Background Covid-19 pandemic has particularly affected older people living in Long-term Care settings in terms of infection and mortality. Methods We carried out a cross-sectional analysis within a cohort of Long-term care nursing home residents between March first and June thirty, 2020, who were ≥ 65 years old and on whom at least one PCR test was performed. Socio-demographic, comorbidities, and clinical data were recorded. Facility size and community incidence of SARS-CoV-2 were also considered. The outcomes of interest were infection (PCR positive) and death. Results A total of 8021 residents were included from 168 facilities. Mean age was 86.4 years (SD = 7.4). Women represented 74.1%. SARS-CoV-2 infection was detected in 27.7% of participants, and the overall case fatality rate was 11.3% (24.9% among those with a positive PCR test). Epidemiological factors related to risk of infection were larger facility size (pooled aOR 1.73; P < .001), higher community incidence (pooled aOR 1.67, P = .04), leading to a higher risk than the clinical factor of low level of functional dependence (aOR 1.22, P = .03). Epidemiological risk factors associated with mortality were male gender (aOR 1.75; P < .001), age (pooled aOR 1.16; P < .001), and higher community incidence (pooled aOR 1.19, P = < 0.001) whereas clinical factors were low level of functional dependence (aOR 2.42, P < .001), Complex Chronic Condition (aOR 1.29, P < .001) and dementia (aOR 1.33, P <0.001). There was evidence of clustering for facility and health area when considering the risk of infection and mortality ( P < .001). Conclusions Our results suggest a complex interplay between structural and individual factors regarding Covid-19 infection and its impact on mortality in nursing-home residents.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, Epidemiology, Long-term care nursing homes, 【초록키워드】 pandemic, SARS-COV-2 infection, Infection, Comorbidities, Gender, outcome, risk factor, Dementia, Cohort, Health, male, Long-term care, Clustering, death, Community, age, incidence, PCR test, Evidence, risk of infection, facility, chronic, Older, Factor, Participants, higher risk, Clinical data, PCR positive, cross-sectional analysis, positive PCR test, Fatality rate, complex interplay, Result, affected, carried, was performed, functional, condition, were recorded, clinical factor, 【제목키워드】 cross-sectional, Cohort, infection risk, Care, Factor,