Objective. Of particular interest is the incidence of COVID-19 in closed groups, in institutions, in particular, in nursing homes, geriatric centers, veterans' homes and neuropsychiatric boarding schools.Methods. Analysis and description of COVID-19 foci in closed long-term care facilities was carried out using literature sources from the MEDLINE medical information database using the PubMed electronic search engine, using the search query CARE HOME OR NURSING HOME OR LONG-TERM CARE FACILITY AND COVID-19 AND OUTBREAK. The share of sick people as a percentage of the total number of residents and individual employees was considered only in those publications that described the outbreak of COVID-19 in a single institution. The absence of data on the number of hospitalizations and deaths, symptoms, and data on the time frame of the outbreak was not an exclusion criterion, but their presence was taken into account in the analysis. We selected mainly publications where people with a positive PCR test for SARS-CoV-2 RNA were considered to be ill with COVID-19. However, it is worth considering that the authors describe outbreaks during the first rise in the incidence of COVID-19 in the world, when there was a shortage of test systems for a new coronavirus infection.Results. An overview of the incidence of COVID-19 in the world in closed long-term care institutions is presented. It has been shown that residents of closed communities are elderly people with many concomitant diseases, in connection with which a severe course of COVID-19 and high mortality are often noted.Conclusion. Convictions about the need to strengthen the quality of anti-epidemic measures in closed long-term care institutions, which are at risk, are summarized.
Relevance. Elderly people have become the fastest growing segment of the global population over the past few decades. The number of people over the working age in Russia, and with them citizens living in closed long-term care facilities (CLTFS), is growing. Residents of these organizations belong to the risk group, and CLTFS have a number of characteristics that turn these institutions into a unique environment for the spread of infectious diseases.Aims. To analyze the CLTFS residents infectious morbidity in the "pre-covid stage" (according to literature sources). A scientific review of research in Russian and English using information portals and platforms has been carried out eLIBRARY. ru , Web of Science, PubMed, Google Academy and Scopus for the period 1981-2022. The search was carried out by keywords. Information about the most frequent infectious diseases affecting residents of closed long-term care institutions was the criterion for inclusion in the sample of publications. Out of 16171 initially identified articles, 61 publications were selected after initial analysis.Conclusions. According to various estimates, the leading infectious diseases in CLTFS were: acute respiratory infections, pneumonia, urinary tract infections, skin and mucous infections, acute intestinal infections. The article describes pathogens and their prevalence in CLTFS including pathogens with multiple drug resistance (MDR), describes the resistance of bacteria to antimicrobial drugs formation problem in these organizations, as well as development of certain diseases risk factors. Studies conducted in various CLTFS in Europe, Russia, the USA, and Asia indicate a high prevalence of infectious diseases among their residents, high colonization of residents with antimicrobial-resistant pathogens, as well as the infection transmission probability from the CLTFS and its spread to other long-term care institutions and medical and preventive organizations.
Background: Residents of long-term care facilities are at higher risk of the severe course and outcomes of COVID-19. Objective: To describe the epidemiological situation and risk factors for severe COVID-19 in nursing homes in the world and Russia. Materials and methods: We reviewed Russian and English-language papers published in March 2020 to October 2022 and found in such resources as eLIBRARY.ru, Web of Science, PubMed, Google Academy, and Scopus using the following keywords: long-term care facilities, nursing homes, COVID-19 morbidity in nursing homes, COVID-19 mortality in nursing homes, and COVID-19 risk factors in nursing homes. Availability of information on morbidity and mortality among residents and employees of long-term care facilities in Russia, Europe and the USA and about the risk factors for severe course and adverse outcomes of COVID-19 was the inclusion criterion. Of 1,013 articles initially identified, 40 publications were included in the review. Results: The analysis of the worldwide epidemiological situation has shown that COVID-19 incidence and mortality rates in nursing homes fluctuate, and, as of October 2022, cases of the disease among residents, including multiple cases within a facility, were still registered. In most countries, the highest incidence of COVID-19 in long-term care facilities was observed in January – March 2022, while the lowest was noted in May – July 2021. The number of deaths has decreased significantly over time and remains low. Risk factors for a severe course and death from the novel coronavirus disease include age, male sex, and concomitant diseases. We established, however, that disease severity was also affected by the staff-to-resident ratio, availability of paid sick leave of the personnel, patient isolation opportunities, division of the working area, type of ownership (private), and COVID-19 incidence rates in the local community. Conclusion: We have analyzed the epidemiological situation and risk factors for severe COVID-19 in long-term care facilities at the national and global levels. As of October 2022, the novel coronavirus disease remains a challenge for nursing facilities. The severity of the infection is influenced by personal characteristics of patients and external factors related to the residential care facility.
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