Clinical Features of SARS-CoV-2 Infection in Italian Long-Term Care Facilities: GeroCovid LTCFs Observational Study

Noale, Marianna; Abbatecola, Angela Marie; Borselli, Gilda; Cafariello, Carmine; Fumagalli, Stefano; Gareri, Pietro; Mossello, Enrico; Trevisan, Caterina; Volpato, Stefano; Monzani, Fabio; Coin, Alessandra; Bellelli, Giuseppe; Okoye, Chukwuma; Signore, Susanna Del; Zia, Gianluca; Incalzi, Raffaele Antonelli

doi:10.1016/j.jamda.2021.10.009

Cited by 10 publications

(10 citation statements)

References 10 publications

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“…Coronavirus Disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has determined a substantial increment in morbidity and mortality worldwide [1]. Nursing home (NH) residents, that often present with a high burden of comorbidities and clinical complexities, suffered the greatest impact of the pandemic in many countries worldwide, independently of health care system organization [2][3][4][5]. Epidemiological data indicate that during the first pandemic wave, up to 50% of deaths from COVID-19 may have occurred within NH facilities [6].…”

Section: Introductionmentioning

confidence: 99%

Humoral immunity induced by mRNA COVID-19 vaccines in Nursing Home Residents previously infected with SARS-CoV-2

Fedele

Palmieri²,

Damiano³

et al. 2022

Aging Clin Exp Res

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Background Nursing home (NH) residents suffered the greatest impact of the COVID-19 pandemic. Limited data are available on vaccine-induced immunity and on the protection ensured by a prior infection in this population. Aims The present study aims to monitor antibody levels and their persistence over a 6-month period in NH residents according to the history of prior SARS-CoV-2 infection. Methods We measured anti-trimeric Spike IgG antibody levels in a sample of 395 residents from 25 NHs in 6 Italian Regions at study enrolment (prior to the first dose of vaccine, T0) and then after 2 (T1) and 6 months (T2) following the first vaccine dose. All participants received mRNA vaccines (BNT162b2 or mRNA-1273). Analyses were performed using log-transformed values of antibody concentrations and geometric means (GM) were calculated. Results Superior humoral immunity was induced in NH residents with previous SARS-CoV-2 infection. (T0: GM 186.6 vs. 6.1 BAU/ml, p < 0.001; T1: GM 5264.1 vs. 944.4 BAU/ml, p < 0.001; T2: GM 1473.6 vs. 128.7 BAU/ml, p < 0.001). Residents with prior SARS-CoV-2 infection receiving two vaccine doses presented significantly higher antibody concentration at T1 and T2. A longer interval between previous infection and vaccination was associated with a better antibody response over time. Discussion In a frail sample of NH residents, prior SARS-CoV-2 infection was associated with a higher humoral response to vaccination. Number of vaccine doses and the interval between infection and vaccination are relevant parameters in determining humoral immunity. Conclusions These findings provide important information to plan future immunization policies and disease prevention strategies in a highly vulnerable population.

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Section: Introductionmentioning

confidence: 99%

Humoral immunity induced by mRNA COVID-19 vaccines in Nursing Home Residents previously infected with SARS-CoV-2

Fedele

Palmieri²,

Damiano³

et al. 2022

Aging Clin Exp Res

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“…Indeed, several studies showed that older people with COVID-19 can develop different clinical pictures and degrees of severity of the disease, also within the same age class (Table 1). 11,[23][24][25] In a mentioned study conducted on older patients with COVID-19, 15 almost 20% of the enrolled populations reported several complications of COVID-19 disease during their hospital stay, including acute respiratory distress syndrome, sepsis, acute renal failure, and acute heart failure. Regardless of age, for example, important clinical differences were reported based on sex, inasmuch as men more frequently develop severe COVID-19 disease than women.…”

Section: Factors Influencing Covid-19 Clinical Presentationmentioning

confidence: 99%

“…5 Finally, a similar picture was observed in 586 residents of long-term care facilities with suspected SARS-CoV-2 infection, with 88.8% of positive patients (n 5 159) reporting 3 or more comorbidities, and this influenced the severity of COVID-19 disease (especially the presence of dementia). 25 Several studies investigated the possible link between frailty and COVID-19 clinical presentation. It is widely known that in older patients the presence of frailty, either defined according to the Fried 28 or Rockwood criteria, 29 is strongly correlated with adverse outcomes.…”

Section: Sars-cov-2 Infection In Older Adultsmentioning

confidence: 99%

Clinical Features of SARS-CoV-2 Infection in Older Adults

Remelli

Volpato

Trevisan

2022

Clinics in Geriatric Medicine

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“…Indeed, older residents commonly suffer from multiple comorbidities that may mimic SARS-CoV-2 infection, thus underlining clinical difficulties related to identifying COVID-19 in this setting. Recent literature has underlined that older residents with three or more chronic diseases, such as dementia or cognitive impairment, malnutrition, or central and peripheral arterial disease have a higher risk of an infection from SARS-CoV-2 [4]. Interestingly, these authors also found that mortality was significantly higher in SARS-CoV-2-positive residents than in SARS-CoV-2-negative residents with suspicious symptoms (21.6% vs. 10.8%, respectively) [4].…”

Section: Introductionmentioning

confidence: 99%

“…Recent literature has underlined that older residents with three or more chronic diseases, such as dementia or cognitive impairment, malnutrition, or central and peripheral arterial disease have a higher risk of an infection from SARS-CoV-2 [4]. Interestingly, these authors also found that mortality was significantly higher in SARS-CoV-2-positive residents than in SARS-CoV-2-negative residents with suspicious symptoms (21.6% vs. 10.8%, respectively) [4]. At the moment, implications and clinical relevance of asymptomatic and paucisymptomatic COVID-19 residents remain unclear as well as specific treatment options and type of clinical monitoring in LTCF residents [5].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Signs and Symptom Clusters in Long-Term Care Facility Residents: Data from the GeroCovid Observational Study

Noale

Abbatecola

Borselli³

et al. 2022

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Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 60 year-old residents at risk of or affected with COVID-19 enrolled in the GeroCovid LTCF network. COVID-19 signs/symptom clusters were identified using cluster analysis. Cluster analyses associated with SARS-CoV-2 infection and mortality were evaluated using logistic regression and Cox proportional hazard models. Results: Cluster 1 symptoms (delirium, fever, low-grade fever, diarrhea, anorexia, cough, increased respiratory rate, sudden deterioration in health conditions, dyspnea, oxygen saturation, and weakness) affected 39.6% of residents and were associated with PCR swab positivity (OR = 7.21, 95%CI 4.78–10.80; p < 0.001). Cluster 1 symptoms were present in deceased COVID-19 residents. Cluster 2 (increased blood pressure, sphincter incontinence) and cluster 3 (new-onset cognitive impairment) affected 20% and 19.8% of residents, respectively. Cluster 3 symptoms were associated with increased mortality (HR = 5.41, 95%CI 1.56–18.8; p = 0.008), while those of Cluster 2 were not associated with mortality (HR = 0.82, 95%CI 0.26–2.56; p = 730). Conclusions: Our study highlights that delirium, fever, and low-grade fever, alone or in clusters should be considered in identifying and predicting the prognosis of SARS-CoV-2 infection in older LTCF patients.

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Clinical Features of SARS-CoV-2 Infection in Italian Long-Term Care Facilities: GeroCovid LTCFs Observational Study

Cited by 10 publications

References 10 publications

Humoral immunity induced by mRNA COVID-19 vaccines in Nursing Home Residents previously infected with SARS-CoV-2

Humoral immunity induced by mRNA COVID-19 vaccines in Nursing Home Residents previously infected with SARS-CoV-2

Clinical Features of SARS-CoV-2 Infection in Older Adults

COVID-19 Signs and Symptom Clusters in Long-Term Care Facility Residents: Data from the GeroCovid Observational Study

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