How Typical is the Spectrum of COVID-19 in Nursing Home Residents?

Janus, Sarah I M; Schepel, Angelique A M; Zuidema, Sytse U.; Haas, Esther C. de

doi:10.1016/j.jamda.2020.12.028

Cited by 5 publications

(6 citation statements)

References 6 publications

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“…We retrospectively registered a priori selected factors, including demographic details, clinical information, functional assessments, and pharmacological data, for all the patients included in our retrospective analysis. These factors encompassed demographic characteristics, any existing comorbidities, prior treatments, assessment of physical function using the Barthel index [13], prognosis as measured by the PROFUND index [14], COVID-19 symptoms and signs at the time of presentation, medical treatments administered during the outbreak, and the ultimate patient outcomes.…”

Section: Data Collection and Variablesmentioning

confidence: 99%

Survival Impact of an On-Site Medicalization Program in the Control of COVID-19 Outbreaks in 11 Nursing Homes

Baron-Franco,

Ollero-Baturone,

Ternero-Vega

et al. 2023

JCM

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Background: The elderly admitted to nursing homes have especially suffered the havoc of the COVID-19 pandemic since most of them are not prepared to face such health problems. Methods: An innovative coordinated on-site medicalization program (MP) in response to a sizeable COVID-19 outbreak in three consecutive waves was deployed, sharing coordination and resources among primary care, the referral hospital, and the eleven residences. The objectives were providing the best possible medical care to residents in their environment, avoiding dehumanization and loneliness of hospital admission, and reducing the saturation of hospitals and the risk of spreading the infection. The main outcomes were a composite endpoint of survival or optimal palliative care (SOPC), survival, and referral to the hospital. Results: 587 of 1199 (49%) residents were infected, of whom 123 (21%) died. Patients diagnosed before the start of the MP presented SOPC, survival, and referrals to the hospital of 83%, 74%, and 22.4%, opposite to 96%, 84%, and 10.6% of patients diagnosed while the MP was set up. The SOPC was independently associated with an MP (OR 3.4 [1.6–7.2]). Conclusion: During the COVID-19 outbreak, a coordinated MP successfully obtained a better rate of SOPC while simultaneously reducing the need for hospital admissions, combining optimal medical management with a more compassionate and humanistic approach in older people.

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Section: Data Collection and Variablesmentioning

confidence: 99%

Survival Impact of an On-Site Medicalization Program in the Control of COVID-19 Outbreaks in 11 Nursing Homes

Baron-Franco,

Ollero-Baturone,

Ternero-Vega

et al. 2023

JCM

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show abstract

“…7 These combined risk factors, as well as failure to adequately prepare LTCFs in the early days of the pandemic, 8 led to high case fatality ratios, estimated between 14% and 53%, [9][10][11][12][13][14][15][16][17][18][19] and swift disease progression (average time to death of 10 days). 10,20 In Quebec, Canada's second-largest province (8.6 million inhabitants), the long-term care facility population accounted for 16% of all COVID-19 infections and nearly 70% of COVID-19 deaths, by the end of the first wave on July 11, 2020. 21 Of 453 LTCFs in the province, 178 had at least one case and the average case fatality ratio was 40%.…”

Section: Introductionmentioning

confidence: 99%

“…Institutional and environmental factors specific to LTCFs also contribute to COVID‐19 vulnerability, including: high occupancy density, shared living spaces, residents with cognitive and behavioral problems, lack of human and material resources, and outdated infrastructure 7 . These combined risk factors, as well as failure to adequately prepare LTCFs in the early days of the pandemic, 8 led to high case fatality ratios, estimated between 14% and 53%, 9–19 and swift disease progression (average time to death of 10 days) 10,20 …”

Section: Introductionmentioning

confidence: 99%

Institutional, therapeutic, and individual factors associated with 30‐day mortality after COVID‐19 diagnosis in Canadian long‐term care facilities

Zhang

Charland²,

Quach

et al. 2022

J American Geriatrics Society

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Background Canadian long‐term care facility (LTCF) residents experienced higher death rates compared to other countries during the first wave of the COVID‐19 pandemic. This cohort study analyzes the individual, therapeutic, and institutional factors associated with death in LTCFs. Methods Institutional data for 17 LTCFs in Montreal, Canada were obtained from local administrative registries. Individual data for 1197 residents infected by SARS‐CoV‐2 between February 23 and July 11, 2020 were obtained through chart reviews. A multivariable modified Poisson regression model, which accounted for LTCF clustering, was used to identify resident and facility covariates associated with 30‐day mortality after COVID‐19 diagnosis. Results Severe shortage of licensed practical nurses (RR 2.60 95% CI 1.20–5.61) and medium‐sized facilities compared to smaller‐sized facilities (RR 2.73 95% CI 1.23–6.07) were associated with 30‐day mortality. Later COVID‐19 diagnosis (RR 0.98 95% CI 0.97–0.99 per additional day) was associated with survival. Individual risk factors for death included age (RR 1.33 95% CI 1.23–1.45 per additional 10 years), male sex (RR 1.46 95% CI 1.24–1.71), functional impairment (RR 1.08 95% CI 1.04–1.12 per unit increase of SMAF), as well as a diagnosis of congestive heart failure (RR 1.31 95% CI 1.04–1.66) and neurocognitive disorder (RR 1.31 95% CI 1.01–1.70). Among severe cases, anticoagulation was associated with survival (RR 0.70 95% CI 0.51–0.96). Conclusions This study identified practical nurse shortages and facility size as institutional risk factors for COVID‐19 death. Anticoagulation was associated with survival among severe cases.

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“…First, age over 65 [ 5 , 6 ], underlying medical conditions, and increased vulnerability all are both common in long-term care and are linked to COVID-19 morbidity and mortality [ 1 ]. Second, large proportions of COVID-19-infected long-term care residents show atypical symptoms [ 7 , 8 ] or remain asymptomatic [ 9 , 10 ]. This complicates diagnosis and thus transmission prevention [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Distancing Measures and Challenges Discussed by COVID-19 Outbreak Teams of Dutch Nursing Homes: The COVID-19 MINUTES Study

Tol

Smaling

Meester

et al. 2022

IJERPH

Self Cite

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The most severe COVID-19 infections and highest mortality rates are seen among long-term care residents. To reduce the risk of infection, physical distancing is important. This study investigates what physical distancing measures were discussed by COVID-19 outbreak teams of Dutch long-term care organizations and what challenges they encountered. The COVID-19 MINUTES study is a qualitative multi-center study (n = 41) that collected minutes of COVID-19 outbreak teams from March 2020 to October 2021. Textual units about distancing measures were selected and analyzed using manifest content analysis for the first wave: early March–early May 2020; the intermediate period of 2020: mid-May–mid-September 2020; and the second wave: late September 2020–mid-June 2021. During all periods, COVID-19 outbreak teams often discussed distancing visitors from residents. Moreover, during the first wave they often discussed isolation measures, during the intermediate period they often discussed distancing staff and volunteers from residents, and during both the intermediate period and the second wave they often discussed distancing among residents. During all periods, less often admission measures were discussed. Challenges persisted and included unrest among and conflicts between visitors and staff, visitors violating measures, resident non-adherence to measures, and staffing issues. The discussed distancing measures and corresponding challenges may guide local long-term care and (inter)national policymakers during the further course of the COVID-19 pandemic, outbreaks of other infectious diseases, and long-term care innovations.

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How Typical is the Spectrum of COVID-19 in Nursing Home Residents?

Cited by 5 publications

References 6 publications

Survival Impact of an On-Site Medicalization Program in the Control of COVID-19 Outbreaks in 11 Nursing Homes

Survival Impact of an On-Site Medicalization Program in the Control of COVID-19 Outbreaks in 11 Nursing Homes

Institutional, therapeutic, and individual factors associated with 30‐day mortality after COVID‐19 diagnosis in Canadian long‐term care facilities

Distancing Measures and Challenges Discussed by COVID-19 Outbreak Teams of Dutch Nursing Homes: The COVID-19 MINUTES Study

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