The impact of COVID-19 first wave on long term care facilities of an Italian Province: an historical reference


Submitted: 1 February 2021
Accepted: 9 March 2021
Published: 24 March 2021
Abstract Views: 2732
PDF: 292
HTML: 4
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

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.


RedZone Online. Coronavirus in Italia, 110.574 casi positivi e 13.155 morti. Il bollettino del 1° Aprile; Corriere della Sera. Available from: https://www.corriere.it/salute/malattie_infettive/20_aprile_01/coronavirus-italia-110574-casi-positivi-13155-morti-bollettino-1-aprile-766df6fc-742c-11ea-b181-d5820c4838fa.shtml

Italian Ministry of Health. Epidemia COVID-19; Aggiornamento nazionale (May 2020). Available from: http://www.salute.gov.it/portale/nuovocoronavirus/dettaglioContenuti

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: https://doi.org/10.1016/j.jinf.2020.03.019

Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature 2020;584:430-6. DOI: https://doi.org/10.1038/s41586-020-2521-4

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: https://doi.org/10.1016/S0140-6736(20)30211-7

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: https://doi.org/10.18632/aging.103000

Berloto S, Notarnicola E, Perobelli E, Rotolo A. Italy and the COVID-19 long-term care situation. Last updated: 22 April 2020. Available from: https://ltccovid.org/wp-content/uploads/2020/04/LTC-COVID19-situation-in-Italy-22-April-2020.pdf

Center for Diseases Control and Prevention. Principle of epidemiology in public health practice; Lesson 6: Investigating an outbreak. Available from: https://www.cdc.gov/csels/dsepd/ss1978/lesson6/section2.html

Società Italiana di Geriatria e Gerontologia. Quando si diventa anziani. Available from: https://www.sigg.it/wp-content/uploads/2018/12/News_Quando-si-diventa-anziani.pdf

World Health Organization (WHO). Clinical management of COVID-19: interim guidance, 27 May 2020. Available from: https://apps.who.int/iris/handle/10665/332196

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: https://doi.org/10.1111/irv.12464

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: https://doi.org/10.1186/s13756-019-0591-6

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: https://doi.org/10.15585/mmwr.mm6912e1

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: https://doi.org/10.1056/NEJMoa2008457

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: https://doi.org/10.15585/mmwr.mm6914e2

Comas-Herrera A, Zalakaín J, Lemmon E, et al. Mortality associated with COVID-19 in care homes: international evidence. Article in LTCcovid.org, International Long-Term Care Policy Network, CPEC-LSE, 2020. Last updated: 1st February 2021. Available from: https://ltccovid.org/2020/04/12/mortality-associated-with-covid-19-outbreaks-in-care-homes-early-international-evidence/

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: https://www.cbc.ca/news/health/coronavirus-canada-long-term-care-deaths-study-1.5626751

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: https://doi.org/10.1016/S1473-3099(20)30243-7

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: https://doi.org/10.1007/s41999-020-00347-6

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). https://doi.org/10.4081/gc.2021.9654

Downloads

Download data is not yet available.

Citations