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Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study

BACKGROUND: The epidemiology of SARS-CoV-2 infection in retirement homes (also known as assisted living facilities) is largely unknown. We examined the association between home-and community-level characteristics and the risk of outbreaks of SARS-CoV-2 infection in retirement homes since the beginni...

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Autores principales: Costa, Andrew P., Manis, Derek R., Jones, Aaron, Stall, Nathan M., Brown, Kevin A., Boscart, Veronique, Castellino, Adriane, Heckman, George A., Hillmer, Michael P., Ma, Chloe, Pham, Paul, Rais, Saad, Sinha, Samir K., Poss, Jeffrey W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: CMA Joule Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158001/
https://www.ncbi.nlm.nih.gov/pubmed/33972220
http://dx.doi.org/10.1503/cmaj.202756
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author Costa, Andrew P.
Manis, Derek R.
Jones, Aaron
Stall, Nathan M.
Brown, Kevin A.
Boscart, Veronique
Castellino, Adriane
Heckman, George A.
Hillmer, Michael P.
Ma, Chloe
Pham, Paul
Rais, Saad
Sinha, Samir K.
Poss, Jeffrey W.
author_facet Costa, Andrew P.
Manis, Derek R.
Jones, Aaron
Stall, Nathan M.
Brown, Kevin A.
Boscart, Veronique
Castellino, Adriane
Heckman, George A.
Hillmer, Michael P.
Ma, Chloe
Pham, Paul
Rais, Saad
Sinha, Samir K.
Poss, Jeffrey W.
author_sort Costa, Andrew P.
collection PubMed
description BACKGROUND: The epidemiology of SARS-CoV-2 infection in retirement homes (also known as assisted living facilities) is largely unknown. We examined the association between home-and community-level characteristics and the risk of outbreaks of SARS-CoV-2 infection in retirement homes since the beginning of the first wave of the COVID-19 pandemic. METHODS: We conducted a population-based, retrospective cohort study of licensed retirement homes in Ontario, Canada, from Mar. 1 to Dec. 18, 2020. Our primary outcome was an outbreak of SARS-CoV-2 infection (≥ 1 resident or staff case confirmed by validated nucleic acid amplification assay). We used time-dependent proportional hazards methods to model the associations between retirement home– and community-level characteristics and outbreaks of SARS-CoV-2 infection. RESULTS: Our cohort included all 770 licensed retirement homes in Ontario, which housed 56 491 residents. There were 273 (35.5%) retirement homes with 1 or more outbreaks of SARS-CoV-2 infection, involving 1944 (3.5%) residents and 1101 staff (3.0%). Cases of SARS-CoV-2 infection were distributed unevenly across retirement homes, with 2487 (81.7%) resident and staff cases occurring in 77 (10%) homes. The adjusted hazard of an outbreak of SARS-CoV-2 infection in a retirement home was positively associated with homes that had a large resident capacity, were co-located with a long-term care facility, were part of larger chains, offered many services onsite, saw increases in regional incidence of SARS-CoV-2 infection, and were located in a region with a higher community-level ethnic concentration. INTERPRETATION: Readily identifiable characteristics of retirement homes are independently associated with outbreaks of SARS-CoV-2 infection and can support risk identification and priority for vaccination.
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spelling pubmed-81580012021-05-27 Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study Costa, Andrew P. Manis, Derek R. Jones, Aaron Stall, Nathan M. Brown, Kevin A. Boscart, Veronique Castellino, Adriane Heckman, George A. Hillmer, Michael P. Ma, Chloe Pham, Paul Rais, Saad Sinha, Samir K. Poss, Jeffrey W. CMAJ Research BACKGROUND: The epidemiology of SARS-CoV-2 infection in retirement homes (also known as assisted living facilities) is largely unknown. We examined the association between home-and community-level characteristics and the risk of outbreaks of SARS-CoV-2 infection in retirement homes since the beginning of the first wave of the COVID-19 pandemic. METHODS: We conducted a population-based, retrospective cohort study of licensed retirement homes in Ontario, Canada, from Mar. 1 to Dec. 18, 2020. Our primary outcome was an outbreak of SARS-CoV-2 infection (≥ 1 resident or staff case confirmed by validated nucleic acid amplification assay). We used time-dependent proportional hazards methods to model the associations between retirement home– and community-level characteristics and outbreaks of SARS-CoV-2 infection. RESULTS: Our cohort included all 770 licensed retirement homes in Ontario, which housed 56 491 residents. There were 273 (35.5%) retirement homes with 1 or more outbreaks of SARS-CoV-2 infection, involving 1944 (3.5%) residents and 1101 staff (3.0%). Cases of SARS-CoV-2 infection were distributed unevenly across retirement homes, with 2487 (81.7%) resident and staff cases occurring in 77 (10%) homes. The adjusted hazard of an outbreak of SARS-CoV-2 infection in a retirement home was positively associated with homes that had a large resident capacity, were co-located with a long-term care facility, were part of larger chains, offered many services onsite, saw increases in regional incidence of SARS-CoV-2 infection, and were located in a region with a higher community-level ethnic concentration. INTERPRETATION: Readily identifiable characteristics of retirement homes are independently associated with outbreaks of SARS-CoV-2 infection and can support risk identification and priority for vaccination. CMA Joule Inc. 2021-05-10 /pmc/articles/PMC8158001/ /pubmed/33972220 http://dx.doi.org/10.1503/cmaj.202756 Text en © 2021 CMA Joule Inc. or its licensors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Research
Costa, Andrew P.
Manis, Derek R.
Jones, Aaron
Stall, Nathan M.
Brown, Kevin A.
Boscart, Veronique
Castellino, Adriane
Heckman, George A.
Hillmer, Michael P.
Ma, Chloe
Pham, Paul
Rais, Saad
Sinha, Samir K.
Poss, Jeffrey W.
Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study
title Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study
title_full Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study
title_fullStr Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study
title_full_unstemmed Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study
title_short Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study
title_sort risk factors for outbreaks of sars-cov-2 infection at retirement homes in ontario, canada: a population-level cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158001/
https://www.ncbi.nlm.nih.gov/pubmed/33972220
http://dx.doi.org/10.1503/cmaj.202756
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