New death risks noted in nursing home residents with COVID-19


Older age, male sex, and physical and cognitive impairments were linked to higher death rates from any cause in 5,256 residents at 351 US nursing homes, according to a study published today in JAMA Internal Medicine.

Led by researchers at Brown University, the cohort study involved mining the electronic health records, daily infection logs, and minimum data sets of resident assessments from a large chain of nursing homes in 25 states from Mar 16 to Sep 15, 2020. By 30 days after their first positive COVID-19 test result, 1,129 of the 5,256 residents (21%) had died from any cause.

Looking beyond age, underlying illnesses

Residents aged 80 to 84 years were 1.46 times more likely to die by 30 days than those aged 75 to 79, while those aged 85 to 90 were 1.59 more likely and those 90 and older were 2.14 more likely.

Signs and symptoms that increased the chances of death included fever (odds ratio [OR], 1.66), shortness of breath (OR, 2.52), abnormally fast heartbeat (OR, 1.31), and low oxygen levels (OR, 2.05). However, relatively few residents had symptoms, with 50% having fever, 19% having low oxygen levels, 17% having a rapid heartbeat, and 11% having shortness of breath.

Compared with residents with unimpaired cognition, those with moderate cognitive impairment were 2.09 times more likely to die, and those with severe impairment were 2.79 times more likely. Similarly, residents with moderate physical impairment were 1.49 times more likely to die than those with no or limited impairment, and those with severe physical limitations were 1.64 times more likely.

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