tetano
Editor, Senior Moderator
J Infect
. 2020 Jun 3;S0163-4453(20)30348-0.
doi: 10.1016/j.jinf.2020.05.073. Online ahead of print.
SARS-CoV-2 Infection, Clinical Features and Outcome of COVID-19 in United Kingdom Nursing Homes
Nsn Graham[SUP] 1 [/SUP], C Junghans[SUP] 2 [/SUP], R Downes[SUP] 3 [/SUP], C Sendall[SUP] 3 [/SUP], H Lai[SUP] 1 [/SUP], A McKirdy[SUP] 4 [/SUP], P Elliott[SUP] 5 [/SUP], R Howard[SUP] 6 [/SUP], D Wingfield[SUP] 7 [/SUP], M Priestman[SUP] 8 [/SUP], M Ciechonska[SUP] 8 [/SUP], L Cameron[SUP] 9 [/SUP], M Storch[SUP] 8 [/SUP], M A Crone[SUP] 8 [/SUP], P S Freemont[SUP] 8 [/SUP], P Randell[SUP] 10 [/SUP], R McLaren[SUP] 11 [/SUP], N Lang[SUP] 12 [/SUP], S Ladhani[SUP] 13 [/SUP], F Sanderson[SUP] 14 [/SUP], D J Sharp[SUP] 1 [/SUP]
Affiliations
Abstract
Objectives: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents.
Methods: An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing.
Results: Overall, 26% (95% CI 22 to 31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70 to 336) compared with previous years. Systematic testing identified 40% (95% CI 35 to 46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34 to 52) were asymptomatic and 18% (95% CI 11 to 24) had only atypical symptoms; 4% (95% CI -1 to 9) of asymptomatic staff also tested positive.
Conclusions: The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.
Keywords: COVID-19; Care home; Coronavirus; Diagnostic testing; Nursing home; SARS-CoV-2.
. 2020 Jun 3;S0163-4453(20)30348-0.
doi: 10.1016/j.jinf.2020.05.073. Online ahead of print.
SARS-CoV-2 Infection, Clinical Features and Outcome of COVID-19 in United Kingdom Nursing Homes
Nsn Graham[SUP] 1 [/SUP], C Junghans[SUP] 2 [/SUP], R Downes[SUP] 3 [/SUP], C Sendall[SUP] 3 [/SUP], H Lai[SUP] 1 [/SUP], A McKirdy[SUP] 4 [/SUP], P Elliott[SUP] 5 [/SUP], R Howard[SUP] 6 [/SUP], D Wingfield[SUP] 7 [/SUP], M Priestman[SUP] 8 [/SUP], M Ciechonska[SUP] 8 [/SUP], L Cameron[SUP] 9 [/SUP], M Storch[SUP] 8 [/SUP], M A Crone[SUP] 8 [/SUP], P S Freemont[SUP] 8 [/SUP], P Randell[SUP] 10 [/SUP], R McLaren[SUP] 11 [/SUP], N Lang[SUP] 12 [/SUP], S Ladhani[SUP] 13 [/SUP], F Sanderson[SUP] 14 [/SUP], D J Sharp[SUP] 1 [/SUP]
Affiliations
- PMID: 32504743
- DOI: 10.1016/j.jinf.2020.05.073
Abstract
Objectives: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents.
Methods: An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing.
Results: Overall, 26% (95% CI 22 to 31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70 to 336) compared with previous years. Systematic testing identified 40% (95% CI 35 to 46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34 to 52) were asymptomatic and 18% (95% CI 11 to 24) had only atypical symptoms; 4% (95% CI -1 to 9) of asymptomatic staff also tested positive.
Conclusions: The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.
Keywords: COVID-19; Care home; Coronavirus; Diagnostic testing; Nursing home; SARS-CoV-2.