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

项目总结/摘要 COVID-19大流行使医院的能力紧张，并导致个人防护设备短缺 和测试用品这一点尤其令人担忧，因为导致COVID-19的SARS-CoV-2病毒 导致了显著的医疗保健相关爆发，其他新型冠状病毒如SARS和 MERS。过去的研究表明，通过及时诊断病例， 适当使用个人防护装备。面对短缺，医院必须迅速 决定病房病人的策略，分配感染控制预防措施，配给个人防护用品 设备，并保持足够的人员。需要准确的数据和预测来告知这些 决策和评估其成功与否对于管理正在发生的疫情和告知未来至关重要 反应通过将K 01 AI 141579的现有目标应用于医院相关SARS，可以满足这一需求- CoV-2感染。现有K 01项目的总体目标是支持Josh Petrie博士在 发展卫生保健流行病学的专业知识，最先进的分子方法， 建模技术通过重点培训和职业发展，正在实现这一目标。 医疗流行病学、下一代测序、生物信息学、成本- 有效性分析和数学建模，由优秀的导师团队监督。的技能 正在制定的培训和职业发展目标得到加强， 研究以实现以下具体目标：（1）确定流行病学和社区负担- 获得性和医院相关呼吸道病毒感染，并比较病毒种类的临床影响;（2） 提高病例定义的敏感性和特异性，以识别医院相关呼吸道病毒病例 通过整合临床，流行病学和分子数据;（3）确定成本效益 增加呼吸道病毒筛查和扩大感染控制措施， 数学模型拟议的行政补充规定将有助于实现这些目标， 医院相关SARS-CoV-2感染。建议项目的预期研究成果如下：1） 确定医院相关SARS-CoV-2感染的发生率和结局; 2）改善 通过整合临床、流行病学和 分子数据;以及3）量化医院COVID-19应对策略对 医院相关SARS-CoV-2的发病率。拟议的研究意义重大，因为预计， 这项工作的成果以及在此基础上开展的未来研究将为持续应对COVID-19提供信息 大流行和未来的大流行。本研究在跨学科方法的运用上具有创新性 为研究开辟了新的途径。

PROJECT SUMMARY / ABSTRACT The COVID-19 pandemic has strained hospital capacity and led to shortages in personal protective equipment and testing supplies. This is particularly concerning because the SARS-CoV-2 virus that causes COVID-19 has resulted in notable healthcare associated outbreaks, as have other novel coronaviruses such as SARS and MERS. Past studies have shown that these outbreaks are preventable with prompt diagnosis of cases and appropriate use of personal protective equipment. In the face of shortages, hospitals must make rapid decisions on strategies to room patients, assign infection control precautions, ration personal protective equipment, and maintain adequate staffing. Accurate data and projections are needed to inform these decisions and evaluating their success is critical to managing the ongoing outbreak and informing future response. 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 the development of expertise in healthcare epidemiology, state-of-the-art molecular methods, and advanced modeling techniques. Completion of this objective is in progress through focused training and career development activities in healthcare epidemiology, next generation sequencing, bioinformatics, cost- effectiveness analysis, and mathematical modeling that is overseen by an excellent team of mentors. The skills that are being developed by the training and career development objectives are strengthened by mentored research 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 cases by integrating clinical, epidemiologic, and molecular data; and (3) Determine the cost-effectiveness of increased respiratory virus screening and expanded infection control measures to reduce HA-RVI using mathematical models. The proposed administrative supplement will facilitate application of these aims to hospital-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) improved identification of hospital-associated SARS-CoV-2 infections through integration of clinical, epidemiologic, and molecular data; and 3) quantification of the effects of COVID-19 response strategies in the hospital on the incidence of hospital-associated SARS-CoV-2. The proposed research is significant because it is expected that the outcomes of this work and future studies that build upon it, will inform ongoing response to the COVID-19 pandemic and future pandemics. This research is innovative both in its use of cross-disciplinary methodology that allows for new avenues of research.