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30/07/2021

A study on the behaviour of Covid-19 in nursing homes shows that some comorbidities and symptoms have a strong predictive value for mortality

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30/07/2021

The research conducted by the Vall d'Hebron University Hospital in cooperation with the Catalan Association of Care Resources (ACRA) analyses the effects of Covid-19 in Catalan residential centres.

Vall d'Hebron in cooperation with the Catalan Association of Care Resources (ACRA) has published the largest study in Europe on the behaviour of Covid-19 in the residential setting in the journal PLOS One. The study focuses on users of residential care homes who lived with the virus between 1 March and 31 May 2020. The research took place during the first wave of the pandemic in Spain and analysed 2,092 Covid-19-positive people from 80 residential centres for dependent elderly people.The paper shows that nursing home users are a vulnerable group for Covid-19 given the high rates of infection and mortality. Covid-19 had an incidence of 28% during the period analysed and mortality figures were very high. In this regard, the study "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255141 Clinical characteristics of COVID19 in older adults. A retrospectives study in long-term nursing homes in Catalonia", led by Dr. Benito Almirante, head of Infectious Diseases at Vall d'Hebron University Hospital and head of the Infectious Diseases Research Group at Vall d'Hebron Research Institute (VHIR), with the participation of nine other researchers, reveals that the cumulative mortality during the research period was 21.75%.The data also show that among the group of people who contracted the disease, 71% showed symptoms while the remaining 29% contracted the virus asymptomatically or asymptomatically. The most common symptoms were fever (50%) and dyspnoea (28%), which are even higher if only residents with symptoms are analysed, at 71% and 40% respectively. In addition, a large proportion of patients presented simultaneously with up to three of the five most common symptoms: fever, dyspnoea, dry cough, asthenia and diarrhoea.On the other hand, the document mentions the case of some comorbidities of high value in predicting mortality. This is the case of dementia, for which patients with Covid-19 who present a clinical picture with dyspnoea, fever, delirium and refuse oral intake have a low probability of survival. Likewise, cardiovascular pathologies or COPD, which in other cases are good predictors, are not determinant in the case of Covid-19.The symptoms, according to the paper, had a different persistence depending on the case. However, the cases presented were mostly acute and lasted about nine days. Another issue is that the size of the spaces where the people in the sample resided was not directly related to the number of cases that were recorded.These data were collected on the basis of a detailed questionnaire that was distributed among the residences of the ACRA group, which represent around 10% of the residences for the elderly in Catalonia."During the first wave of the pandemic, the incidence and mortality of Covid-19 in people living in nursing homes was very high. Most patients had symptoms compatible with the infection. From the results of this study we can draw knowledge applicable to the clinical management and prevention of infection in these institutions," says Dr Almirante.

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