Abstract
Introduction: The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality.Results: We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse “activities of daily living (ADL)” scores, such as Barthel index, Tinetti scale and S.OS.I.A. classification.Conclusion: Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation.Design: In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.
Highlights
The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality
Serological evaluation found 8 positive patients among the patients who were negative to the swab, still alive at the end of the observation and who performed the serological evaluation (n. 34), whereas it found 4 negative results among the 40 patients positive to nasopharyngeal swab who were alive at the end of the observation and accepted to perform the test for anti-COVID-19 immunoglobulins
The COVID-19 pandemic had an exponential expansion and a high death toll in the first regions to be hit by the new virus, such as Lombardy, especially in frail subsets of patients as the older residents of nursing homes
Summary
The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality. In symptomatic patients, clinical presentation at illness onset may vary, over the course of the disease, most will experience fever, cough, difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea [4, 6,7,8,9,10,11] It was quite evident from the start of the pandemic that older adults, and those with chronic medical comorbidities such as male subjects, were vulnerable and prone to a more severe outcome of the disease [4, 6,7,8,9,10]
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