infections and compare clinical impact by viral species; (2)Improve the sensitivity and specificity of case definitions to identify hospital-associated respiratory virus casesby integrating clinical, epidemiologic, and molecular data; and (3) Determine the cost-effectiveness ofincreased respiratory virus screening and expanded infection control measures to reduce HA-RVI usingmathematical models. The proposed administrative supplement will facilitate application of these aims tohospital-associated SARS-CoV-2 infection. The expected research outcomes of the proposed project are, 1)determination of the incidence and outcomes of hospital-associated SARS-CoV-2 infections; 2) improvedidentification of hospital-associated SARS-CoV-2 infections through integration of clinical, epidemiologic, andmolecular data; and 3) quantification of the effects of COVID-19 response strategies in the hospital on theincidence of hospital-associated SARS-CoV-2. The proposed research is significant because it is expected thatthe outcomes of this work and future studies that build upon it, will inform ongoing response to the COVID-19pandemic and future pandemics. This research is innovative both in its use of cross-disciplinary methodologythat allows for new avenues of research.