scholarly journals Associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 in nursing homes and healthcare workers in Catalonia: prospective cohort study

BMJ ◽  
2021 ◽  
pp. n1868
Author(s):  
Carmen Cabezas ◽  
Ermengol Coma ◽  
Nuria Mora-Fernandez ◽  
Xintong Li ◽  
Montse Martinez-Marcos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Nursing Homes ◽  
Hospital Admission ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Nursing Home Residents ◽  
Nursing Home Staff ◽  
Hazard Ratios

Abstract Objective To determine associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 among nursing home residents, nursing home staff, and healthcare workers. Design Prospective cohort study. Setting Nursing homes and linked electronic medical record, test, and mortality data in Catalonia on 27 December 2020. Participants 28 456 nursing home residents, 26 170 nursing home staff, and 61 791 healthcare workers. Main outcome measures Participants were followed until the earliest outcome (confirmed SARS-CoV-2 infection, hospital admission or death with covid-19) or 26 May 2021. Vaccination status was introduced as a time varying exposure, with a 14 day run-in after the first dose. Mixed effects Cox models were fitted to estimate hazard ratios with index month as a fixed effect and adjusted for confounders including sociodemographics, comorbidity, and previous medicine use. Results Among the nursing home residents, SARS-CoV-2 infection was found in 2482, 411 were admitted to hospital with covid-19, and 450 died with covid-19 during the study period. In parallel, 1828 nursing home staff and 2968 healthcare workers were found to have SARS-CoV-2 infection, but fewer than five were admitted or died with covid-19. The adjusted hazard ratio for SARS-CoV-2 infection after two doses of vaccine was 0.09 (95% confidence interval 0.08 to 0.11) for nursing home residents, 0.20 (0.17 to 0.24) for nursing home staff, and 0.13 (0.11 to 0.16) for healthcare workers. Adjusted hazard ratios for hospital admission and mortality after two doses of vaccine were 0.05 (0.04 to 0.07) and 0.03 (0.02 to 0.04), respectively, for nursing home residents. Nursing home staff and healthcare workers recorded insufficient events for mortality analysis. Conclusions Vaccination was associated with 80-91% reduction in SARS-CoV-2 infection in all three cohorts and greater reductions in hospital admissions and mortality among nursing home residents for up to five months. More data are needed on longer term effects of covid-19 vaccines.

scholarly journals Cancer events in Belgian nursing home residents (NHR): An EORTC prospective cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13066-e13066
Author(s):  
Hans Wildiers ◽  
Monique Elseviers ◽  
Murielle E. Mauer ◽  
Jonas de Wolf ◽  
Edith Bastiaens ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Skin Cancer ◽  
Nursing Homes ◽  
Head And Neck ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Nursing Home Residents ◽  
Clinical Suspicion ◽  
Local Staff

e13066 Background: A large prospective cohort study was designed to describe cancer events, referral patterns, anticancer treatments and outcome in NHR. Methods: The study was set up in 39 nursing homes from the Armonea network in Belgium, covering 4262 nursing home beds. Cancer events were defined as a new cancer event (new cancer or progressive disease of a previously known cancer) where a diagnostic/treatment decision had to be taken; and patients with strong clinical suspicion (physician’s judgement) of a new cancer event, but where the decision was made not to take further diagnostic/therapeutic steps. Cancer events in NHR were collected during a 1y-period in these 39 nursing homes. After training, each site’s local staff identified patients with cancer events in collaboration with the treating general practitioner (GP). NHR were included after informed consent, and relevant data, including a questionnaire for the GP at baseline, were recorded at least every 3 months up to 2 years. Results: The study was open from 3-2015 till 3-2016 in 37 nursing homes (and 2 pilot nursing homes started and stopped 6 months earlier). In only 9 NHR (median age 87y, range 72-92), cancer events were recorded during this period (incidence rate = 222/100,000 NHR per year). The 9 tumor cases were: one strong clinical suspicion of new prostate cancer, and one undefined cancer; a strong clinical suspicion of breast cancer progression; 3 newly diagnosed cancers (angiosarcoma of the breast, head and neck plus gingiva cancer, and one undefined) ; 3 cases with diagnosed progression of a previously known tumor (skin cancer, head and neck cancer plus skin cancer, bladder cancer). During follow-up, 6/9 NHR died, with a median overall survival of 5 Mo (range 2-16 Mo). Further details on diagnostic/therapeutic approach and outcome are pending. Conclusions: This study evaluated for the first time cancer events prospectively in a large nursing home population. Clinically relevant cancer events occur at a much lower frequency in NHR than expected from cancer incidence data in the general older population, supporting several previous retrospective observations that cancer events are much less frequent and problematic in very frail older persons than previously expected. Clinical trial information: NCT01910376.

Double-swab 5% versus single-swab 10% iodophor for reducing methicillin-resistant Staphylococcus aureus with routine chlorhexidine bathing

2021 ◽  
pp. 1-3
Author(s):  
Lauren T. Heim ◽  
Loren G. Miller ◽  
Raveena D. Singh ◽  
James A. McKinnell ◽  
Tabitha D. Catuna ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Nursing Home ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Nursing Home Residents ◽  
Nasal Carriage ◽  
Methicillin Resistant ◽  
Chlorhexidine Bathing

Abstract In a prospective cohort study, we compared a 2-swabs-per-nostril 5% iodophor regimen with a 1-swab-per-nostril 10% iodophor regimen on methicillin-resistant Staphylococcus aureus carriage in nursing-home residents. Compared with baseline, both single-swab and double-swab regimens resulted in an identical 40% reduction in nasal carriage and 60% reduction in any carriage, skin or nasal.

scholarly journals Cancer events in Belgian nursing home residents: An EORTC prospective cohort study

2019 ◽  
Vol 10 (5) ◽  
pp. 805-810 ◽  
Author(s):  
Hans Wildiers ◽  
Murielle Mauer ◽  
Monique Elseviers ◽  
Jonas De Wolf ◽  
Sigrid Hatse ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Nursing Home Residents

scholarly journals Initiation of advance care planning in newly admitted nursing home residents in Flanders, Belgium: A prospective cohort study

2018 ◽  
Vol 19 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Kristel Paque ◽  
Ivana Ivanova ◽  
Monique Elseviers ◽  
Robert Vander Stichele ◽  
Tinne Dilles ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Prospective Cohort Study ◽  
Advance Care Planning ◽  
Prospective Cohort ◽  
Nursing Home Residents ◽  
Care Planning ◽  
Advance Care

scholarly journals Inhospital Mortality in Patients with Type 2 Diabetes Mellitus: A Prospective Cohort Study in Lima, Peru

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Henry Zelada ◽  
Antonio Bernabe-Ortiz ◽  
Helard Manrique
Keyword(s):  
Renal Failure ◽  
Cohort Study ◽  
Hospital Admission ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Respiratory Infections ◽  
Inhospital Mortality ◽  
Risk Of Death ◽  
Hazard Ratios

Objective. To estimate cause of death and to identify factors associated with risk of inhospital mortality among patients with T2D.Methods. Prospective cohort study performed in a referral public hospital in Lima, Peru. The outcome was time until event, elapsed from hospital admission to discharge or death, and the exposure was the cause of hospital admission. Cox regression was used to evaluate associations of interest reporting Hazard Ratios (HR) and 95% confidence intervals.Results. 499 patients were enrolled. Main causes of death were exacerbation of chronic renal failure (38.1%), respiratory infections (35.7%), and stroke (16.7%). During hospital stay, 42 (8.4%) patients died. In multivariable models, respiratory infections (HR = 6.55,p<0.001), stroke (HR = 7.05,p=0.003), and acute renal failure (HR = 16.9,p=0.001) increased the risk of death. In addition, having 2+ (HR = 7.75,p<0.001) and 3+ (HR = 21.1,p<0.001) conditions increased the risk of dying.Conclusion. Respiratory infections, stroke, and acute renal disease increased the risk of inhospital mortality among hospitalized patients with T2D. Infections are not the only cause of inhospital mortality. Certain causes of hospitalization require standardized and aggressive management to decrease mortality.

scholarly journals Predictive value of the neutrophil to lymphocyte ratio for disease deterioration and serious adverse outcomes in patients with COVID-19: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhi-Yong Zeng ◽  
Shao-Dan Feng ◽  
Gong-Ping Chen ◽  
Jiang-Nan Wu
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Adverse Outcomes ◽  
Neutrophil To Lymphocyte Ratio ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Background Early identification of patients who are at high risk of poor clinical outcomes is of great importance in saving the lives of patients with novel coronavirus disease 2019 (COVID-19) in the context of limited medical resources. Objective To evaluate the value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for the prediction of the subsequent presence of disease progression and serious clinical outcomes (e.g., shock, death). Methods We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020, in Yichang City, Hubei Province. Patients with an NLR equal to or higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposed group. The primary outcome was disease deterioration, defined as an increase of the clinical disease severity classification during hospitalization (e.g., moderate to severe/critical; severe to critical). The secondary outcomes were shock and death during the treatment. Results During the follow-up period, 51 (14.5%) patients’ conditions deteriorated, 15 patients (4.3%) had complicated septic shock, and 15 patients (4.3%) died. The NLR was higher in patients with deterioration than in those without deterioration (median: 5.33 vs. 2.14, P < 0.001), and higher in patients with serious clinical outcomes than in those without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P < 0.001; death vs. survival: 7.19 vs. 2.25, P < 0.001). The NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of an NLR ≥ 2.6937 for predicting subsequent disease deterioration, shock and death was 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100), and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively. Conclusions The NLR measured at admission and in isolation can be used to effectively predict the subsequent presence of disease deterioration and serious clinical outcomes in patients with COVID-19.

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