COVID-19 Risk Factors Amongst 14,786 Care Home Residents: an Observational Longitudinal Analysis Including Daily Community Positive Test Rates of COVID-19, Hospital Stays and Vaccination Status in Wales (UK) Between 1 September 2020 and 1 May 2021

Overview

Journal Age Ageing

Publisher Oxford University Press

Specialty Geriatrics

Date 2022 May 5

PMID 35511729

Authors

Joe Hollinghurst

Robyn Hollinghurst

Laura North

Amy Mizen

Ashley Akbari

Sara Long

Ronan A Lyons

Rich Fry

Affiliations

Soon will be listed here.

Abstract

Background: COVID-19 vaccinations have been prioritised for high risk individuals.

Aim: Determine individual-level risk factors for care home residents testing positive for SARS-CoV-2.

Study Design: Longitudinal observational cohort study using individual-level linked data from the Secure Anonymised Information Linkage (SAIL) databank.

Setting: Fourteen thousand seven hundred and eighty-six older care home residents (aged 65+) living in Wales between 1 September 2020 and 1 May 2021. Our dataset consisted of 2,613,341 individual-level daily observations within 697 care homes.

Methods: We estimated odds ratios (ORs [95% confidence interval]) using multilevel logistic regression models. Our outcome of interest was a positive SARS-CoV-2 PCR test. We included time-dependent covariates for the estimated community positive test rate of COVID-19, hospital inpatient status, vaccination status and frailty. Additional covariates were included for age, sex and specialist care home services.

Results: The multivariable regression model indicated an increase in age (OR 1.01 [1.00,1.01] per year), community positive test rate (OR 1.13 [1.12,1.13] per percent increase), hospital inpatients (OR 7.40 [6.54,8.36]), and residents in care homes with non-specialist dementia care (OR 1.42 [1.01,1.99]) had an increased odds of a positive test. Having a positive test prior to the observation period (OR 0.58 [0.49,0.68]) and either one or two doses of a vaccine (0.21 [0.17,0.25] and 0.05 [0.02,0.09], respectively) were associated with a decreased odds.

Conclusions: Care providers need to remain vigilant despite the vaccination rollout, and extra precautions should be taken when caring for the most vulnerable. Minimising potential COVID-19 infection for care home residents when admitted to hospital should be prioritised.

Citing Articles

Analysis of the impact of COVID-19 on Scotland's care-homes from March 2020 to October 2021: national linked data cohort analysis.

Burton J, McMinn M, Vaughan J, Nightingale G, Fleuriot J, Guthrie B Age Ageing. 2024; 53(2).

PMID: 38342752 PMC: 10859243. DOI: 10.1093/ageing/afae015.

The impact of dementia, frailty and care home characteristics on SARS-CoV-2 incidence in a national cohort of Welsh care home residents during a period of high community prevalence.

Emmerson C, Hollinghurst J, North L, Fry R, Akbari A, Humphreys C Age Ageing. 2022; 51(12).

PMID: 36469089 PMC: 9721242. DOI: 10.1093/ageing/afac250.

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