Center for Comprehensive Care on Memory Disorders, Kanazawa Medical University, Uchinada, Japan.
Geriatr Gerontol Int. 2020 Jul;20(7):715-719. doi: 10.1111/ggi.13973.
To clarify the association of cluster number and size of coronavirus disease 2019 (COVID-19) in long-term care (LTC) hospitals/facilities, general medical/welfare facilities and non-medical/welfare facilities with morbidity and mortality in 47 prefectures during 16 January to 9 May 2020 in Japan.
Information on COVID-19 clusters (n ≥2), and morbidity and mortality of COVID-19 was collected.
A total of 381 clusters with 3786 infected cases were collected, accounting for 23.9% of 15 852 cumulated cases on 9 May 2020. Although the cluster number (/10 subjects) in LTC hospitals/facilities was significantly smaller compared with those in the other two groups, the cluster size in LTC hospitals/facilities was significantly larger than that in non-medical/welfare facilities. Cluster numbers in general medical/welfare facilities and in non-medical/welfare facilities were significantly positively correlated with morbidity (/10 ), indicating relatively early identification of clusters in these facilities. Unlike in these facilities, cluster size in LTC hospitals/facilities was significantly positively correlated with morbidity, indicating that clusters in LTC hospitals/facilities were finally identified after already having grown to a large size in areas where infection was prevalent. Multivariate logistic regression analysis showed that both cluster number and cluster size only in LTC hospitals/facilities were independently associated with higher mortality (≥median 0.64/10 subjects) after adjustment.
Preventive efforts against COVID-19 outbreaks even at the early phase of the epidemic are critically important in LTC hospitals/facilities, as both the larger number and size of clusters only in LTC hospitals/facilities were independently linked to higher mortality in prefectures in Japan. Geriatr Gerontol Int 2020; 20: 715-719.
明确 2020 年 1 月 16 日至 5 月 9 日期间，日本 47 个都道府县长期护理（LTC）医院/设施、综合医疗/福利设施和非医疗/福利设施中 COVID-19 聚集病例数量和规模与发病率和死亡率的关系。
收集 COVID-19 聚集病例（n≥2）以及 COVID-19 发病率和死亡率的信息。
共收集到 381 个聚集病例，共 3786 例感染，占 2020 年 5 月 9 日累计病例的 23.9%。虽然 LTC 医院/设施中的聚集病例数（/10 例）明显少于其他两组，但 LTC 医院/设施中的聚集规模明显大于非医疗/福利设施。综合医疗/福利设施和非医疗/福利设施的聚集病例数与发病率（/10 例）呈显著正相关，表明这些设施中聚集病例的发现相对较早。与这些设施不同的是，LTC 医院/设施的聚集规模与发病率呈显著正相关，表明 LTC 医院/设施的聚集病例在感染流行地区已发展到较大规模后才被最终确认。多变量逻辑回归分析表明，仅在 LTC 医院/设施中聚集病例数和规模与调整后的死亡率（≥中位数 0.64/10 例）升高独立相关。
即使在疫情早期，对 LTC 医院/设施中 COVID-19 爆发的预防工作也至关重要，因为仅在 LTC 医院/设施中聚集病例数量和规模与日本各都道府县的死亡率升高独立相关。
老年医学与老年病学杂志 2020；20：715-719。
