Article ; Online: Signs, Symptoms, and Comorbidities Associated With Onset and Prognosis of COVID-19 in a Nursing Home.
Journal of the American Medical Directors Association
2021 Volume 22, Issue 3, Page(s) 498–503
Abstract: ... Our findings reinforce the critical role that monitoring of signs and symptoms can have in identifying COVID-19 ... March 16, 2020. Records were abstracted for comorbidities, signs and symptoms, and illness outcomes ... and oxygen saturation and consider ensuring common signs and symptoms identified in Facility A are ...
| Abstract | Background: Effective halting of outbreaks in skilled nursing facilities (SNFs) depends on the earliest recognition of cases. We assessed confirmed COVID-19 cases at an SNF impacted by COVID-19 in the United States to identify early indications of COVID-19 infection. Methods: We performed retrospective reviews of electronic health records for residents with laboratory-confirmed SARS-CoV-2 during February 28-March 16, 2020. Records were abstracted for comorbidities, signs and symptoms, and illness outcomes during the 2 weeks before and after the date of positive specimen collection. Relative risks (RRs) of hospitalization and death were calculated. Results: Of the 118 residents tested among approximately 130 residents from Facility A during February 28-March 16, 2020, 101 (86%) were found to test positive for SARS-CoV-2. At initial presentation, about two-thirds of SARS-CoV-2-positive residents had an abnormal vital sign or change in oxygen status. Most (90.2%) symptomatic residents had elevated temperature, change in mental status, lethargy, change in oxygen status, or cough; 9 (11.0%) did not have fever, cough, or shortness of breath during their clinical course. Those with change in oxygen status had an increased relative risk (RR) of 30-day mortality [51.1% vs 29.7%, RR 1.7, 95% confidence interval (CI) 1.0-3.0]. RR of hospitalization was higher for residents with underlying hepatic disease (1.6, 95% CI 1.1-2.2) or obesity (1.5, 95% CI 1.1-2.1); RR of death was not statistically significant. Conclusions and implications: Our findings reinforce the critical role that monitoring of signs and symptoms can have in identifying COVID-19 cases early. SNFs should ensure they have a systematic approach for responding to abnormal vital signs and oxygen saturation and consider ensuring common signs and symptoms identified in Facility A are among those they monitor. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; COVID-19/diagnosis ; COVID-19/physiopathology ; COVID-19 Testing/methods ; Comorbidity ; Female ; Humans ; Male ; Medical Records ; Middle Aged ; Prognosis ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; Skilled Nursing Facilities ; United States | |||||
| Language | English | |||||
| Publishing date | 2021-01-28 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2171030-2 | |||||
| ISSN | 1538-9375 ; 1525-8610 | |||||
| ISSN (online) | 1538-9375 | |||||
| ISSN | 1525-8610 | |||||
| DOI | 10.1016/j.jamda.2021.01.070 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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