During the first wave of the pandemic, the risk of death from COVID-19 in long-term care facilities and nursing homes in the northern part of the country was 48% higher than outside these institutions.
The information results from a study by the Instituto de Saúde Pública da Universidade do Porto (ISPUP), with data referring to the period between April and June of 2020, when the first wave of the COVID-19 pandemic was experienced in Portugal.
The research, published in the Journal of the American Geriatrics Society, sought to assess the infection transmission and its lethality among residents and long-term care facility workers in the Northern region.
Data was collected on age, diagnosis, and prognosis of infection in 247 long-term care facilities in the northern region of the country, totalling 13,376 individuals, of whom 7642 were residents and 6094 were workers.
Increased risk of infection
During the period analysed, 3% of the individuals assessed were infected with the new SARS-CoV-2 coronavirus.
3.5% of the elderly residents in long-term care facilities tested positive for the virus, while 2.4% of the workers in these facilities were infected.
The average age of the residents was 85 years, and the average age of the workers was 46 years. Therefore, considering their age distribution, the residents had an increased risk of infection of 37% compared to the general population. The workers presented double the risk of infection.
48% higher case fatality rate in nursing homes
In addition to the infection rate being higher among long-term care facility residents and workers, the case fatality rate of COVID-19 was found to be 48% higher in residents of these institutions when compared to the general population, taking into account their age distribution.
One fifth of the infected elderly residents eventually died of COVID-19, while no deaths were observed among the workers assessed.
Reasons for the high mortality
According to researcher Teresa Leão, first author of the study, “the high mortality among residents may be explained by the severe and varied comorbidities of the population living in long-term care facilities, but also by the management of the virus in these structures at an early stage of the pandemic.”
Similarly, the increased risk of infection observed, especially in some structures, may be linked to the living and working conditions in these types of facilities, typically of higher occupancy, and the lack of workers adequatelly skilled in infection control and proper personal protective equipment. Furthermore, in this period, testing for SARS-CoV-2 was more frequently conducted in nursing homes than in the community at large.
The study, developed under the Epidemiology Research Unit (EPIUnit) of ISPUP, is entitled COVID-19 transmission and case fatality in long-term care facilities during the epidemic first wave.
ISPUP researchers Milton Severo and Henrique Barros also participated in the article.
