Nursing homes and the elderly regarding the COVID-19 pandemic: situation report from Hungary

Kemenesi, Gábor; Kornya, László; Tóth, Gábor Endre; Kurucz, Kornélia; Zeghbib, Safia; Somogyi, B; Zöldi, Viktor; Urbán, Péter; Herczeg, Róbert; Jakab, Ferenc

doi:10.1007/s11357-020-00195-z

Cited by 55 publications

(56 citation statements)

References 7 publications

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“…It should be noted that our hospitalized cases were substantially older than previously reported cases, probably reflecting the case mix of our institute [21,22]. While these observations seem to be counterintuitive given the notion that COVID-19 is an ageing disease, it should be emphasized that risk factors of acquiring the disease and that of severity or mortality could be rather different: while the mean age of patients presenting with SARS-CoV-2-associated pneumonia is approximately 67 years in our sample, 93% of deceased patients were older than 60 years according to Hungarian data from the same time period [25].…”

Section: Discussioncontrasting

confidence: 61%

Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary – a pilot historical case-control study

et al. 2020

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The distinction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related and community-acquired pneumonias poses significant difficulties, as both frequently involve the elderly. This study aimed to predict the risk of SARS-CoV-2-related pneumonia based on clinical characteristics at hospital presentation. Case-control study of all patients admitted for pneumonia at Semmelweis University Emergency Department. Cases (n = 30) were patients diagnosed with SARS-CoV-2-related pneumonia (based on polymerase chain reaction test) between 26 March 2020 and 30 April 2020; controls (n = 82) were historical pneumonia cases between 1 January 2019 and 30 April 2019. Logistic models were built with SARS-CoV-2 infection as outcome using clinical characteristics at presentation. Patients with SARS-CoV-2-related pneumonia were younger (mean difference, 95% CI: 9.3, 3.2–15.5 years) and had a higher lymphocyte count, lower C-reactive protein, presented more frequently with bilateral infiltrate, less frequently with abdominal pain, diarrhoea, and nausea in age- and sex-adjusted models. A logistic model using age, sex, abdominal pain, C-reactive protein, and the presence of bilateral infiltrate as predictors had an excellent discrimination (AUC 0.88, 95% CI: 0.81–0.96) and calibration (p = 0.27–Hosmer-Lemeshow test). The clinical use of our screening prediction model could improve the discrimination of SARS-CoV-2 related from other community-acquired pneumonias and thus help patient triage based on commonly used diagnostic approaches. However, external validation in independent datasets is required before its clinical use.

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Section: Discussioncontrasting

confidence: 61%

Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary – a pilot historical case-control study

et al. 2020

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“…CFRs for 11 studies of all people at long-term care institutions facing outbreaks (including COVID-19 positive and negative residents and staff) are summarised in Table 5, 10,22,26,29,30,36,39,41,48,51,63 while CFRs for seven studies of COVID-19 positive populations are described further down. 23,25,32,38,60,67,68 For most studies included in Table 5, the source population for the identification of people with COVID-19 were all or close to all (>90%) residents or staff at long-term care institutions where an outbreak occurred. The CFR among long-term care users for these studies ranged from 0% to 33.7%, with differences in follow-up time between one and 12 weeks.…”

Section: Evidence On Disease Incidence In Institutionalised Long-termmentioning

confidence: 99%

“…56 Not included in Table 5 are CFRs reported by seven studies for which the source population consisted exclusively of people who contracted COVID-19. 23,25,32,38,60,67,68 Due to the absence of systematic testing, these studies tended to only include symptomatic people in the denominator, resulting in higher CFRs compared to studies based on systematic testing, as described below.…”

Section: Evidence On Disease Incidence In Institutionalised Long-termmentioning

confidence: 99%

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COVID-19 related mortality and spread of disease in long-term care: a living systematic review of emerging evidence

Salcher‐Konrad

Jhass

Naci

et al. 2020

Preprint

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Background: Policy responses to mitigate the impact of the COVID-19 pandemic on long-term care (LTC) require robust and timely evidence on mortality and spread of the disease in these settings. The aim of this living systematic review is to synthesise early international evidence on mortality rates and incidence of COVID-19 among people who use and provide LTC. Methods: We report findings of a living systematic review (CRD42020183557), including studies identified through database searches up to 5 June 2020. We searched seven databases (MEDLINE; Embase; CINAHL Plus; Web of Science; Global Health; WHO COVID-19 Research Database; medRxiv) to identify all studies reporting primary data on COVID-19 related mortality and incidence of disease among LTC users and staff. We excluded studies not focusing on LTC. Included primary studies were critically appraised and results on number of deaths and COVID-19 related mortality rates, case fatality rates, and excess deaths (co-primary outcomes), as well as incidence of disease, hospitalisations, and ICU admissions were synthesised narratively. We further included official figures on number of deaths in LTC. Findings: A total of 33 study reports for 30 unique primary studies or outbreak reports were included. Outbreak investigations in LTC facilities found COVID-19 incidence rates of between 0.0% and 71.7% among residents and between 1.5% and 64.0% among staff. Mortality rates varied from 0.0% to 9.5% of all residents at outbreak facilities, with case fatality rates between 0.0% and 33.7%. In included studies, no LTC staff members had died. LTC residents accounted for between 0% (Hong Kong) and 85% (Canada) of COVID-related deaths, according to official figures. Interpretation: Long-term care users have been particularly vulnerable to the COVID-19 pandemic. However, we found wide variation in spread of disease and mortality rates between outbreaks at individual LTC facilities. Further research into the factors determining successful prevention and containment of COVID-19 outbreaks is needed to protect long-term care users and staff.

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“…This study did not cover elderly people incapable of participating in web surveys, such as those living in retirement homes. Retirement homes (which were insufficiently prepared for Covid-19) became hotspots for the coronavirus, not only in Slovenia but also in other countries [50][51][52][53]. To limit the spread of Covid-19, most retirement homes prohibited visits by relatives, even socializing within homes.…”

Section: Discussionmentioning

confidence: 99%

The social support networks of elderly people in Slovenia during the Covid-19 pandemic

Cugmas¹,

Ferligoj²,

Kogovšek³

et al. 2020

Preprint

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Population ageing requires society to adjust by ensuring additional types of services and assistance for elderly people. These may be provided by either organized services and sources of informal social support. The latter is especially important since a lack of social support is associated with a lower level of psychological and physical well-being. During the Covid-19 pandemic, social support for the elderly has proven to be even more crucial, also due to physical distancing. Therefore, this study aims to identify and describe the various types of personal social support networks of the elderly population during the coronavirus pandemic. To this end, a survey of Slovenians older than 64 years was conducted from April 25 to May 4, 2020 on a probability Web-panel-based sample (n = 605). The ego-networks were clustered by a hierarchical clustering approach for symbolic data. Clustering was performed for different types of social support (socializing, instrumental support, emotional support) and different characteristics of the social support networks (i.e., type of relationship, number of contacts, geographical distance). The results show that most of the elderly population in Slovenia have a satisfactory social support network, while the share of those without any (accessible) source of social support is significant. The results are particularly valuable for sustainable care policy planning, crisis intervention planning as well as any future waves of the coronavirus.

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Nursing homes and the elderly regarding the COVID-19 pandemic: situation report from Hungary

Cited by 55 publications

References 7 publications

Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary – a pilot historical case-control study

Comparison of clinical characteristics of patients with pandemic SARS-CoV-2-related and community-acquired pneumonias in Hungary – a pilot historical case-control study

COVID-19 related mortality and spread of disease in long-term care: a living systematic review of emerging evidence

The social support networks of elderly people in Slovenia during the Covid-19 pandemic

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