COVID-19 infection and 2-year mortality in nursing home residents who survived the first wave of the pandemic (preprint)

ABSTRACT

Background During the first COVID-19 pandemic wave (1stCoPW), nursing homes (NHs) experienced a high rate of COVID-19 infection and death. Residents who survived the COVID-19 infection may have become frailer. This study aimed to determine the predictive value of having a COVID-19 infection during the 1st CoPW for 2-year mortality in NH residents.Methods This was a retrospective study conducted in three NHs. Residents who had survived the 1st CoPW (March to May 2020) were included. The diagnosis of COVID-19 was based on the results of a positive reverse transcriptase-polymerase chain reaction test. The collected data also included age, sex, length of residence in the NH, disability status, legal guardianship status, nutritional status, need for texture-modified food and hospitalization during lockdown. Nonadjusted and adjusted Cox models were used to analyse factors associated with 2-year post-1st CoPW mortality.Results Among the 315 CoPW1 survivors (72% female, mean age 88 years, 48% with severe disability), 35% presented with COVID-19. Having a history of COVID-19 was not associated with 2-year mortality hazard ratio (HR) [95% confidence interval] = 0.96 [0.81–1.13], p = 0.62. The factors independently associated with 2-year mortality were older age (for each additional year, HR = 1.05 [1.03–1.08], p < 0.01), severe disability vs moderate or no disability (HR = 1.35 [1.12–1.63], p < 0.01) and severe malnutrition vs no malnutrition (HR = 1.29 [1.04–1.60], p = 0.02).Conclusions Having survived a COVID-19 infection during the 1st CoPW did not affect subsequent 2-year survival in older adults living in NHs, suggesting that most of these residents recovered from the infection without COVID-19-related life-threatening sequelae.