COVID-19 in long-term care facilities: An upcoming threat that cannot be ignored

Lai, Chih Cheng; Wang, Jui Hsiang; Ko, Wen Chien; Yen, Muh Yong; Lü, Min; Lee, Chun Ming; Hsueh, Po-Ren

doi:10.1016/j.jmii.2020.04.008

Cited by 85 publications

(72 citation statements)

References 20 publications

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“…Prognosis of LTCF residents suffering from Covid-19: According to an epidemiologic study by McMichael et al, during the outbreak in one LTCF in Washington, USA, 54.5% of residents required hospitalization and required hospital admission and 33.7% of infected residents died [8]. In our study, we identi ed 59 residents with positive swabs for SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 85%

Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a Long-term Care Facility during Covid-19 Outbreak

Sabaka

Koščálová

Straka³

et al. 2020

Preprint

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Background: Covid-19 is a disease with high morbidity and mortality among elderly residents of long-term care facilities (LTCF). During an outbreak of SARS-CoV-2 infection in the LTCF an effective screening tool is essential to identify the patients at risk for severe illness and death. We explored the role of interleukin 6 (IL-6) as a predictor for severe disease during the outbreak of Covid-19 in one LTCF in Slovakia. Methods: We conducted a retrospective data analysis of cases of COVID-19, diagnosed during the outbreak in one LTCF in Slovakia between April 11, 2020, and May 5, 2020. Within 24 hours after the diagnosis of Covid-19, clinical and laboratory screening was performed in the LTCF to identify patients in need of hospitalization. Patients with oxygen saturation below 90% were immediately referred to the hospital. Patients staying in the LFTC were monitored daily and those that developed hypoxemia were transferred to the hospital. We analyzed the association between the IL-6 at the initial assessment and development of hypoxemia during follow up and determined the cut-off of the IL-6 able to predict the development of hypoxemia requiring oxygen therapy. Results : Fifty-three patients (11 men, 42 women) with diagnosed Covid-19 were included in the analysis. 19 (53%) patients developed hypoxemia during the disease. Patients with hypoxemia had significantly higher concentrations of IL-6, C-reactive protein, procalcitonin, fibrinogen, total bilirubin, aspartate aminotransferase and alanine aminotransferase at initial screening. ROC analyses identified IL-6 as the most robust predictor of hypoxemia. The concentration of IL-6 > 24 pg/mL predicted the development of hypoxemia with the sensitivity of 100% and specificity of 88.9%. The positive and negative predictive values were 76.9%, and 100% respectively. Conclusions : The concentration of IL-6 > 24 pg/mL at initial assessment predicted the development of hypoxemia requiring hospitalization with excellent sensitivity and good specificity. IL-6 appears as a potential predictor for the development of the severe Covid-19 and might serve for early identification of patients in need of hospitalization. Further studies are needed to evaluate the robustness of the use of IL-6 as an effective screening tool for the severe course of Covid-19.

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Section: Discussionmentioning

confidence: 85%

Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a Long-term Care Facility during Covid-19 Outbreak

Sabaka

Koščálová

Straka³

et al. 2020

Preprint

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“…Hospital mortality ranges from less than 5% among patients younger than 40 years to 35% for patients aged 70 to 79 years and greater than 60% for patients aged 80 to 89 years (17). Among the latter, the elderly in long-term care facilities (LTCFs) have been reported as vulnerable to infections and at high risk for mortality (18). Nonetheless, patients with severe illness are likely to suffer substantial sequelae associated with a new physical disability, new cognitive impairment, and increased vulnerability to recurrent infection (1,18).…”

Section: Discussionmentioning

confidence: 99%

Combined lymphocyte/monocyte count, D-dimer and iron status predict COVID-19 course and outcome in a long-term care facility

Biamonte

Botta

Mazzitelli

et al. 2020

Preprint

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Background: The Sars-CoV-2 can cause severe pneumonia with multiorgan disease, which created an urgent need for the identification of clinical and laboratory predictors of the progression towards severe and fatal forms of this illness. In the present study, we retrospectively evaluated and integrated laboratory parameters/variables of 45 elderly subjects from a long-term care facility with Sars-CoV-2 outbreak and spread, to identify potential common patterns of systemic response able to better stratify patients’ clinical course and outcome.Methods: Baseline white blood cells, granulocytes’, lymphocytes’, and platelets’ counts, hemoglobin, total iron, ferritin, D-dimer, and interleukin 6 (IL-6) concentration were used to generate a principal component analysis (PCA). Statistical analysis was performed by using R statistical package version 4.0.Results: Of the 45 patients, 19 were male and 26 were female, with a median age of 81 years. The overall mortality rate was 26.67%. By PCA and clustering approach we identified 3 laboratory patterns of response, renamed as low-risk, intermediate-risk, and high-risk, strongly associated with patients’ survival (p<0.01). D-dimer, iron status, lymphocyte/monocyte count represented the main markers discriminating high- and low-risk groups. Furthermore, patients belonging to the high-risk group presented a significantly longer time to ferritin decrease (p:0.047). Iron-to-ferritin-ratio (IFR) significantly segregated recovered and dead patients in the intermediate-risk group (p:0.012).Conclusions: Our data generate the hypothesis that a combination of few laboratory parameters, and in particular iron status, D-dimer and lymphocyte/monocyte count at admission and during the hospital stay, can predict clinical progression in COVID-19.

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“…In the past two decades, humans have experienced two fatal coronavirus Transmission is mainly produced by symptomatic patients; however, a larger incubation period (which can last longer than 14 days) and asymptomatic shedding can exacerbate the infectivity of the virus, resulting in a large number of carriers [33]. This combination of being highly transmissible and asymptomatic carrier's contributes to its rapid spread [30][31][32][33][34][35][36].…”

Section: Covid Pandemicmentioning

confidence: 99%

Olfactory Dysfunction in the COVID-19 Outbreak

Izquierdo-Domínguez¹,

Rojas-Lechuga²,

Mullol³

et al. 2020

J Investig Allergol Clin Immunol

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The first cases of coronavirus 2019 (COVID-19) occurred in Wuhan, China, and rapidly become a public health emergency of international proportions. The disease may cause mild-to-severe acute respiratory syndrome (SARS) and is caused by a SARS-CoV-2 coronavirus infection. The clinical manifestations of COVID-19 include fever, dry cough, fatigue, sputum production, shortness of breath, sore throat, and headache. This article is a narrative review with the aim of analyzing the current literature on postviral olfactory dysfunction (OD) related to SARS-CoV-2 pandemics. Since the initial anecdotal reports from China, international reports on COVID-19 patients have been increasing, describing a 5% to 85% range of loss of smell. To date, the literature is widely heterogeneous regarding the loss of smell; therefore, we advise home isolation measures and/or social distancing, and to carry out diagnostic tests for SARS-CoV-2 when possible in those patients with sudden and severe loss of smell who cannot be promptly evaluated.neurons nor the olfactory bulb neurons express specific genes that are instead expressed in support cells, stem cells, and perivascular cells. These findings suggest that infection of non-neuronal cell types leads to anosmia and related disturbances in odour perception in patients [7,8]

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COVID-19 in long-term care facilities: An upcoming threat that cannot be ignored

Cited by 85 publications

References 20 publications

Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a Long-term Care Facility during Covid-19 Outbreak

Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a Long-term Care Facility during Covid-19 Outbreak

Combined lymphocyte/monocyte count, D-dimer and iron status predict COVID-19 course and outcome in a long-term care facility

Olfactory Dysfunction in the COVID-19 Outbreak

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