466. SARS-CoV-2 Diagnosis And Point Prevalence in a Non-Cohorted Tertiary Care Center

Background: The CDC recommends testing for SARS-CoV-2 in patients who present with symptoms consistent with COVID-19 and to cohort hospitalized patients diagnosed with COVID-19 Up to 35% of persons infected with SARS-CoV-2 are asymptomatic;however, no recommendations exist for universal testing in hospitalized patients We assessed the point prevalence of SARS-CoV-2 infection amongst hospitalized patients at a tertiary care center during a time when there was a regional surge of cases Methods: Nasopharyngeal SARS-CoV-2 PCR testing was performed on inpatients at Georgetown University Hospital on 4/27/20, excluding those who were SARS-CoV-2 positive, tested within 72 hours or admitted to pediatric, psychiatric, labor & delivery or ICUs Patients within the hospital were not cohorted based on COVID-19 status Patient demographics and comorbidities were obtained from the EMR and analyzed for significance based on SARS-CoV-2 status Results: Hospital census on the testing date was 297;204/297(68 7%) met inclusion criteria;78/297(26 3%) were known COVID-19 patients Within the study group 78/204 (38 2%) had known COVID-19, 21/204 (10 3%) were PUIs (4 of whom tested positive), 31/204 (15 1%) tested negative for COVID-19 within 72 hours and 74/204 (36 3%) met criteria for testing The median age was 62 years (IQR, 53 to 70), 59%(n=122) were male, 56%(n= 115) were Black, and 90%(n=185) had at least one co-morbidity 0/74 of those tested on 4/27/20 were positive for SARS-CoV-2, and none were diagnosed with COVID-19 within 28 days In adjusted analyses, patients who were hospitalized for COVID-19 were more likely to be Black(OR=10 53 95% CI 3 02, 36 68, p=0 0002);male(OR=3 27 95% CI 1 26, 8 47, p=0 0143);reside in group/nursing homes(OR= 11 78 95%CI 3 03, 45 76, p=0 0004);have a history of prior stroke(OR= 6 25 95%CI 1 49, 26 12, p=0 012);but less likely to smoke(OR=0 10 95%CI 0 02, 0 48, p=0 0039), or have active malignancy (OR= 0 11 95%CI 0 01, 0 73, p=0 0223) Conclusion: The use of CDC testing criteria for PUIs were successful in identifying COVID-19 patients and limiting the need for routine testing in all hospitalized patients during a time when access to testing was limited Nosocomial transmission did not occur in our institution despite a lack of cohorting