SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes
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Date
2020Author
Graham, N.S.N.
Junghans, C.
Downes, R.
Sendall, C.
Lai, H.
McKirdy, A.
Elliott, P.
Howard, R.
Wingfield, D.
Priestman, M.
Ciechonska, M.
Cameron, L.
Storch, M.
Crone, M.A.
Freemontl, P.S.
Randell, P.
McLaren, R.
Lang, N.
Ladhani, S.
Sanderson, F.
Sharp, D.J.
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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 22–31) of residents died over the two-month period. All-cause mortality
increased by 203% (95% CI 70–336) compared with previous years. Systematic testing identified 40% (95%
CI 35–46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34–52) were asymptomatic
and 18% (95% CI 11–24) 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 had 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.
Palabras clave
Coronavirus; COVID-19; SARS-CoV-2; Nursing home; Care home; Diagnostic testingLink to resource
https://doi.org/10.1016/j.jinf.2020.05.073Collections
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