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COVID-19 risk factors amongst 14,786 care home residents: an observational longitudinal analysis including daily community positive test rates of COVID-19, hospital stays and vaccination status in Wales (UK) between 1 September 2020 and 1 May 2021.
Hollinghurst, Joe; Hollinghurst, Robyn; North, Laura; Mizen, Amy; Akbari, Ashley; Long, Sara; Lyons, Ronan A; Fry, Rich.
  • Hollinghurst J; Swansea University, Wales, UK.
  • Hollinghurst R; Swansea University, Wales, UK.
  • North L; Swansea University, Wales, UK.
  • Mizen A; Swansea University, Wales, UK.
  • Akbari A; Swansea University, Wales, UK.
  • Long S; Swansea University, Wales, UK.
  • Lyons RA; Population Data Science, Swansea University, Wales, UK.
  • Fry R; Swansea University, Wales, UK.
Age Ageing ; 51(5)2022 05 01.
Article in English | MEDLINE | ID: covidwho-1890851
ABSTRACT

BACKGROUND:

COVID-19 vaccinations have been prioritised for high risk individuals.

AIM:

Determine individual-level risk factors for care home residents testing positive for SARS-CoV-2. STUDY

DESIGN:

Longitudinal observational cohort study using individual-level linked data from the Secure Anonymised Information Linkage (SAIL) databank.

SETTING:

Fourteen thousand seven hundred and eighty-six older care home residents (aged 65+) living in Wales between 1 September 2020 and 1 May 2021. Our dataset consisted of 2,613,341 individual-level daily observations within 697 care homes.

METHODS:

We estimated odds ratios (ORs [95% confidence interval]) using multilevel logistic regression models. Our outcome of interest was a positive SARS-CoV-2 PCR test. We included time-dependent covariates for the estimated community positive test rate of COVID-19, hospital inpatient status, vaccination status and frailty. Additional covariates were included for age, sex and specialist care home services.

RESULTS:

The multivariable regression model indicated an increase in age (OR 1.01 [1.00,1.01] per year), community positive test rate (OR 1.13 [1.12,1.13] per percent increase), hospital inpatients (OR 7.40 [6.54,8.36]), and residents in care homes with non-specialist dementia care (OR 1.42 [1.01,1.99]) had an increased odds of a positive test. Having a positive test prior to the observation period (OR 0.58 [0.49,0.68]) and either one or two doses of a vaccine (0.21 [0.17,0.25] and 0.05 [0.02,0.09], respectively) were associated with a decreased odds.

CONCLUSIONS:

Care providers need to remain vigilant despite the vaccination rollout, and extra precautions should be taken when caring for the most vulnerable. Minimising potential COVID-19 infection for care home residents when admitted to hospital should be prioritised.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: Ageing

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Vaccines Limits: Humans Country/Region as subject: Europa Language: English Year: 2022 Document Type: Article Affiliation country: Ageing