Jordan Mah1, Anthony Lieu1, Mark Palayew1, Pouria Alipour1, Ling Yuan Kong1, Sunny Song1, Adam Palayew1, Marc Antoine Tutt-Guérette1, Stephen Su Yang1, Machelle Wilchesky1, Jed Lipes1, Laurent Azoulay1, Christina Greenaway2. 1. Faculty of Medicine (Mah, Lieu, M. Palayew, Alipour, Kong, Yang, Wilchesky, Lipes, Greenaway), McGill University; Division of Respirology (M. Palayew), Jewish General Hospital, Montréal; Lady Davis Institute for Medical Research (Kong, Song, Tutt-Guérette, Wilchesky, Lipes, Azoulay, Greenaway), Jewish General Hospital; Division of Infectious Diseases (Kong, Greenaway), Jewish General Hospital; Department of Epidemiology and Biostatistics and Occupational Health (A. Palayew, Azoulay, Greenaway), McGill University; Department of Anesthesia (Yang), Jewish General Hospital; Division of Critical Care (Yang, Lipes), Jewish General Hospital; Donald Berman Maimonides Centre for Research in Aging (Wilchesky); Gerald Bronfman Department of Oncology (Azoulay), McGill University, Montréal, Que. 2. Faculty of Medicine (Mah, Lieu, M. Palayew, Alipour, Kong, Yang, Wilchesky, Lipes, Greenaway), McGill University; Division of Respirology (M. Palayew), Jewish General Hospital, Montréal; Lady Davis Institute for Medical Research (Kong, Song, Tutt-Guérette, Wilchesky, Lipes, Azoulay, Greenaway), Jewish General Hospital; Division of Infectious Diseases (Kong, Greenaway), Jewish General Hospital; Department of Epidemiology and Biostatistics and Occupational Health (A. Palayew, Azoulay, Greenaway), McGill University; Department of Anesthesia (Yang), Jewish General Hospital; Division of Critical Care (Yang, Lipes), Jewish General Hospital; Donald Berman Maimonides Centre for Research in Aging (Wilchesky); Gerald Bronfman Department of Oncology (Azoulay), McGill University, Montréal, Que. ca.greenaway@mcgill.ca.
Abstract
BACKGROUND: As in other jurisdictions, the demographics of people infected with SARS-CoV-2 changed in Quebec over the course of the first COVID-19 pandemic wave, and affected those living in residential care facilities (RCFs) disproportionately. We evaluated the association between clinical characteristics and outcomes of hospitalized patients with COVID-19, comparing those did or did not live in RCFs. METHODS: We conducted a retrospective case series of all consecutive adults (≥ 18 yr) admitted to the Jewish General Hospital in Montréal with laboratory-confirmed SARS-CoV-2 infection from Mar. 4 to June 30, 2020, with in-hospital follow-up until Aug. 6, 2020. We collected patient demographics, comorbidities and outcomes (i.e., admission to the intensive care unit, mechanical ventilation and death) from medical and laboratory records and compared patients who did or did not live in public and private RCFs. We evaluated factors associated with the risk of in-hospital death with a Cox proportional hazard model. RESULTS: In total, 656 patients were hospitalized between March and June 2020, including 303 patients who lived in RCFs and 353 patients who did not. The mean age was 72.9 (standard deviation 18.3) years (range 21 to 106 yr); 349 (53.2%) were female and 118 (18.0%) were admitted to the intensive care unit. The overall mortality rate was 23.8% (156/656), but was higher among patients living in RCFs (36.6% [111/303]) compared with those not living in RCFs (12.7% [45/353]). Increased risk of death was associated with age 80 years and older (hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.35-4.24), male sex (HR 1.74, 95% CI 1.25-2.41), the presence of 4 or more comorbidities (HR 2.01, 95% CI 1.18-3.42) and living in an RCF (HR 1.62, 95% CI 1.09-2.39). INTERPRETATION: During the first wave of the COVID-19 epidemic in Montréal, more than one-third of RCF residents hospitalized with SARS-CoV-2 infection died during hospitalization. Policies and practices that prevent future outbreaks of SARS-CoV-2 infection in this setting must be implemented to prevent high mortality in this vulnerable population.
BACKGROUND: As in other jurisdictions, the demographics of peopleinfected with SARS-CoV-2 changed in Quebec over the course of the first COVID-19 pandemic wave, and affected those living in residential care facilities (RCFs) disproportionately. We evaluated the association between clinical characteristics and outcomes of hospitalized patients with COVID-19, comparing those did or did not live in RCFs. METHODS: We conducted a retrospective case series of all consecutive adults (≥ 18 yr) admitted to the Jewish General Hospital in Montréal with laboratory-confirmed SARS-CoV-2 infection from Mar. 4 to June 30, 2020, with in-hospital follow-up until Aug. 6, 2020. We collected patient demographics, comorbidities and outcomes (i.e., admission to the intensive care unit, mechanical ventilation and death) from medical and laboratory records and compared patients who did or did not live in public and private RCFs. We evaluated factors associated with the risk of in-hospital death with a Cox proportional hazard model. RESULTS: In total, 656 patients were hospitalized between March and June 2020, including 303 patients who lived in RCFs and 353 patients who did not. The mean age was 72.9 (standard deviation 18.3) years (range 21 to 106 yr); 349 (53.2%) were female and 118 (18.0%) were admitted to the intensive care unit. The overall mortality rate was 23.8% (156/656), but was higher among patients living in RCFs (36.6% [111/303]) compared with those not living in RCFs (12.7% [45/353]). Increased risk of death was associated with age 80 years and older (hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.35-4.24), male sex (HR 1.74, 95% CI 1.25-2.41), the presence of 4 or more comorbidities (HR 2.01, 95% CI 1.18-3.42) and living in an RCF (HR 1.62, 95% CI 1.09-2.39). INTERPRETATION: During the first wave of the COVID-19 epidemic in Montréal, more than one-third of RCF residents hospitalized with SARS-CoV-2 infectiondied during hospitalization. Policies and practices that prevent future outbreaks of SARS-CoV-2 infection in this setting must be implemented to prevent high mortality in this vulnerable population.
Authors: Ilyse Darwish; Luke B Harrison; Ana Maria Passos-Castilho; Annie-Claude Labbé; Sapha Barkati; Me-Linh Luong; Ling Yuan Kong; Marc-Antoine Tutt-Guérette; James Kierans; Cécile Rousseau; Andrea Benedetti; Laurent Azoulay; Christina Greenaway Journal: PLoS One Date: 2022-08-24 Impact factor: 3.752