Case–control study to estimate odds of death within 28 days of positive test for SARS-CoV-2 prior to vaccination for residents of long-term care facilities in England, 2020–2021

BackgroundPersons living in long-term care facilities (LTCFs) are presumed to be at higher risk of adverse outcomes from SARS-CoV-2 infection due to increasing age and frailty, but the magnitude of increased risk is not well quantified.MethodsAfter linking demographic and mortality data for cases wi...

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Veröffentlicht in:Journal of epidemiology and community health (1979) Jg. 76; H. 5; S. 428 - 434
Hauptverfasser: Paranthaman, Karthik, Allen, Hester, Chudasama, Dimple, Verlander, Neville Q, Sedgwick, James
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group Ltd 01.05.2022
BMJ Publishing Group LTD
BMJ Publishing Group
Schlagworte:
Age
ageing
COVID-19
Datasets
Death
Epidemics
epidemiology
Ethnicity
Laboratories
Long term health care
Long-term care
Minority & ethnic groups
Mortality
Nursing
Nursing care
Original Research
Patients
Regression analysis
Relative deprivation
Severe acute respiratory syndrome coronavirus 2
Software
Statistical analysis
Vaccination
Variables
United Kingdom > UK
England
COVID-19
epidemiology
ageing
ISSN:0143-005X, 1470-2738, 1470-2738
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Zusammenfassung:BackgroundPersons living in long-term care facilities (LTCFs) are presumed to be at higher risk of adverse outcomes from SARS-CoV-2 infection due to increasing age and frailty, but the magnitude of increased risk is not well quantified.MethodsAfter linking demographic and mortality data for cases with confirmed SARS-CoV-2 infection between March 2020 and January 2021 in England, a random sample of 6000 persons who died and 36 000 who did not die within 28 days of a positive test was obtained from the dataset of 3 020 800 patients. Based on an address-matching process, the residence type of each case was categorised into one of private home and residential or nursing LTCF. Univariable and multivariable logistic regression analysis was conducted.ResultsMultivariable analysis showed that an interaction effect between age and residence type determined the outcome. Compared with a 60-year-old person not living in LTCF, the adjusted OR (aOR) for same-aged persons living in residential and nursing LTCFs was 1.77 (95% CI 1.21 to 2.6, p=0.0017) and 3.95 (95% CI 2.77 to 5.64, p<0.0001), respectively. At 90 years of age, aORs were 0.87 (95% CI 0.72 to 1.06, p=0.21) and 0.74 (95% CI 0.61 to 0.9, p=0.001), respectively. The model had an overall accuracy of 94.2% (94.2%) when applied to the full dataset of 2 978 800 patients.ConclusionThis study found that residents of LTCFs in England had higher odds of death up to 80 years of age. Beyond 80 years, there was no difference in the odds of death for LTCF residents compared with those in the wider community.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0143-005X
1470-2738
1470-2738
DOI:10.1136/jech-2021-218135