COVID-19 Risk From Attending Outpatient Radiology Appointments
Condition: Covid19
MeSH terms: COVID-19
Study type: Observational

Summary: 
      By using recent data on hospital attendance and COVID-19 laboratory tests, available within
      two NHS trusts in Nottingham and Cardiff we will enable the calculation of the risk of
      developing COVID-19 infection after attending an outpatient hospital appointment. This will
      assist in the restart planning when resuming face to face outpatient radiology appointment.
    

Detailed description: 
      Since March 2020, the novel coronavirus (COVID-19) pandemic has caused considerable
      disruption to the provision of routine healthcare in the UK. A key priority for healthcare
      providers when gaining control of COVID-19, is to restart the provision of urgent non-COVID
      care. There are several barriers including a reluctance for people to attend hospital
      appointments for fears of contracting COVID-19. Although SARS-COV2 infections have been
      reported to occur during hospital inpatient stay, the risk of acquiring SARS-COV2 during
      outpatient consultations or radiological investigations has not been reported.

      In a pilot study at our hospitals during the pandemic, we have found radiology to reliably
      record in person attendance contrary to outpatient clinic appointments records that were
      contaminated by remote consultations. The investigators will calculate the incidence of
      infection in approximately 30,000 patients at Nottingham and 17,000 patients at Cardiff and
      calculate the risk of infection within 28 days of attending outpatient radiology
      appointments. Controls will use data on patients who attended the hospitals in 2019.

      The study team will utilize the data held in the electronic systems of NUH and University
      Hospital of Wales to perform a cohort study which will comprise both an exposed cohort and
      unexposed cohort.

      The exposed cohort will comprise patients who attended outpatient radiology appointments
      during (between 29/1/20 - 24/5/20) and whether they subsequently developed a positive or
      negative PCR test for Sars-CoV2 result within 28-days of their attendance. The unexposed
      cohort will work as a control group, comprising individuals who attended outpatient radiology
      appointments during the equivalent period in 2019.

      All of this data will be retrospective, so will not require any additional data collection,
      nor will it interfere with routine clinical care. Pseudo-anonymised data will be transferred
      from University Hospital of Wales in Cardiff to Nottingham University Hospitals (NUH) Trust
      via a password-protected, encrypted spreadsheet, with original patient identifiers removed,
      and a unique code assigned, that only the researcher in Cardiff can use to trace back to the
      individual, this is so all the analysis can be performed at NUH by a Nottingham based
      statistician.

      The study team consisting of clinicians, data analysts, epidemiologist and clinical
      researchers will analyse this information to quantify the risk of infection which will help
      inform the recovery plans and service provision during the restart of urgent and routine
      non-COVID care.
    

Intervention name(s): Observational
Intervention type(s): Other
Intervention description(s): There will be no interventions in this study, it is purely observational using data already collected.
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        All individuals attending outpatient clinics will be included for analysis, this is
        anticipated this to be in excess of 30,000 patients at NUH and around 17,000 patients at
        Cardiff. To ensure a substantive number of patients are included for analysis and
        comparison across the UK, 2 large hospitals (Nottingham University Hospitals and Cardiff
        University Hospitals) will be participating in this study.
      
Keywords: Radiology; Outpatient; Hospital