Short- and Long-Term Mortality and Mortality Risk Factors among Nursing Home Patients after COVID-19 Infection

OBJECTIVE: To assess short- and long-term mortality and risk factors in nursing home patients with COVID-19 infection. DESIGN: Retrospective 2-center cohort study. SETTING AND PARTICIPANTS: Dutch nursing home patients with clinically suspected COVID-19 infection confirmed by reverse transcription-po...

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Detalles Bibliográficos
Autores principales: Booij, Johannes A., van de Haterd, Julie C.H.Q., Huttjes, Sanne N., van Deijck, Rogier H.P.D., Koopmans, Raymond T.C.M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AMDA - The Society for Post-Acute and Long-Term Care Medicine. 2022
Materias:
Brief Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9212799/
https://www.ncbi.nlm.nih.gov/pubmed/35809633
http://dx.doi.org/10.1016/j.jamda.2022.06.005
Descripción
Sumario:OBJECTIVE: To assess short- and long-term mortality and risk factors in nursing home patients with COVID-19 infection. DESIGN: Retrospective 2-center cohort study. SETTING AND PARTICIPANTS: Dutch nursing home patients with clinically suspected COVID-19 infection confirmed by reverse transcription-polymerase chain reaction testing. METHODS: Data were gathered between March 2020 and November 2020 using electronic medical records, including demographic characteristics, comorbidities, medical management, and symptoms on the first day of suspected COVID-19 infection. Mortality at 30 days and 6 months was assessed using multivariate logistic regression models and Kaplan-Meier analysis. At 6 months, a subgroup analysis was performed to estimate the mortality risk between COVID-negative patients and patients who survived COVID-19. Risk factors for mortality were assessed through multivariate logistic regression models. RESULTS: A total of 321 patients with suspected COVID-19 infection were included, of whom 134 tested positive. Sixty-two patients in the positive group died at 30 days, with a short-term mortality rate of 2.9 (95% CI 1.7–5.3). Risk factors were fatigue (OR 2.6, 95% CI 1.3–6.2) and deoxygenation (OR 2.9, 95% CI 1.3–7.6). At 6 months, the mortality risk was 2.1 (95% CI 1.3–3.7). Risk factors for 6-month mortality were shortness of breath (OR 2.7, 95% CI 1.3–7.0), deoxygenation (OR 2.5, 95% CI 1.1–6.5) and medical management (OR 4.5, 95% CI 1.7–25.8). However, among patients who survived COVID-19 infection, the long-term mortality risk was not sustained (OR 1.0, 95% CI 0.4–2.7). CONCLUSIONS AND IMPLICATIONS: Overall, COVID-19 infection increases short- and long-term mortality risk among nursing home patients. However, this study shows that surviving COVID-19 infection does not lead to increased mortality in the long term within this population. Therefore, advanced care planning should focus on quality of life among nursing home patients after COVID-19 infection.

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