Mortality among Care Home Residents in England during the first and second waves of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65

Schultze, Anna; Nightingale, Emily; Evans, David; Hulme, William J; Roselló, Alicia; Bates, Chris; Cockburn, Jonathan; MacKenna, Brian; Curtis, Helen J; Morton, Caroline E; Croker, Richard; Bacon, Seb; McDonald, Helen I; Rentsch, Christopher T; Bhaskaran, Krishnan; Mathur, Rohini; Tomlinson, Laurie; Williamson, Elizabeth; Forbes, Harriet; Tazare, John; Grint, Daniel; Walker, Alex J; Inglesby, Peter; DeVito, Nicholas J; Mehrkar, Amir; Hickman, George; Davy, Simon; Ward, Tom; Fisher, Louis; Green, Amelia; Wing, Kevin; Wong, Angel; McManus, Robert; Parry, John; Hester, Frank; Harper, Sam; Evans, Stephen; Douglas, Ian; Smeeth, Liam; Eggo, Rosalind M; Goldacre, Ben; Leon, David A.

doi:10.1016/j.lanepe.2021.100295

Cited by 50 publications

(53 citation statements)

References 25 publications

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“…These institutions represent a setting at a high risk of COVID-19 transmission due to the advanced age of residents and their underlying conditions. SARS-CoV-2 spreading has been deeply described in nursing homes around the world, including other Spanish regions [ 8 ], other European countries [ 9 - 13 ], China [ 14 ] or the USA [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

High incidence of COVID-19 at nursing homes in Madrid, Spain, despite preventive measures

Escribano

Pérez‐Granda²,

Alonso³

et al. 2022

Rev Esp Quimioter

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Objective. To assess the impact of COVID-19 at nine nursing homes in Madrid, Spain, during the first wave of COVID-19 infection and lockdown period when preventive measures were taken to avoid transmission among residents. Methods. Nine hundred forty-two residents and 846 staff members from nine nursing homes participated in the study (April 18 to June 20, 2020). All participants were tested for SARS-CoV-2 in the nasopharynx by PCR and for IgG antibodies detection. Microbiological status at sampling was defined as active infection (positive PCR ± presence of antibodies), past infection (negative PCR + presence of antibodies), or naïve participants (negative PCR + absence of antibodies). Results. Laboratory results helped classify the residents as having active infection (n=224; 23.8%), past infection (n=462; 49.1%), or being naïve (n=256; 27.1%); staff members were actively infected (n=127; 15.1%), had had a past infection (n=290; 34.2%), or were naïve (n=429; 50.7%). Overall, the percentage of participants with COVID-19 was significantly higher in residents than in staff members (72.8% vs 49.2%; P=0.001). The clinical situation of residents vs staff at sampling was as follows: acute manifestations compatible with COVID-19 (7.3% vs 3.9%; P<0.01) and no manifestations of infection (92.7% vs 96.0%; P<0.01). A large proportion of both asymptomatic and symptomatic residents (69.4% vs 86.6%; P=0.015) had positive PCR results (mostly alongside positive IgG determinations). Conclusions. COVID-19 affects 75% of the residents in nursing homes in Madrid. The high impact in these settings, despite the strict restrictions adopted during the lockdown, demonstrates the ability of SARS-CoV-2 to cause outbreaks.

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Section: Discussionmentioning

confidence: 99%

High incidence of COVID-19 at nursing homes in Madrid, Spain, despite preventive measures

Escribano

Pérez‐Granda²,

Alonso³

et al. 2022

Rev Esp Quimioter

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“…We were unable to ascertain which patients resided in care homes due to information governance restrictions of sensitive data fields and as a result we could not study this population who were disproportionately impacted by the pandemic. 26 Exploiting linkage across EHRs at the national scale highlighted the health-care trajectories of individuals with COVID-19, to identify who has been affected and how.…”

Section: Icu Admission Icu Admission Primary Care Diagnosismentioning

confidence: 99%

COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records

Banerjee

Pagel

et al. 2022

The Lancet Digital Health

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“…This is due in part to a lack of published data on counts of COVID-19 deaths by both age and place of residence (i.e., living in a care home or living at home). Three studies that did examine this relationship are Hardy et al (2021), Fisman et al (2020) and Schultze et al (2022). Using data from the Wallonia region of Belgium, Hardy et al (2021) compared the care home population to the general population (of all ages) living outside of care homes.…”

Section: Introductionmentioning

confidence: 99%

Why did care home residents face an elevated risk of death from COVID-19? A demographic perspective using data from Belgium and from England and Wales

Lai¹

2022

Populationyearbook

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In many countries, deaths from COVID-19 were highly concentrated among care home residents during the initial wave of the pandemic. Care home residents may have faced higher risks of exposure and infection than the general population of older people. Once infected, residents may have been more likely to succumb to this disease as they were both older and frailer than the general population of older people. This study presents a quantified assessment of these factors in Belgium and in England and Wales. In doing so, this paper applies the Das Gupta decomposition method to explain the contributions of these three factors to the observed differences in mortality rates from COVID-19 between older people residing in care homes and older people living at home. According to these estimates, older people residing in care homes were 36 times more likely to die in Belgium and were 23 times more likely to die in England and Wales from COVID-19 than older people living at home during the initial wave of the pandemic. Decomposition of the differences in the mortality rates of these populations in Belgium and in England and Wales showed that the two key determinants were the greater underlying frailty of older people in care homes (accounting for 46% of the differences in Belgium and 66% of the differences in England and Wales) and the higher infection prevalence of older people in care homes (accounting for 40% of the differences in Belgium and 26% of the differences in England and Wales).

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Mortality among Care Home Residents in England during the first and second waves of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65

Cited by 50 publications

References 25 publications

High incidence of COVID-19 at nursing homes in Madrid, Spain, despite preventive measures

High incidence of COVID-19 at nursing homes in Madrid, Spain, despite preventive measures

COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records

Why did care home residents face an elevated risk of death from COVID-19? A demographic perspective using data from Belgium and from England and Wales

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