COVID-19 morbimortality in long-term care facilities in the state of Bahia, Brazil

Abstract

OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) morbidity and mortality in long-term care facilities (LTCFs) in the state of Bahia, Brazil. METHODS: This is an ecological study involving identified and active LTCFs in Bahia, monitored by the Intersectoral Monitoring Commission of LTCFs. Data analysis included COVID-19 incidence among older residents and workers and COVID-19 hospitalization, fatality, and mortality rates among older residents. In addition to a global analysis of data from Bahia, a stratified analysis compared (i) the East macroregion with the rest of Bahia, and (ii) private LTCFs with philanthropic ones. RESULTS: Our sample consisted of 175 LTCFs, more than half located in the East macroregion (n = 99). Most facilities declared themselves as philanthropic (n = 94) or private (n = 59). From April/2020 to June/2021, COVID-19 incidence was 30.71% among residents and 19.86% among LTCF workers. Considering older residents, mortality was 3.57% and fatality was 11.63%. Incidence was lower in the East macroregion, for older residents (relative risk [RR] = 0.77; 95% confidence interval [CI] 0.68–0.87) and LTCF workers (RR = 0.70; 95%CI 0.59–0.83). The hospitalization rate due to COVID-19 was 19.97%, being higher in private LTCFs (RR = 1.61; 95%CI 1.30–2.00). CONCLUSIONS: This study reveals that COVID-19 morbidity and mortality in LTCFs in Bahia were consistent with the wide ranges described in the literature, although case fatality was lower than expected. This demonstrates the importance of strategies to coordinate, identify, assess, and target support for LTCFs, highlighting the need for stronger public policies.