SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes

Source avec lien : Journal of Infection, 81(3), 9/1/2020. 10.1016/j.jinf.2020.05.073

Objectifs Comprendre l’infection et la transmission du SRAS-Co-V-2 dans les maisons de retraite britanniques afin de développer des stratégies préventives pour protéger les résidents âgés fragiles. Méthodes Une enquête sur l’épidémie, impliquant 394 résidents et 70 employés, a été menée dans 4 maisons de retraite touchées par des épidémies de COVID-19 dans le centre de Londres. Deux enquêtes de prévalence ponctuelle ont été réalisées à une semaine d’intervalle, au cours desquelles les résidents ont subi un test de dépistage du SRAS-CoV-2 et ont présenté des symptômes pertinents. Le personnel asymptomatique de trois des quatre maisons a également été soumis à un test de dépistage du CoV-2.

Objectives To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents. Methods An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing. Results Overall, 26% (95% CI 22–31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70–336) compared with previous years. Systematic testing identified 40% (95% CI 35–46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34–52) were asymptomatic and 18% (95% CI 11–24) had only atypical symptoms; 4% (95% CI −1 to 9) of asymptomatic staff also tested positive. Conclusions The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or had no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.

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