S214 Clostridium difficile Infection and COVID-19 Pandemic: Insights From Google Trends Analysis

Abstract

Introduction: The Coronavirus Disease- 19 (COVID-19) pandemic has significantly impacted the healthcare system across the United States. The virus has been predominantly found to spread via contact, droplet, and airborne routes. Both healthcare personnel and the general public have employed cautionary measures such as maintaining physical distance, handwashing, and masks to prevent transmission. Co-incidentally, these precautions should also be beneficial for halting the spread of other infectious pathogens such as Clostridium difficile. Methods: Google Trends is a tool used to track topics that are being searched on Google. It creates a normalized statistic called “search volume index” (SVI) which assigns each search topic a value from 0-100 based on the number of relative searches for that topic. SVI is well studied as a surrogate for general public interest in health-related topics. Results: We searched Google Trends for COVID-19 and Clostridium difficile from 10/01/2019 to 08/30/2020 in the US. There was a statistically significant increase (p< 0.05) in the SVI before and after declaration of COVID-19 as a national emergency by President Donald Trump. Incidentally, there was also a statistically significant decrease (p< 0.05) in C. difficile SVI (Figure 1). However, in a noncommunicable disease like heart failure, there was no change. Figure 1 shows the temporal trends in SVI of the three topics pre- and post-declaration of COVID-19 as a national emergency. Overall, the peak in interest for COVID-19 was found to coincide with the decline in C. difficile related searches on Google. However, the interest in a non-communicable disease like heart failure remained stable throughout the same time period. Conclusion: The on-going pandemic has necessitated the practice of appropriate hand hygiene and social distancing in order to decrease new cases. We hypothesized that these techniques should also have translated to a decrease in the spread of communicable diseases like C. difficile infection (CDI). Another consideration includes the increased use of antibiotics during this pandemic as well which could increase the risk of C. difficile. One study has shown that patients with COVID do not have an increased risk of CDI while another study showed that during the initial 3-month period of COVID there was a decrease in CDI. We need to continue to investigate the impact of the COVID-19 pandemic on the incidence of CDI and the subsequent impact on healthcare costs and overall outcomes in hospitalized patients.Figure 1.: Temporal trends in Google Trends search volume indices for COVID-19, Clostridium difficile infection and heart failure in the United States. (COVID-19 was declared as a national emergency in the United States on March 13,2020). (x-axis is the date and y-axis is the SVI).