Lumbosciatalgia as the first manifestation of COVID-19 infection

Background and aims: Healthcare-associated infections (HAI) are a major cause of inpatient morbimortality. Those include respiratory (RI) and urinary (UI) infections, among others (OI). COVID-19 has raised awareness about the importance of hygiene measures and respiratory etiquette, potentially reducing the incidence of HAI. We aimed to assess the impact of measures implemented or reinforced during the pandemic, on the incidence of HAI in a Neurology Department. Methods: Retrospective comparative study of the incidence of HAI between relevant periods in 2019 and 2020. Comparisons of percentage of HAI was performed using a 2-proportion z-test. Statistical significance was defined by p-value=0.05 corrected for multiple comparisons using Bonferroni's method. Results: Between January and July of 2019, 560 patients were admitted, with 25%HAI (11%RI, 12%UI, 2%OI) versus 519 patients and 20%HAI (10%RI, 8%UI, 2%OI) in the equivalent period of 2020. The incidence of HAI between the first three months of 2019 and 2020 was, respectively, 32% (15%RI, 13%UI, 4%OI) versus 20% (16%RI, 13%UI, 1%OI). We observed 20%HAI (8%RI, 11%UI, 1%OI) between April and July 2019 versus 19%HAI (11%IR, 6%UI, 2%OI) in the same period of 2020. No statistically significant differences were seen between any groups. Conclusion: In a tertiary Neurology Department, there was a tendency (not reaching statistical significance from March to July 2020) for a reduction of the global incidence of HAI in 2020, mainly due to fewer UI. This reduction seems to be due to progressive improvement of global/hand hygiene measures between 2019 and 2020, rather than directly associated to masks/respiratory infections, or just the pandemic period.