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, nursing home, Infection, Comorbidities, Gender, outcome, risk factor, Dementia, Cohort, Health, COVID-19 infection, male, Long-term care, Case fatality rate, Clustering, death, Community, age, incidence, PCR test, chronic condition, Evidence, risk of infection, facility, chronic, evidence of, Older, Factor, Participants, higher risk, Clinical data, PCR positive, cross-sectional analysis, positive PCR test, Fatality rate, complex interplay, clinical factors, Result, affected, carried, was performed, functional, condition, were recorded, clinical factor, 【제목키워드】 cross-sectional, infection risk, Care, Factor,