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Risk factors for COVID-19 deaths among elderly nursing home Medicare beneficiaries in the pre-vaccine period.
Lu, Yun; Jiao, Yixin; Graham, David J; Wu, Yue; Wang, Jing; Menis, Mikhail; Chillarige, Yoganand; Wernecke, Michael; Kelman, Jeffrey; Forshee, Richard A; Izurieta, Hector S.
  • Lu Y; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
  • Jiao Y; Acumen LLC, Burlingame, CA, USA.
  • Graham DJ; Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
  • Wu Y; Acumen LLC, Burlingame, CA, USA.
  • Wang J; Acumen LLC, Burlingame, CA, USA.
  • Menis M; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
  • Chillarige Y; Acumen LLC, Burlingame, CA, USA.
  • Wernecke M; Acumen LLC, Burlingame, CA, USA.
  • Kelman J; Centers for Medicare and Medicaid Services, Washington DC, USA.
  • Forshee RA; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
  • Izurieta HS; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
J Infect Dis ; 2021 Oct 07.
Article in English | MEDLINE | ID: covidwho-1455314
ABSTRACT

BACKGROUND:

Evaluate pre-vaccine pandemic period COVID-19 death risk factors among nursing home (NH) residents.

METHODS:

Retrospective cohort study covering Medicare fee-for-service beneficiaries ages ≥65 residing in U.S. NHs. We estimated adjusted hazard ratios (HRs) using multivariate Cox proportional hazards regressions.

RESULTS:

Among 608,251 elderly NH residents, 57,398 (9.4%) died of COVID-related illness April 1 to December 22, 2020. About 46.9% (26,893) of these COVID-19 deaths occurred without prior COVID-19 hospitalizations. We observed a consistently increasing age trend for COVID-19 deaths. Racial/ethnic minorities generally shared a similarly high risk of NH COVID-19 deaths with Whites. NH facility characteristics including for-profit ownership and low health inspection ratings were associated with higher death risk. Resident characteristics, including male (HR 1.69), end-stage renal disease (HR 1.42), cognitive impairment (HR 1.34), and immunocompromised status (HR 1.20) were important death risk factors. Other individual-level characteristics were less predictive of death than they were in community-dwelling population.

CONCLUSIONS:

Low NH health inspection ratings and private ownership contributed to COVID-19 death risks. Nearly half of NH COVID-19 deaths occurred without prior COVID-19 hospitalization and older residents were less likely to get hospitalized with COVID-19. No substantial differences were observed by race/ethnicity and socioeconomic status for NH COVID-19 deaths.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Etiology study / Observational study / Prognostic study / Risk factors Language: English Clinical aspect: Etiology / Prediction / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Etiology study / Observational study / Prognostic study / Risk factors Language: English Clinical aspect: Etiology / Prediction / Prognosis Year: 2021
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