scholarly journals COVID-19 related mortality and spread of disease in long-term care: a living systematic review of emerging evidence

2020 ◽  
Author(s):  
Maximilian Salcher-Konrad ◽  
Arnoupe Jhass ◽  
Huseyin Naci ◽  
Marselia Tan ◽  
Yousef El-Tawil ◽  
...  
Keyword(s):  
Systematic Review ◽  
Long Term Care ◽  
Case Fatality ◽  
Mortality Rates ◽  
Primary Data ◽  
Research Database ◽  
Term Care ◽  
The Impact ◽  
Related Mortality

AbstractBackgroundPolicy responses to mitigate the impact of the COVID-19 pandemic on long-term care (LTC) require robust and timely evidence on mortality and spread of the disease in these settings. The aim of this living systematic review is to synthesise early international evidence on mortality rates and incidence of COVID-19 among people who use and provide LTC.MethodsWe report findings of a living systematic review (CRD42020183557), including studies identified through database searches up to 5 June 2020. We searched seven databases (MEDLINE; Embase; CINAHL Plus; Web of Science; Global Health; WHO COVID-19 Research Database; medRxiv) to identify all studies reporting primary data on COVID-19 related mortality and incidence of disease among LTC users and staff. We excluded studies not focusing on LTC. Included primary studies were critically appraised and results on number of deaths and COVID-19 related mortality rates, case fatality rates, and excess deaths (co-primary outcomes), as well as incidence of disease, hospitalisations, and ICU admissions were synthesised narratively. We further included official figures on number of deaths in LTC.FindingsA total of 33 study reports for 30 unique primary studies or outbreak reports were included. Outbreak investigations in LTC facilities found COVID-19 incidence rates of between 0.0% and 71.7% among residents and between 1.5% and 64.0% among staff. Mortality rates varied from 0.0% to 9.5% of all residents at outbreak facilities, with case fatality rates between 0.0% and 33.7%. In included studies, no LTC staff members had died. LTC residents accounted for between 0% (Hong Kong) and 85% (Canada) of COVID-related deaths, according to official figures.InterpretationLong-term care users have been particularly vulnerable to the COVID-19 pandemic. However, we found wide variation in spread of disease and mortality rates between outbreaks at individual LTC facilities. Further research into the factors determining successful prevention and containment of COVID-19 outbreaks is needed to protect long-term care users and staff.FundingThis work was partially conducted as part of the “Strengthening responses to dementia in developing countries” (STRiDE) project, supported by the UK Research and Innovation’s Global Challenges Research Fund (ES/P010938/1). The funders had no role in the design and execution of this study, interpretation of its results, and decision to submit this work to be published.

Epidemiological and genetic characteristics of norovirus outbreaks in long-term care facilities, 2003–2006

2010 ◽  
Vol 139 (2) ◽  
pp. 286-294 ◽  
Author(s):  
N. A. ROSENTHAL ◽  
L. E. LEE ◽  
B. A. J. VERMEULEN ◽  
K. HEDBERG ◽  
W. E. KEENE ◽  
...  
Keyword(s):  
Long Term Care ◽  
Laboratory Data ◽  
Case Fatality ◽  
Term Care ◽  
Genetic Characteristics ◽  
Duration Of Illness ◽  
Care Facilities ◽  
Polymerase Chain ◽  
The Impact

SUMMARYTo identify the epidemiological and genetic characteristics of norovirus (NoV) outbreaks and estimate the impact of NoV infections in an older population, we analysed epidemiological and laboratory data collected using standardized methods from long-term care facilities (LTCFs) during 2003–2006. Faecal specimens were tested for NoV by real-time reverse transcriptase–polymerase chain reaction. NoV strains were genotyped by sequencing. Of the 234 acute gastroenteritis (AGE) outbreaks reported, 163 (70%) were caused by NoV. The annual attack rate of outbreak-associated NoV infection in LTCF residents was 4%, with a case-hospitalization rate of 3·1% and a case-fatality rate of 0·5%. GII.4 strains accounted for 84% of NoV outbreaks. Median duration of illness was longer for GII.4 infections than non-GII.4 infections (33 vs. 24 h, P<0·001). Emerging GII.4 strains (Hunter/2004, Minerva/2006b, Terneuzen/2006a) gradually replaced the previously dominant strain (Farmington Hills/2002) during 2004–2006. NoV GII.4 strains are now associated with the majority of AGE outbreaks in LTCFs and prolonged illness in Oregon.

scholarly journals The impact of community paramedicine interventions on Transfers from Long Term Care to Emergency Departments: A systematic review

2021 ◽  
Author(s):  
Abraham Munene ◽  
Dominic Alaazi ◽  
Jane Mathew ◽  
Patrick McLane ◽  
Greta Cummings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Departments ◽  
Long Term Care ◽  
Care Needs ◽  
Term Care ◽  
Community Paramedicine ◽  
Review Articles ◽  
System P ◽  
The Impact

OBJECTIVES: Long term care (LTC) facilities are essential in the provision of daily care needs for older adults experiencing frailty. In times of acute medical distress, LTC residents may require transfer to emergency departments (ED). However, many transfers from the LTC to ED may not be required and residents could instead be treated within LTC utilizing community paramedics (CP). We conducted a systematic review to assess the impact of community paramedicine on the frequency of resident transfer from LTC to ED. METHODS: We searched five electronic databases (Medline, CINAHL, PubMed, Embase, and Cochrane). The search was limited to primary peer-reviewed publications and excluded conference proceedings, review articles, and non-peer review articles. We restricted the search to papers published in English and articles published within the last 30 years. RESULTS: A total of 19,308 titles and abstracts were screened with a total of 181 full text reviews. One study that comprised of 4 articles was included in the review that evaluated the impact of community paramedic interventions in LTC. The study noted a reduction in transfers to the ED attributed to the presence of CP, reducing transports to ED by nearly 30%. CONCLUSIONS: There is a scarcity of research examining the role of CP in LTC. While the current research points towards CP interventions in LTC reducing the number of transfers to ED, further research needs to be conducted on the effectiveness of community paramedicine interventions in improving health outcomes for residence and improving cost efficiency within the health system.

scholarly journals Aging, Dependence, and Long-Term Care: A Systematic Review of Employment Creation

2021 ◽  
Vol 58 ◽  
pp. 004695802110624
Author(s):  
Roberto Martinez-Lacoba ◽  
Isabel Pardo-Garcia ◽  
Francisco Escribano-Sotos
Keyword(s):  
Systematic Review ◽  
Long Term Care ◽  
Population Aging ◽  
Job Creation ◽  
Developed Countries ◽  
Economic Benefits ◽  
Migrant Labor ◽  
Term Care ◽  
The Impact

Population aging is an economic and social challenge in most countries in the world as it generates higher dependency rates and increased demand for long-term care. Undertaking the care of older dependent adults can result in new opportunities for job creation. There is limited knowledge of the impact of dependent care and long-term care on employment. We examined this impact through a systematic review. Countries with conditional cash benefits show job creation, and countries with unconditional economic benefits reveal the development of a grey care market with high participation of migrant labor. Migrant employment in developed countries affects the development of the labor market in the countries of origin. The employment created to care for dependent persons is generally precarious. In conclusion, global aging will increase long-term care worker demand, but the variations in policies can determine what kind of employment is created.

scholarly journals A rapid systematic review of measures to protect older people in long term care facilities from COVID-19

2020 ◽  
Author(s):  
Kate Frazer ◽  
Lachlan Mitchell ◽  
Diarmuid Stokes ◽  
Ella Lacey ◽  
Eibhlin Crowley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nursing Homes ◽  
Older People ◽  
Long Term Care ◽  
Morbidity And Mortality ◽  
Term Care ◽  
Symptom Screening ◽  
Care Facilities ◽  
The Impact

AbstractThe global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in long term care facilities to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff, and visitors. Databases (including MedRXiv pre-published repository) were systematically searched to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff, or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities, and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted. The search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2-85.4% in residents and 0.6-62.6% in staff. Mortality rates ranged from 5.3-55.3% in residents. Novel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in long term care facilities.

Sign in / Sign up

Export Citation Format

Share Document