scholarly journals Clinical Suspicion of COVID-19 in Nursing Home residents: symptoms and mortality risk factors

2020 ◽  
Author(s):  
Jeanine J.S. Rutten ◽  
Anouk M. van Loon ◽  
Janine van Kooten ◽  
Laura W. van Buul ◽  
Karlijn J. Joling ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Rt Pcr ◽  
Atypical Symptoms ◽  
Low Threshold ◽  
Polymerase Chain ◽  
Reduced Kidney Function ◽  
Essential Prerequisite ◽  
Pcr Test

AbstractObjectivesTo describe symptomatology, mortality and risk factors for mortality in a large group of Dutch nursing home (NH) residents with clinically-suspected COVID-19 who were tested with a Reverse Transcription Polymerase Chain Reaction (RT-PCR) test.DesignProspective cohort study.Setting and participantsResidents of Dutch NHs with clinically-suspected COVID-19 and who received RT-PCR test.MethodsWe collected data of NH residents with clinically-suspected COVID-19, via electronic health records between March 18th and May 13th, 2020. Registration was performed on diagnostic status (confirmed (COVID-19+)/ruled out (COVID-19-)) and symptomatology (typical and atypical symptoms). Information on mortality and risk factors for mortality were extracted from usual care data.ResultsIn our sample of residents with clinically-suspected COVID-19 (N=4007), COVID-19 was confirmed in 1538 residents (38%). Although, symptomatology overlapped between residents with COVID-19+ and COVID-19-, those with COVID-19+ were three times more likely to die within 30 days (hazard ratio (HR), 3·1; 95% CI, 2·7 to 3·6). Within this group, mortality was higher for men than for women (HR, 1·8; 95%, 1·5-2·2) and we observed a higher mortality for residents with dementia, reduced kidney function, and Parkinson’s Disease, even when corrected for age, gender, and comorbidities.Conclusions and implicationsAbout 40% of the residents with clinically-suspected COVID-19 actually had COVID-19, based on the RT-PCR test. Despite an overlap in symptomatology, mortality rate was three times higher for residents with COVID-19+. This emphasizes the importance of using low-threshold testing in NH residents which is an essential prerequisite to using limited personal protective equipment and isolation measures efficiently.

scholarly journals Antibody response after one and two doses of the BNT162b2 vaccine in nursing home residents: The CONsort-19 study

2021 ◽  
Author(s):  
Jean Bousquet ◽  
Hubert Blain ◽  
Edouard Tuaillon ◽  
Lucie Gamon ◽  
Amandine Pisoni ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Nursing Home ◽  
Antibody Response ◽  
Nursing Home Residents ◽  
Rt Pcr ◽  
Chain Reaction ◽  
S Protein ◽  
N Protein ◽  
Polymerase Chain ◽  
Low Levels

Methods: Twenty-two French nursing homes were included. COVID-19 had been diagnosed with real-time reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2. Blood S-protein IgG and nucleocapsid (N) IgG protein (N-protein IgG) were measured 21-24 days after the first jab (1,004 residents) and 6 weeks after the second (820 residents). Results: Among the 735 residents without prior COVID-19, 41.7% remained seronegative for S-protein IgG after the first jab vs 2.1% of the 270 residents with a previous positive RT-PCR (p<0.001). After the second jab, only 3% of the 586 residents without prior COVID-19 remained seronegative. However, 26.5% of them had low S-protein IgG levels (50-1050 UA/mL) vs 6.4% of the 222 residents with prior COVID-19. Residents with old infection (first wave), or seropositive for N-protein IgG at the time of vaccination, had the highest S-protein IgG levels. Residents with a prior COVID-19 infection had higher S-protein IgG levels after one dose than those without two jabs. Interpretation: A single vaccine jab is sufficient to reach immunity in residents with prior COVID-19. Most residents without prior COVID-19 are seropositive for S-protein IgG after the second jab, but around 30% have low levels of S-protein IgG. Whether residents with no or low post-vaccine immunity are at higher risk of symptomatic COVID-19 requires further analysis.

scholarly journals Delayed pulmonary embolism after COVID-19 pneumonia: a case report

2020 ◽  
Author(s):  
Mohamad Kanso ◽  
Thomas Cardi ◽  
Halim Marzak ◽  
Alexandre Schatz ◽  
Loïc Faucher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Index Hospitalization ◽  
Rt Pcr ◽  
Moderate Severity ◽  
Respiratory Status ◽  
Case Summary ◽  
Pcr Test

Abstract Background  Since the onset of the COVID-19 pandemic, several cardiovascular manifestations have been described. Among them, venous thromboembolism (VTE) seems to be one of the most frequent, particularly in intensive care unit patients. We report two cases of COVID-19 patients developing acute pulmonary embolism (PE) after discharge from a first hospitalization for pneumonia of moderate severity. Case summary  Two patients with positive RT-PCR test were initially hospitalized for non-severe COVID-19. Both received standard thromboprophylaxis during the index hospitalization and had no strong predisposing risk factors for VTE. Few days after discharge, they were both readmitted for worsening dyspnoea due to PE. One patient was positive for lupus anticoagulant. Discussion  Worsening respiratory status in COVID-19 patients must encourage physicians to search for PE since SARS-CoV-2 infection may act as a precipitant risk factor for VTE. Patients may thus require more aggressive and longer thromboprophylaxis after COVID-19 related hospitalization.

scholarly journals Advanced cognitive impairment among older nursing home residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadeja Gracner ◽  
Patricia W. Stone ◽  
Mansi Agarwal ◽  
Mark Sorbero ◽  
Susan L Mitchell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Mortality Risk ◽  
Advanced Disease ◽  
Nursing Home Residents ◽  
Functional Score ◽  
Data Set

Abstract Background Though work has been done studying nursing home (NH) residents with either advanced Alzheimer’s disease (AD) or Alzheimer’s disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD. Methods This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011–2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions. Results Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p < 0.01). However, stroke and difficulty with transfer (for women) were significant mortality risk factors only for those with advanced AD. Urinary tract infection, and hypertension (for women) only were mortality risk factors for those with advanced ADRD. Median survival was significantly shorter for the advanced ADRD group (194 days) compared to the advanced AD group (300 days). Conclusions There were distinct mortality and survival patterns of NH residents with advanced AD and ADRD. This may help with care planning decisions regarding therapeutic and palliative care.

Death and COVID-19 Anxiety in Home-Quarantined Individuals Aged 65 and Over During the Pandemic

2021 ◽  
pp. 003022282110598
Author(s):  
Hümeyra Aslaner ◽  
Betül Özen ◽  
Zeliha K. Erten ◽  
Mebrure Beyza Gökçek
Keyword(s):  
Polymerase Chain Reaction ◽  
Death Anxiety ◽  
Short Form ◽  
Anxiety Score ◽  
Test Results ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Test Result ◽  
Pcr Test

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.

scholarly journals Risk Factors for Adverse Drug Events Among Nursing Home Residents

2001 ◽  
Vol 161 (13) ◽  
pp. 1629 ◽  
Author(s):  
Terry S. Field ◽  
Jerry H. Gurwitz ◽  
Jerry Avorn ◽  
Danny McCormick ◽  
Shailavi Jain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Adverse Drug Events ◽  
Nursing Home Residents

scholarly journals The Interplay Between Infection Risk Factors of SARS-CoV-2 and Prognosis: A Cross-Sectional Study from a Cohort of Long-Term Care Nursing Home Residents

2021 ◽  
Author(s):  
Laura Soldevila ◽  
Núria Prat ◽  
Miquel À. Mas ◽  
Mireia Massot ◽  
Ramon Miralles ◽  
...  
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Risk Of Infection ◽  
Cross Sectional ◽  
Term Care ◽  
Facility Size ◽  
Care Nursing ◽  
Pcr Test

Abstract Background: Covid-19 pandemic has particularly affected older people living in Long-term Care settings. Methods: We carried out a cross-sectional analysis of a cohort of Long-term care nursing home residents between March first and June thirty, 2020, who were ≥ 65 years old and on whom at last one PCR test was performed. Socio-demographic, comorbidities, and clinical data were recorded. Facility size and community incidence of SARS-CoV-2 were also considered.Results: A total of 8021 participants were included from 168 facilities. Mean age was 86.4 years (SD = 7.4). Women represented 74.1%. SARS-CoV-2 infection was detected in 27.7% of participants, and the overall case fatality rate was 11.3% (24.9% among those with a positive PCR test). Epidemiological factors related to risk of infection were larger facility size (pooled aOR 1.73; P < .001), higher community incidence (pooled aOR 1.67, P = .04), leading to a higher risk than the clinical factor of low level of functional dependence (aOR 1.22, P = 0.03). Epidemiological risk factors associated with mortality were male gender (aOR 1.75; P < .001), age (pooled aOR 1.16; P < .001), and higher community incidence (pooled aOR 1.19, P = < .001). There was evidence of clustering for facility and health area when considering the risk of infection and mortality (P < .001). Conclusions: Our results suggest a complex interplay between structural and individual factors regarding Covid-19 infection and its impact on mortality in nursing-home residents.

Health and Care Related Risk Factors for Suicide Among Nursing Home Residents: A Data Linkage Study

2018 ◽  
Vol 49 (3) ◽  
pp. 695-706 ◽  
Author(s):  
Briony Murphy ◽  
Briohny Kennedy ◽  
Catherine Martin ◽  
Lyndal Bugeja ◽  
Melissa Willoughby ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Data Linkage ◽  
Nursing Home Residents ◽  
Linkage Study ◽  
Related Risk ◽  
Risk Factors For Suicide

scholarly journals Descriptive epidemiology of coronavirus disease 2019 in Nigeria, 27 February–6 June 2020

2020 ◽  
Vol 148 ◽  
Author(s):  
K. O. Elimian ◽  
C. L. Ochu ◽  
E. Ilori ◽  
J. Oladejo ◽  
E. Igumbor ◽  
...  
Keyword(s):  
Health Planning ◽  
Case Fatality ◽  
National Surveillance ◽  
Descriptive Epidemiology ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Response Strategies ◽  
Polymerase Chain ◽  
Insight Into ◽  
Pcr Test

Abstract The objective of this study was to describe the epidemiology of COVID-19 in Nigeria with a view of generating evidence to enhance planning and response strategies. A national surveillance dataset between 27 February and 6 June 2020 was retrospectively analysed, with confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR). The primary outcomes were cumulative incidence (CI) and case fatality (CF). A total of 40 926 persons (67% of total 60 839) had complete records of RT-PCR test across 35 states and the Federal Capital Territory, 12 289 (30.0%) of whom were confirmed COVID-19 cases. Of those confirmed cases, 3467 (28.2%) had complete records of clinical outcome (alive or dead), 342 (9.9%) of which died. The overall CI and CF were 5.6 per 100 000 population and 2.8%, respectively. The highest proportion of COVID-19 cases and deaths were recorded in persons aged 31–40 years (25.5%) and 61–70 years (26.6%), respectively; and males accounted for a higher proportion of confirmed cases (65.8%) and deaths (79.0%). Sixty-six per cent of confirmed COVID-19 cases were asymptomatic at diagnosis. In conclusion, this paper has provided an insight into the early epidemiology of COVID-19 in Nigeria, which could be useful for contextualising public health planning.

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