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Clinical characteristics of COVID-19 in older adults. A retrospective study in long-term nursing homes in Catalonia.
Meis-Pinheiro, Uxío; Lopez-Segui, Francesc; Walsh, Sandra; Ussi, Anton; Santaeugenia, Sebastia; Garcia-Navarro, Jose Augusto; San-Jose, Antonio; Andreu, Antoni L; Campins, Magda; Almirante, Benito.
  • Meis-Pinheiro U; Associació Catalana de Recursos Assistencials, ACRA, Barcelona, Spain.
  • Lopez-Segui F; Centre de Recerca en Economia de la Salut-CRES UPF, Barcelona, Spain.
  • Walsh S; Institut de Biologia Evolutiva (UPF-CSIC), Universitat Pompeu Fabra, Barcelona, Spain.
  • Ussi A; European Infrastructure for Translational Medicine, EATRIS, Amsterdam, Netherlands.
  • Santaeugenia S; Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic-University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.
  • Garcia-Navarro JA; Chronic Care Program, Ministry of Health, Generalitat de Catalunya, Barcelona, Spain.
  • San-Jose A; Spanish Society of Geriatrics and Gerontology, Barcelona, Spain.
  • Andreu AL; Geriatric Unit, Hospital Universitari Vall d´Hebron, Barcelona, Spain.
  • Campins M; Associació Catalana de Recursos Assistencials, ACRA, Barcelona, Spain.
  • Almirante B; European Infrastructure for Translational Medicine, EATRIS, Amsterdam, Netherlands.
PLoS One ; 16(7): e0255141, 2021.
Article in English | MEDLINE | ID: covidwho-1323020
ABSTRACT
The natural history of COVID-19 and predictors of mortality in older adults need to be investigated to inform clinical operations and healthcare policy planning. A retrospective study took place in 80 long-term nursing homes in Catalonia, Spain collecting data from March 1st to May 31st, 2020. Demographic and clinical data from 2,092 RT-PCR confirmed cases of SARS-CoV-2 infection were registered, including structural characteristics of the facilities. Descriptive statistics to describe the demographic, clinical, and molecular characteristics of our sample were prepared, both overall and by their symptomatology was performed and an analysis of statistically significant bivariate differences and constructions of a logistic regression model were carried out to assess the relationship between variables. The incidence of the infection was 28%. 71% of the residents showed symptoms. Five major symptoms included fever, dyspnea, dry cough, asthenia and diarrhea. Fever and dyspnea were by far the most frequent (50% and 28%, respectively). The presentation was predominantly acute and symptomatology persisted from days to weeks (mean 9.1 days, SD = 10,9). 16% of residents had confirmed pneumonia and 22% required hospitalization. The accumulated mortality rate was 21.75% (86% concentrated during the first 28 days at onset). A multivariate logistic regression analysis showed a positive predictive value for mortality for some variables such as age, pneumonia, fever, dyspnea, stupor refusal to oral intake and dementia (p<0.01 for all variables). Results suggest that density in the nursing homes did not account for differences in the incidence of the infection within the facilities. This study provides insights into the natural history of the disease in older adults with high dependency living in long-term nursing homes during the first pandemic wave of March-May 2020 in the region of Catalonia, and suggests that some comorbidities and symptoms have a strong predictive value for mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dyspnea / Fever / SARS-CoV-2 / COVID-19 / Nursing Homes Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0255141

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dyspnea / Fever / SARS-CoV-2 / COVID-19 / Nursing Homes Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0255141