A Comparison of Characteristics and Outcomes of Patients with Community-Acquired and Hospital-Acquired COVID-19 in the United Kingdom: An Observational Study

Shiwani, Haaris A.; Bilal, Muhammad; Shahzad, Muhammad U.; Rodrigues, Alson; Suliman, Jehad A.; Soban, Muhammad; Mirza, Shahzeb; Lotca, Nicoleta; Ruslan, Mohammed R.; Memon, Danyal; Arshad, Muhammad A.; Fatima, Kiran; Kamran, Asma; Egom, Emmanuel E.; Aziz, Abdul

BACKGROUND AND OBJECTIVES: Reports comparing the characteristics of patients and their clinical outcomes between community-acquired (CA) and hospital-acquired (HA) COVID-19 have not yet been reported in the literature. We aimed to characterise and compare clinical, biochemical and haematological features, in addition to clinical outcomes, between these patients. METHODS: This multi-centre, retrospective, observational study enrolled 488 SARS-CoV-2 positive patients - 339 with CA infection and 149 with HA infection. All patients were admitted to a hospital within the University Hospitals of Morecambe Bay NHS Foundation Trust between March 7(th) and May 18(th) 2020. RESULTS: The CA cohort comprised of a significantly younger population, median age 75 years, versus 80 years in the HA cohort (P=0·0002). Significantly less patients in the HA group experienced fever (P=0·03) and breathlessness (P<0·0001). Furthermore, significantly more patients had anaemia and hypoalbuminaemia in the HA group, compared to the CA group (P<0·0001 for both). Hypertension and a lower median BMI were also significantly more pronounced in the HA cohort (P=0·03 and P=0·0001, respectively). The mortality rate was not significantly different between the two cohorts (34% in the CA group and 32% in the HA group, P=0·64). However, the CA group required significantly greater ICU care (10% versus 3% in the HA group, P=0·009). CONCLUSION: Hospital-acquired and community-acquired COVID-19 display similar rates of mortality despite significant differences in baseline characteristics of the respective patient populations. Delineation of community- and hospital-acquired COVID-19 in future studies on COVID-19 may allow for more accurate interpretation of results.