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Mortality among Care Home Residents in England during the first and second waves of the COVID-19 pandemic: an observational study of 4.3 million adults over the age of 65.
Schultze, Anna; Nightingale, Emily; Evans, David; Hulme, William; Rosello, Alicia; Bates, Chris; Cockburn, Jonathan; MacKenna, Brian; Curtis, Helen J; Morton, Caroline E; Croker, Richard; Bacon, Seb; McDonald, Helen I; Rentsch, Christopher T; Bhaskaran, Krishnan; Mathur, Rohini; Tomlinson, Laurie A; Williamson, Elizabeth J; Forbes, Harriet; Tazare, John; Grint, Daniel; Walker, Alex J; Inglesby, Peter; DeVito, Nicholas J; Mehrkar, Amir; Hickman, George; Davy, Simon; Ward, Tom; Fisher, Louis; Green, Amelia Ca; Wing, Kevin; Wong, Angel Ys; McManus, Robert; Parry, John; Hester, Frank; Harper, Sam; Evans, Stephen Jw; Douglas, Ian J; Smeeth, Liam; Eggo, Rosalind M; Goldacre, Ben; Leon, David A.
  • Schultze A; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Nightingale E; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Evans D; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Hulme W; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Rosello A; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Bates C; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX.
  • Cockburn J; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX.
  • MacKenna B; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Curtis HJ; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Morton CE; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Croker R; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Bacon S; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • McDonald HI; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Rentsch CT; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Bhaskaran K; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Mathur R; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Tomlinson LA; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Williamson EJ; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Forbes H; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Tazare J; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Grint D; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Walker AJ; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Inglesby P; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • DeVito NJ; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Mehrkar A; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Hickman G; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Davy S; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Ward T; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Fisher L; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Green AC; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Wing K; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Wong AY; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • McManus R; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX.
  • Parry J; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX.
  • Hester F; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX.
  • Harper S; TPP, TPP House, 129 Low Lane, Horsforth, Leeds, LS18 5PX.
  • Evans SJ; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Douglas IJ; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Smeeth L; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Eggo RM; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
  • Goldacre B; The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, OX26GG.
  • Leon DA; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT.
Lancet Reg Health Eur ; 14: 100295, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1747703
ABSTRACT

BACKGROUND:

Residents in care homes have been severely impacted by COVID-19. We describe trends in the mortality risk among residents of care homes compared to private homes.

METHODS:

On behalf of NHS England we used OpenSAFELY-TPP to calculate monthly age-standardised risks of death due to all causes and COVID-19 among adults aged >=65 years between 1/2/2019 and 31/03/2021. Care home residents were identified using linkage to Care and Quality Commission data.

FINDINGS:

We included 4,340,648 people aged 65 years or older on the 1st of February 2019, 2.2% of whom were classified as residing in a care or nursing home. Age-standardised mortality risks were approximately 10 times higher among care home residents compared to those in private housing in February 2019 comparative mortality figure (CMF) = 10.59 (95%CI = 9.51, 11.81) among women, and 10.87 (9.93, 11.90) among men. By April 2020 these relative differences had increased to more than 17 times with CMFs of 17.57 (16.43, 18.79) among women and 18.17 (17.22, 19.17) among men. CMFs did not increase during the second wave, despite a rise in the absolute age-standardised COVID-19 mortality risks.

INTERPRETATION:

COVID-19 has had a disproportionate impact on the mortality of care home residents in England compared to older residents of private homes, but only in the first wave. This may be explained by a degree of acquired immunity, improved protective measures or changes in the underlying frailty of the populations. The care home population should be prioritised for measures aimed at controlling COVID-19.

FUNDING:

Medical Research Council MR/V015737/1.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Lancet Reg Health Eur Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Lancet Reg Health Eur Year: 2022 Document Type: Article