ABSTRACT
Aims COVID-19 disproportionately affects older people, with those aged ≥65 years representing a significant proportion of hospital admissions and deaths. Our aim was to examine characteristics, inpatient course and one-month outcomes of older patients with COVID-19 managed in an Irish urban tertiary hospital. Methods A retrospective cohort study of patients aged ≥65 diagnosed with laboratory-confirmed-COVID-19 over one-month and managed as inpatients in an Irish tertiary referral hospital. Electronic and paper medical records were reviewed. Results Eighty-six inpatients aged ≥65 years (mean age 77) with laboratory-confirmed-COVID-19 were included. Participants were frail (Median Clinical Frailty Scale:5) with multiple comorbidities (Median Charlson Comorbidity Index:5). One month after diagnosis, 44.2% (38/86) were discharged, 33.7% (29/86) had died and 14.0% (12/86) were awaiting rehabilitation or long-term care(LTC). The remainder were medically recovering. Discussion COVID-19 had a significant impact on older people admitted to hospital with high case-fatality rates. The proportion awaiting rehabilitation or LTC at four weeks demonstrates a significant functional impact on this cohort.
Subject(s)
Civil Defense , Coronavirus Infections , Homes for the Aged , Infection Control , Nursing Homes , Pandemics , Pneumonia, Viral , Aged , Betacoronavirus/isolation & purification , COVID-19 , Civil Defense/methods , Civil Defense/standards , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Disease Transmission, Infectious/prevention & control , Disease Transmission, Infectious/statistics & numerical data , Health Services Needs and Demand , Homes for the Aged/organization & administration , Homes for the Aged/standards , Humans , Infection Control/methods , Infection Control/standards , Nursing Homes/organization & administration , Nursing Homes/standards , Pandemics/prevention & control , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Quality Assurance, Health Care , Risk Factors , SARS-CoV-2ABSTRACT
Residents in nursing home care have borne a disproprtionate morbidity and mortality in the COVID-19 pandemic in comparison to the general population. Although the high rate of infection, morbidity and mortality in older people living in nursing homes may be attributable to increased levels of frailty and comorbidity in residents, the physical infrastructure and governance structures within nursing homes is also likely to be highly significant. The authors present, on behalf of Irish Society of Physicians in Geriatric Medicine, a position paper on changes that should be implemented to enhance the safety and quality of care for nursing home residents in Ireland.