Article ; Online: Predictors of infection, symptoms development, and mortality in people with SARS-CoV-2 living in retirement nursing homes.
PloS one
2021 Volume 16, Issue 3, Page(s) e0248009
Abstract: ... a retrospective study enrolling all people living in retirement nursing homes (PLRNH), where at least one SARS-CoV-2 ... of the people with SARS-CoV-2 infection developed symptoms. Chronic obstructive pulmonary disease and ... and death in a setting with high mortality such as retirement nursing homes, that should be carefully ...
| Abstract | Introduction: Since the start of the pandemic, millions of people have been infected, with thousands of deaths. Many foci worldwide have been identified in retirement nursing homes, with a high number of deaths. Our study aims were to evaluate the spread of SARS-CoV-2 in the retirement nursing homes, the predictors to develop symptoms, and death. Methods and findings: We conducted a retrospective study enrolling all people living in retirement nursing homes (PLRNH), where at least one SARS-CoV-2 infected person was present. Medical and clinical data were collected. Variables were compared with Student's t-test or Pearson chi-square test as appropriate. Uni- and multivariate analyses were conducted to evaluate variables' influence on infection and symptoms development. Cox proportional-hazards model was used to evaluate 30 days mortality predictors, considering death as the dependent variable. We enrolled 382 subjects. The mean age was 81.15±10.97 years, and males were 140(36.7%). At the multivariate analysis, mental disorders, malignancies, and angiotensin II receptor blockers were predictors of SARS-CoV-2 infection while having a neurological syndrome was associated with a lower risk. Only half of the people with SARS-CoV-2 infection developed symptoms. Chronic obstructive pulmonary disease and neurological syndrome were correlated with an increased risk of developing SARS-CoV-2 related symptoms. Fifty-six (21.2%) people with SARS-CoV-2 infection died; of these, 53 died in the first 30 days after the swab's positivity. Significant factors associated with 30-days mortality were male gender, hypokinetic disease, and the presence of fever and dyspnea. Patients' autonomy and early heparin treatment were related to lower mortality risk. Conclusions: We evidenced factors associated with infection's risk and death in a setting with high mortality such as retirement nursing homes, that should be carefully considered in the management of PLRNH. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Angiotensin Receptor Antagonists/administration & dosage ; COVID-19/complications ; COVID-19/mortality ; COVID-19/pathology ; COVID-19/virology ; Dyspnea/etiology ; Female ; Fever/etiology ; Heparin, Low-Molecular-Weight/therapeutic use ; Humans ; Male ; Mental Disorders/complications ; Mental Disorders/pathology ; Neoplasms/complications ; Neoplasms/pathology ; Nursing Homes ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; SARS-CoV-2/isolation & purification ; Sex Factors ; Survival Rate |
| Chemical Substances | Angiotensin Receptor Antagonists ; Heparin, Low-Molecular-Weight |
| Language | English |
| Publishing date | 2021-03-16 |
| Publishing country | United States |
| Document type | Journal Article |
| ISSN | 1932-6203 |
| ISSN (online) | 1932-6203 |
| DOI | 10.1371/journal.pone.0248009 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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