The study provided baseline data of NI in the Veneto Region hospitals. It showed that NI are frequent, and display a wide inter-hospital variability of rates. The highest prevalence has been reported in intensive care units. The unusual high frequency of blood stream infections and the relatively lower prevalence rate of surgical site infections highlighted the limits of prevalence studies.

Aim Coronavirus-19 disease (COVID-19) is a widespread condition in nursing home (NH). It is not known whether COVID-19 is associated with a higher risk of death than residents without COVID-19. Therefore, the aim of this study was to assess whether COVID-19 is associated with a higher mortality rate in NH residents, considering frailty status assessed with the Multidimensional Prognostic Index (MPI). Methods In this retrospective study, made in 31 NHs in Venice, Italy, the presence of COVID-19 was ascertained with a nasopharyngeal swab. Frailty was evaluated using the MPI, modified according to the tools commonly used in our NHs. A Cox’s regression analysis was used reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs), using COVID-19 as exposure and mortality as outcome and stratified by MPI tertiles. Similar analyses were run using MPI tertiles as exposure. Results Overall, 3946 NH residents (median age = 87 years, females: 73.9%) were eligible, with 1136 COVID-19 + . During a median follow-up of 275 days, higher values of MPI, indicating frailer people, were associated with an increased risk of mortality. The incidence of mortality in COVID-19 + was more than doubled than COVID-19- either in MPI-1, MPI-2 and MPI-3 groups. The presence of COVID-19 increased the risk of death (HR = 1.85; 95% CI 1.59–2.15), also in the propensity score model using MPI as confounder (HR = 2.48; 95% CI 2.10–2.93). Conclusion In this retrospective study of NH residents, COVID-19 was associated with a higher risk of all-cause mortality than those not affected by COVID-19 also considering the different grades of frailty.

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Coronavirus disease 2019 (COVID-19) is a widespread condition in nursing homes (NHs). However, no research was made regarding frailty in NH residents during COVID-19 pandemic. The aim of this study was to assess whether frailty, assessed by the multidimensional prognostic index (MPI), can predict mortality/hospitalization in COVID-19 NH residents. A Cox’s regression analysis was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). 1146 NH residents affected by COVID-19 were included (mean age: 86 years; 75.4% females). During the followup period, we observed 286 deaths and 239 hospitalizations. Taking those with MPI <0.41 as reference, an MPI ≥0.50 was associated with a higher risk of death (HR=1.41; 95%CI: 1.07-1.85). Similar results were obtained using the MPI score increase in 0.10 points (HR=1.12; 95%CI: 1.03-1.23). Using hospitalization as outcome, only MPI score as continuous variable was associated with this outcome (HR=1.08; 95%CI: 1.002-1.17). In conclusion, frailty, as assessed by the MPI, was associated with a significant higher risk of mortality and hospitalization in NH residents affected by COVID-19 further indicating the necessity of assessing frailty in NH.

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