The impact of COVID-19 first wave on long term care facilities of an Italian Province: an historical reference

  • Andrea Tramarin | Primary Health Care, AULSS8, Vicenza, Italy.
  • Nicola Gennaro Epidemiological service of the Veneto Region, Padua, Italy.
  • Giancarlo Dal Grande Don Bruzzo Long Term Care Facility, Gambellara (VI), Italy.
  • Luciana Bragagnolo Laboratory of Microbiology of San Bortolo Hospital, AULSS8 (VI), Italy.
  • Maria Rosa Carta Laboratory of Clinical Chemistry of San Bortolo Hospital, AULSS8 (VI), Italy.
  • Davide Giavarina Laboratory of Clinical Chemistry of San Bortolo Hospital, AULSS8 (VI), Italy.
  • Michela Pascarella Laboratory of Microbiology of San Bortolo Hospital, AULSS8 (VI), Italy.
  • Mario Rassu Laboratory of Microbiology of San Bortolo Hospital, AULSS8 (VI), Italy.
  • Antonio Matteazzi Primary Health Care, AULSS8, Vicenza, Italy.
  • Giampaolo Stopazzolo Primary Health Care, AULSS8, Vicenza, Italy.


The coronavirus disease 2019 (COVID-19) pandemic will leave a profound imprint in the collective memory of humanity. In Italy, Long-Term Care Facilities (LTCFs) have seen a disproportionally high number of deaths during and the COVID-19 pandemic and, certainly, they may be considered as its epicenter. Aiming to leave a symbolic mark of what the pandemic did in these care settings, we report on an outbreak in a single LTCF where, 53 out of 64 residents, resulted infected. Our narration is based on an epidemiological field investigation together with a calendar of passages through the stages of disease in the infected population. We found an age-gradient in all clinical and epidemiological variables explored such as symptoms onset, illness severity, recovery from symptoms and deaths. According to the disease staging, 26 (49%) were asymptomatic; 9 (17%) had a mild disease; 7 (13%) a moderate stage and 11 (21%) a severe illness severity of whom 10 died. For a more comprehensive description of the impact of the pandemic on LTCFs, we compared the standard mortality ratio (SMR) in the first six months of 2020 to that of 2018 and 2019 in all the 34 facilities of the Vicenza province. Overall, there was a SMR higher 60% than the equivalent period of the previous years.



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RedZone Online. Coronavirus in Italia, 110.574 casi positivi e 13.155 morti. Il bollettino del 1° Aprile; Corriere della Sera. Available from:

Italian Ministry of Health. Epidemia COVID-19; Aggiornamento nazionale (May 2020). Available from:

Wang L, He W, Yu X, et al. Coronavirus disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;80:639-45. DOI:

Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020;584:430-6. DOI:

Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13. DOI:

Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (Albany NY). 2020;12:6049-57. DOI:

Berloto S, Notarnicola E, Perobelli E, Rotolo A. Italy and the COVID-19 long-term care situation. Last updated: 22 April 2020. Available from:

Center for Diseases Control and Prevention. Principle of epidemiology in public health practice; Lesson 6: Investigating an outbreak. Available from:

Società Italiana di Geriatria e Gerontologia. Quando si diventa anziani. Available from:

World Health Organization (WHO). Clinical management of COVID-19: interim guidance, 27 May 2020. Available from:

Mahoney FI, Barthel. Functional evaluation: the Barthel index. Md State Med J 1965;14:61-5.

Lansbury LE, Brown CD, Nguyen-Van-Tam JS. Influenza in long‐term care facilities. Influenza Other Respir Viruses 2017;11:356-66. DOI:

Ambretti S, Bassetti M, Clerici P, et al.. Screening for carriage of carbapenem-resistant Enterobacteriaceae in settings of high endemicity: a position paper from an Italian working group on CRE infections. Antimicrob Resist Infect Control 2019;13:136. DOI:

McMichael TM, Clark S, Pogosjans S, et al. COVID-19 in a long-term care facility - King County, Washington, February 27-March 9, 2020. MMWR Morb Mortal Wkly Rep 2020;69:339-42. DOI:

Arons MM, Hatfield KM, Reddy SC, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. New Engl J Med 2020;382:2081-90 DOI:

Roxby AC, Greninger AL, Hatfield KM, et al. Detection of SARS-CoV-2 among residents and staff members of an independent and assisted living community for older adults - Seattle, Washington, 2020. MMWR Morb Mortal Wkly Rep 2020;69:416-8. DOI:

Comas-Herrera A, Zalakaín J, Lemmon E, et al. Mortality associated with COVID-19 in care homes: international evidence. Article in, International Long-Term Care Policy Network, CPEC-LSE, 2020. Last updated: 1st February 2021. Available from:

Szklaski C. Canada’s proportion of COVID-19 deaths in long-term care double the average of other countries, study shows. The Canadian Press; Posted: Jun 25, 2020. Available from:

Verity R, Okell LC, Dorigatti I, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis 2020;20:669-77. DOI:

O’Neill D, Briggs R, Holmerová I, et al.COVID-19 highlights the need for universal adoption of standards of medical care for physicians in nursing homes in Europe Eur Geriatr Med 2020;11:645-50. DOI:

Original Articles
COVID-19, aging, mortality, Long Term Care Facilities.
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How to Cite
Tramarin , A., Gennaro, N., Dal Grande, G., Bragagnolo, L., Carta, M. R., Giavarina, D., Pascarella, M., Rassu, M., Matteazzi, A., & Stopazzolo, G. (2021). The impact of COVID-19 first wave on long term care facilities of an Italian Province: an historical reference. Geriatric Care, 7(1).