Does nosocomial SARS-CoV-2 infection result in increased 30-day mortality? A multi-centre observational study to identify risk factors for worse outcomes in COVID-19 disease

We aimed to determine whether nosocomial SARS-CoV-2 infection has worse outcomes than community-acquired disease. This was prospective cohort study of all hospitalised patients in three acute hospitals with confirmed COVID-19 on 9th April 2020. Patients were followed up for at least 30 days. Nosocomial infection was defined as a positive swab after 7 days of admission. 173 patients were identified; 19 (11.0%) had nosocomial infection. 32 (18.5%) had 30-day all-cause mortality; there was no statistically significant differences between 30-day mortality (21.1% vs 17.6% vs 21.6% respectively, p=0.755). Nosocomial SARS-CoV-2 infection is not associated with increased mortality compared with community acquired infection.