Biagio Cangiano1,2,3, Letizia Maria Fatti1, Leila Danesi1, Giacomo Gazzano4, Marina Croci1, Giovanni Vitale1,3,5, Luisa Gilardini1, Stefania Bonadonna1, Iacopo Chiodini1,2, Chiara Francesca Caparello6, Antonio Conti1, Luca Persani1,2,3, Marco Stramba-Badiale7, Marco Bonomi1,2,3. 1. IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy. 2. IRCCS Istituto Auxologico Italiano, Laboratory of Endocrine and Metabolic Diseases, Cusano Milanino, Italy. 3. Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy. 4. IRCCS Istituto Auxologico Italiano, Anatomic Pathology Unit, Milan, Italy. 5. IRCCS Istituto Auxologico Italiano, Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Milan, Italy. 6. IRCCS Istituto Auxologico Italiano, Gastroenterology and Digestive Endoscopy, Milan, Italy. 7. IRCCS Istituto Auxologico Italiano, Department of Geriatrics and Cardiovascular Medicine, Milan, Italy.
Abstract
INTRODUCTION: The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality. RESULTS: We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse "activities of daily living (ADL)" scores, such as Barthel index, Tinetti scale and S.OS.I.A. CONCLUSION: Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation. DESIGN: In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.
INTRODUCTION: The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality. RESULTS: We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse "activities of daily living (ADL)" scores, such as Barthel index, Tinetti scale and S.OS.I.A. CONCLUSION: Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation. DESIGN: In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.
Entities:
Keywords:
COVID-19; activities of daily living; hydroxychloroquine; nasopharyngeal swab; sensitivity and specificity; serology
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