scholarly journals COVID Seroprevalence, Symptoms and Mortality During the First Wave of SARS-CoV-2 in Canada

Author(s):  
◽  
Prabhat Jha

Background: Efforts to stem the SARS-CoV-2 pandemic in Canada can benefit from direct understanding of the prevalence, infection fatality rates (IFRs), and information on asymptomatic infection. Methods: We surveyed a representative sample of 19,994 adult Canadians about COVID symptoms and analyzed IgG antibodies against SARS-CoV-2 from self-collected dried blood spots (DBS) in 8,967 adults. A sensitive and specific chemiluminescence ELISA detected IgG to the spike trimer. We compared seroprevalence to deaths to establish IFRs and used mortality data to estimate infection levels in nursing home residents. Results: The best estimate (high specificity) of adult seroprevalence nationally is 1.7%, but as high as 3.5% (high sensitivity) depending on assay cut-offs. The highest prevalence was in Ontario (2.4-3.9%) and in younger adults aged 18-39 years (2.5-4.4%). Based on mortality, we estimated 13-17% of nursing home residents became infected. The first viral wave infected 0.54-1.08 million adult Canadians, half of whom were <40 years old. The IFR outside nursing homes was 0.20-0.40%, but the COVID mortality rate in nursing home residents was >70 times higher than that in comparably-aged adults living in the community. Seropositivity correlated with COVID symptoms, particularly during March. Asymptomatic adults constituted about a quarter of definite seropositives, with a greater proportion in the elderly. Interpretation: Canada had relatively low infection prevalence and low IFRs in the community, but not in nursing homes, during the first viral wave. Self-collected DBS for antibody testing is a practicable strategy to monitor the ongoing second viral wave and, eventually, vaccine-induced immunity among Canadian adults.

2022 ◽  
Vol 8 (1) ◽  
pp. 51-66
Author(s):  
Vesna Žegarac Leskovar ◽  
Vanja Skalicky Klemenčič

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.


Author(s):  
F. BUNTINX ◽  
I. ASNONG ◽  
M. GULIKERS ◽  
G. VAES ◽  
H. DEWITTE ◽  
...  

Uptake and results of Covid-19 vaccination during a pandemic in nursing home residents and staff This study involves the participation of residents and staff of 2 Flemish nursing homes in the Covid-19 vaccination program, as well as the subsequent presence and titres of Covid-19 antibodies. With 1 exception, all 259 residents and 94% of the eligible staff members (n = 237) were vaccinated, 16 young female staff members were vaccinated with some delay because of pregnancy and fertility related fears. Post-vaccination SARS-CoV-2 antibody testing was performed in 214 (83%) residents and 201 (85%) staff members. Of these, respectively 98% and 100% had SARS-CoV-2 antibodies. A clear negative association was found between antibody titres and age. Within these nursing homes (and a number of surrounding nursing homes) the vaccination campaign was successful as well as effective.


2021 ◽  
Vol 12 (2) ◽  
pp. 632-639
Author(s):  
Lyly Nazemi ◽  
Ingmar Skoog ◽  
Ingvar Karlsson ◽  
Margda Waern ◽  
Agneta Yngve ◽  
...  

Background: Very few studies have shown the possible relationship between magnesium (Mg) status and depression. In the present study, the intracellular Mg status of the elderly population living in nursing homes (NHs) was assessed to determine its relationship with depression. Methods: A descriptive-analytical study was conducted on the elderly population living in nursing homes (Tehran-Iran; 2010-2012). Participants' demographic and clinical characteristics were collected and recorded in a checklist. Evaluating the participants’ nutritional status, Mini Nutritional Assessment Method was implemented. Determining participant's depressive symptoms, 15-item Geriatric Depression Scale was used. Final scores were classified into4 categories not depressed, mild, moderate, and severe depression. Mg level in leukocytes was also measured by flame atomic absorption spectrometry. Results: Totally 113 elderly were included and only 9.8% of subjects were not depressed. About 21% of the subjects were well nourished. Of participants who suffered from heart disease, 80.2% were depressed (p=0.03). Regarding correlations between Mg status and depression, results showed no significant difference in Mg levels of two depressed and non-depressed participants (p=0.73). Conclusion: The results of the present study showed notable prevalence rates of depression and malnutrition among nursing home residents. It was also found that the relationship between intracellular Mg levels and depression was not significant. Further studies are needed to determine the major factors related to these preventable psychological and nutritional disorders among elderly NH residents.


2020 ◽  
pp. 1420326X2096772
Author(s):  
Emine Tarakci Eren ◽  
Tuğba Düzenli ◽  
Mustafa Var

The present study presents a three-step methodology to determine the environmental satisfaction levels of the elderly individuals in nursing home gardens. The first step comprised the selection of seven nursing homes in five provinces in the Eastern Black Sea region in Turkey. In the second step, 130 participants were selected among the residents of these seven nursing homes via random sampling. In the third step, the satisfaction level of the nursing home residents with the institution gardens was determined. A correlation analysis showed a positive relationship between the environmental and individual characteristics ( r =  0.554; p < 0.01). Simple regression analysis was conducted to determine the effect of environmental characteristics on the satisfaction of individual needs, after determining the direction and level of the relationship between the environmental and the individual characteristics via correlation analysis. The analysis indicated a significant relationship between the environmental and individual characteristics ( R = 0.610; R2 = 0.373; F = 75.991; p <0.001). In conclusion, increased level of satisfaction with the existing physical characteristics of the gardens resulted in an increased level in meeting the psychosocial needs of the elderly individuals, thus, the environmental satisfaction level of nursing home residents increased as well.


Neurology ◽  
2003 ◽  
Vol 60 (4) ◽  
pp. 555-559 ◽  
Author(s):  
A. Birnbaum ◽  
N. A. Hardie ◽  
I. E. Leppik ◽  
J. M. Conway ◽  
S. E. Bowers ◽  
...  

Background: Approximately 6% of all elderly nursing home residents receive phenytoin. Phenytoin concentrations are often measured to guide therapy.Objective: To evaluate the intraresident variability among multiple measurements of total phenytoin serum concentrations in nursing home residents.Methods: This was an observational study of 56 elderly (≥65 years) nursing home residents from 32 nursing homes who had at least 3 phenytoin concentrations measured while on the same dose of phenytoin for at least 4 weeks and who were not taking any interfering concomitant medications. These were a subset of 387 elderly nursing home residents from 112 nursing homes across the United States who had total phenytoin concentration measurements between June 1998 and December 2000.Results: The mean age was 80.1 years (range, 65 to 100 years) and 58.9% were women. The mean daily dose of phenytoin per resident was 4.9 ± 1.5 mg/kg. Total phenytoin concentrations within an elderly nursing home resident varied as much as two- to threefold, even though there was no change in dose. The person with the smallest variability had a minimum concentration of 10.0 μg/mL and a maximum of 10.4 μg/mL. The person with the largest variability had a minimum concentration of 9.7 μg/mL and a maximum of 28.8 μg/mL.Conclusions: There is considerable variability in the total phenytoin concentrations in the elderly nursing home resident and measurement of a single total phenytoin concentration should not be used to guide treatment.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Maria E. Goossens ◽  
Kristof Y. Neven ◽  
Pieter Pannus ◽  
Cyril Barbezange ◽  
Isabelle Thomas ◽  
...  

Abstract Background The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented itself as one of the most important health concerns of the 2020’s, and hit the geriatric population the hardest. The presence of co-morbidities and immune ageing in the elderly lead to an increased susceptibility to COVID-19, as is the case for other influenza-like illnesses (ILI) or acute respiratory tract infections (ARI). However, little is known, about the impact of a previous or current infection on the other in terms of susceptibility, immune response, and clinical course. The aim of the “Prior Infection with SARS-COV-2” (PICOV) study is to compare the time to occurrence of an ILI or ARI between participants with a confirmed past SARS-CoV-2 infection (previously infected) and those without a confirmed past infection (naïve) in residents and staff members of nursing homes. This paper describes the study design and population characteristics at baseline. Methods In 26 Belgian nursing homes, all eligible residents and staff members were invited to participate, resulting in 1,226 participants. They were classified as naïve or previously infected based on the presence of detectable SARS-CoV-2 antibodies and/or a positive RT-qPCR result before participation in the study. Symptoms from a prior SARS-CoV-2 infection between March and August 2020 were compared between previously infected residents and staff members. Results Infection naïve nursing home residents reported fewer symptoms than previously infected residents: on average 1.9 and 3.1 symptoms, respectively (p = 0.016). The same effect was observed for infection naïve staff members and previously infected staff members (3.1 and 6.1 symptoms, respectively; p <0.0001). Moreover, the antibody development after a SARS-CoV-2 infection differs between residents and staff members, as previously infected residents tend to have a higher rate of asymptomatic cases compared to previously infected staff members (20.5% compared to 12.4%; p <0.0001). Conclusions We can postulate that COVID-19 disease development and symptomatology are different between a geriatric and younger population. Therefore, the occurrence and severity of a future ILI and/or ARI might vary from resident to staff.


2006 ◽  
Vol 12 (3) ◽  
pp. 104 ◽  
Author(s):  
Stella Koritsas ◽  
Sandra Davidson ◽  
David Clarke ◽  
Daniel O'Connor

Depression is more common in elderly people residing in nursing homes than it is in people of the same age residing in the community. In Australia, general practitioners (GPs) are the primary providers of medical services to the elderly in nursing homes; however, they often under-diagnose and/or inadequately treat depression in this population. The difficulties experienced by GPs are confounded by the breakdown in the continuity of care that is evident when a patient is admitted into a nursing home, by inadequate communication between GPs and nursing home staff, and systems within the nursing home that are not conducive to general practice. This paper discusses the challenges GPs face in diagnosing and treating depression in nursing home residents, and provides suggestions for strategies that may overcome these challenges.


2019 ◽  
Vol 18 (4) ◽  
pp. 220-227
Author(s):  
Dorota Trybusińska ◽  
Agnieszka Saracen

AbstractIntroduction. Ageing of societies is a process apparent in nearly all countries worldwide. Many families will not be able to provide care services for the elderly, the burden of care will fall mainly on public and private institutions. This puts employees of nursing homes in front of numerous challenges in order to provide seniors with improvement of their life satisfaction.Aim. The purpose of the study was to assess the life satisfaction of elderly nursing home residents in the Mazovian region and to demonstrate variables that affect it.Material and methods.. The research was carried out in 2018 among the 250 elderly nursing home residents from Mazovia. During the test, a diagnostic survey method and a questionnaire technique were used. The research tool was the Satisfaction With Life Scale (SWLS), Katz’s Activities of Daily Living Scale, Hodgkinson’s Abbreviated Mental Test Score, Basic Hope Inventory (BHI-12), Acceptance of Illness Scale (AIS), and the authors’ survey questionnaire.Results. Among the respondents, the dominant group included people with low life satisfaction (42.8%). A statistically significant relationship was found between life satisfaction and the age of the respondents and selected psychometric scales. There was no such correlation for the level of mobility, duration of stay at the nursing home and the size of the inhabited facility.Conclusions. Elderly people living in nursing homes from Mazovia enjoy life satisfaction at a low and average level. The results distinguish three groups of residents exhibiting a lower satisfaction with life, namely, new arrivals, the oldest, and suffering from a minimum of one illness. Nursing home personnel who deal with patients on an everyday basis should aim to improve their life satisfaction.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Andrew Shearn ◽  
Kathleen Unroe, MD, MHA ◽  
Jennifer Carnahan, MD, MPH, MA

Background  The Optimizing Patient Transfers, Impacting Medical Quality, & Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project is a Centers for Medicare and Medicaid (CMS) demonstration project, tasked with reducing potentially avoidable hospitalizations of nursing home residents. OPTIMISTIC-enrolled nursing homes are reimbursed by CMS for treating residents with pneumonia in place. The purpose of this study is to examine the diagnosis, treatment, and outcomes of episodes of pneumonia in OPTIMISTIC nursing homes.  Project Methods  This case series uses data from nursing home medical records of the seven facilities with the highest pneumonia caseload identified from the OPTIMISTIC database. Cases are from billing episodes spanning November 2017 through April 2018. Within each facility, cases of pneumonia were randomly selected for inclusion. Data were entered into an extraction tool designed by the study team.  Results  Data were extracted from 41 records of unique patients. Despite CMS reimbursing for a maximum of 7 days for treatment of pneumonia, 78.0% of patients were monitored beyond that time and with greater attention than usual care. Of all 41 patients treated with antibiotics, 53.7% were given a fluoroquinolone and 24.4% were given amoxicillin/clavulanate.  CURB-65 scores showed 58.3% scored in a range recommending hospitalization. Most patients (87.8%) were stabilized in the nursing home; three (7.3%) were hospitalized, one (2.4%) transferred to hospice, and one (2.4%) died.  Conclusion and Potential Impact  OPTIMISTIC-affiliated nursing facilities successfully provide enhanced care for most patients diagnosed with pneumonia in the facilities. Given the high incidence of fluoroquinolone use, one area for improvement is reduction of this medication contraindicated in the elderly.


2021 ◽  
Author(s):  
Eline Meyers ◽  
Stefan Heytens ◽  
Asangwing Formukong ◽  
Hanne Vercruysse ◽  
An De Sutter ◽  
...  

In the current SARS-CoV-2 pandemic, testing for SARS-CoV-2 specific antibodies is paramount to monitor immune responses in post-authorization vaccination and sero-epidemiology studies. However, large scale and iterative serological testing by venipuncture in older persons can be challenging. Capillary blood sampled using a finger prick and collected on protein saver cards, i.e. dried blood spots (DBS), has already proven to be a promising alternative. However, elderly persons have a reduced cutaneous microvasculature, which may affect DBS-based antibody testing. Therefore, we aimed to evaluate the performance of DBS for the detection of SARS-CoV-2 antibodies in nursing homes residents. We collected venous blood and paired Whatman and EUROIMMUN DBS from nursing home residents, and from staff as a reference population. Venous blood samples were analyzed for the presence of SARS-CoV-2 IgG antibodies using the Abbot chemiluminescent microparticle immunoassay (CMIA). DBS were analyzed by the EUROIMMUN enzyme-linked immuno sorbent assay (ELISA) for SARS-CoV-2 IgG antibodies. We performed a statistical assessment to optimize the ELISA cut-off value for the DBS using the Youden's J index. A total of 273 paired DBS-serum samples were analyzed, of which 129 were positive as assessed by the reference test. The sensitivities and specificities of DBS ranged from 95% to 97.1% and from 97.1% to 98.8%, respectively, depending on population (residents or staff) or DBS card type. These results demonstrate that DBS sampling is a valid alternative to venepuncture for the detection of SARS-CoV-2 antibodies in the elderly.


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