Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=33036702
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
COVID-19 in seniors: Findings and lessons from mass screening in a nursing home
#MMPMID33036702
Sacco G
; Foucault G
; Briere O
; Annweiler C
Maturitas
2020[Nov]; 141
(?): 46-52
PMID33036702
show ga
BACKGROUND/OBJECTIVE: The COVID-19 epidemic is particularly serious in older
adults. The symptomatology and epidemic profile remain little known in this
population, especially in disabled oldest-old people with chronic diseases living
in nursing homes. The objective of the present study was to comprehensively
describe symptoms and chronological aspects of the diffusion of the SARS-CoV-2
virus in a nursing home, among both residents and caregivers. DESIGN: Five-week
retrospective cohort study. SETTING: A middle-sized nursing home in
Maine-et-Loire, west of France. PARTICIPANTS: Eighty-seven frail older residents
(87.9 ± 7.2years; 71 % female) and 92 staff members (38.3 ± 11.7years; 89 %
female) were included. MEASUREMENTS: Mass screening for SARS-CoV-2 was performed
in both residents and staff. Attack rate, mortality rate, and symptoms among
residents and staff infected with SARS-CoV-2 were recorded. RESULTS: The attack
rate of COVID-19 was 47 % in residents (case fatality rate, 27 %), and 24 % in
staff. Epidemic curves revealed that the epidemic started in residents before
spreading to caregivers. Residents exhibited both general and respiratory signs
(59 % hyperthermia, 49 % cough, 42 % polypnea) together with geriatric syndromes
(15 % falls, 10 % altered consciousness). The classification tree revealed 100 %
COVID-19 probability in the following groups: i) residents younger than 90 with
dyspnea and falls; ii) residents older than 90 with anorexia; iii) residents
older than 90 without anorexia but with altered consciousness. Finally, 41 % of
staff members diagnosed with COVID-19 were asymptomatic. CONCLUSIONS: The
pauci-symptomatic expression of COVID-19 in older residents, together with the
high prevalence of asymptomatic forms in caregivers, justifies mass screening in
nursing homes, possibly prioritizing residents with suggestive combinations of
clinical signs including dyspnea, falls, anorexia and/or altered consciousness.
free
free
free
