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A rapid systematic review of measures to protect older people in long-term care facilities from COVID-19.
Frazer, Kate; Mitchell, Lachlan; Stokes, Diarmuid; Lacey, Ella; Crowley, Eibhlin; Kelleher, Cecily C.
  • Frazer K; School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
  • Mitchell L; National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland lachlan.mitchell@ucd.ie.
  • Stokes D; School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland.
  • Lacey E; Health Sciences Library, University College Dublin, Dublin, Ireland.
  • Crowley E; School of Medicine, University College Dublin, Dublin, Ireland.
  • Kelleher CC; Office for Health Affairs, College of Health and Agricultural Science, University College Dublin, Dublin, Ireland.
BMJ Open ; 11(10): e047012, 2021 10 18.
Article in English | MEDLINE | ID: covidwho-1476597
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ABSTRACT

OBJECTIVES:

The global COVID-19 pandemic produced large-scale health and economic complications. Older people and those with comorbidities are particularly vulnerable to this virus, with nursing homes and long term care facilities (LTCF) experiencing significant morbidity and mortality associated with COVID-19 outbreaks. The aim of this rapid systematic review was to investigate measures implemented in LTCF to reduce transmission of COVID-19 and their effect on morbidity and mortality of residents, staff and visitors.

SETTING:

Long-term care facilities.

PARTICIPANTS:

Residents, staff and visitors of facilities. PRIMARY AND SECONDARY OUTCOME

MEASURES:

Databases (PubMed, EMBASE, CINAHL, Cochrane Databases and repositories and MedRXiv prepublished database) were systematically searched from inception to 27 July 2020 to identify studies reporting assessment of interventions to reduce transmission of COVID-19 in nursing homes among residents, staff or visitors. Outcome measures include facility characteristics, morbidity data, case fatalities and transmission rates. Due to study quality and heterogeneity, no meta-analysis was conducted.

RESULTS:

The search yielded 1414 articles, with 38 studies included. Reported interventions include mass testing, use of personal protective equipment, symptom screening, visitor restrictions, hand hygiene and droplet/contact precautions, and resident cohorting. Prevalence rates ranged from 1.2% to 85.4% in residents and 0.6% to 62.6% in staff. Mortality rates ranged from 5.3% to 55.3% in residents.

CONCLUSIONS:

Novel evidence in this review details the impact of facility size, availability of staff and practices of operating between multiple facilities, and for-profit status of facilities as factors contributing to the size and number of COVID-19 outbreaks. No causative relationships can be determined; however, this review provides evidence of interventions that reduce transmission of COVID-19 in LTCF. PROSPERO REGISTRATION NUMBER CRD42020191569.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Reviews / Risk factors / Systematic review Limits: Aged / Humans Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-047012

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Reviews / Risk factors / Systematic review Limits: Aged / Humans Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2020-047012