Risk factors for developing symptomatic COVID-19 in older residents of nursing homes: A hypothesis-generating observational study

  1. Anna Escribà-Salvans
  2. Sandra Rierola-Fochs
  3. Pau Farrés-Godayol
  4. Miriam Molas-Tuneu
  5. Dyego Leandro Bezerra de Souza
  6. Dawn A Skelton
  7. Ester Goutan-Roura
  8. Daniel Alonso Masmitjà
  9. Eduard Minobes-Molina
  10. Javier Jerez-Roig

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

Background

COVID-19 pandemic has had a major impact on society, including on residents of nursing homes (NH), who have a higher risk of complications and mortality due their physical and intellectual disabilities.

Aim

To identify which risk factors associated with developing COVID-19 infection with symptoms in institutionalized older people.

Methods

A 1-year longitudinal multicenter study was conducted in 5 NH during the period December 2019 to March 2021. The inclusion criteria used were residents aged 65 years or over, living in the NH permanently, with a diagnostic test for COVID-19 confirmed by reverse transcription polymerase chain reaction and/or serological test. The main variable was symptomatic COVID-19, with at least one of the following symptoms (fever, respiratory difficulties, cough, diarrhea, sudden urinary incontinence and disorientation or delirium). Three assessments were performed: baseline, six and twelve months follow-up. Descriptive and bivariate analysis (calculating relative risk-RR) were performed, considering a 95% confidence level and a statistically significant p <0.05.

Results

Of the total sample of 78 individuals who tested positive for COVID-19, mean age 84.6 years (SD=±7.8), 62 (79.5%) were female; 40 (51.3%) participants presented with COVID-19 symptoms. Living in a private NH (RR=3.6, 95% CI [1.2–11.0], p =0.023) and having suffered a stroke (RR=4.1, 95% CI [1.1–14.7], p =0.033) were positively associated with developing COVID-19 infection with symptoms.

Conclusions

Having suffered a stroke and living permanently in a private health care facility were positively associated with symptomatic COVID-19 in this sample of institutionalized older people.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2022.01.18.22269433: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Consent and ethical approval: Ethical permission was obtained by the Ethics and Research Committee of the University of Vic - Central University of Catalonia (registration number 92/2019 and 109/2020).
    IRB: Consent and ethical approval: Ethical permission was obtained by the Ethics and Research Committee of the University of Vic - Central University of Catalonia (registration number 92/2019 and 109/2020).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were analyzed with SPSS version 27 (SPSS Inc.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The main limitation of this study is the small sample size; nevertheless, the pandemic outbreak in March 2020 marked the end of the baseline NHs data collection. In addition, we are uncertain about the accuracy of serologic testing in persons with mild or no symptoms37, but this study was based on the tools used in the NHs and the existing literature at the time. In terms of implications for clinical practice, it is important to screen institutionalized older adults who suffered a stroke since they are at increased risk for symptomatic COVID-19 in order to provide early care. Now we know more about COVID-19 and its impact on NHs, social and health services should improve and tailor contingency plans to prevent the spread of infectious diseases in NHs to protect the most vulnerable and frail population segment of our society. Special attention to address environmental factors such as inadequate infrastructure, poorly ventilated environment, high occupancy and low staffing is required.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04297904SuspendedUrinary Incontinence and Sedentary Behaviour in Nursing Home…

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.01.18.22269433v1 on medRxiv