Service de gériatrie à orientation cardiovasculaire et neuropsychogériatrique, Hôpital Charles Foix, Ivry-sur-Seine, France; Sorbonne Université, Paris, France.
Santé Publique France, the National Public Health Institute, Saint-Maurice, France.
J Am Med Dir Assoc. 2021 Jun;22(6):1142-1145. doi: 10.1016/j.jamda.2021.03.013. Epub 2021 Mar 20.
The Coronavirus 2019 (COVID-19) pandemic caused a considerable mortality in long-term care facilities (LTCFs), including residential care setting and nursing homes. This study aimed to estimate COVID-19 incidence and mortality in residential care facilities and to compare them with those recorded in nursing homes.
Nationwide observational study conducted by French health authorities.
Since March 1, 2020, all LTCFs in France reported all COVID-19 cases and COVID-19-related deaths among their residents.
Possible cases were those with COVID-19-related symptoms without laboratory confirmation and confirmed cases those with a reverse transcriptase polymerase chain reaction test or serology positive for SARS-CoV-2. We included facilities with at least 1 confirmed case of COVID-19 and estimated the cumulative incidence of COVID-19 cases and mortality due to COVID-19 reported until June 30, 2020, using the maximum bed capacity as a denominator.
Of the 2288 residential care facilities, 310 (14%) and, of the 7688 nursing homes, 3110 (40%) reported COVID-19 cases among residents (P < .001). The cumulative incidence of COVID-19 was significantly lower in residential care facilities as compared with nursing homes (1.10 vs 9.97 per 100 beds, P < .001). Mortality due to COVID-19 was also lower in residential care facilities compared with nursing homes (0.07 vs 1.29 per 100 beds, P < .001). Case fatality was lower in residential care facilities (6.49% vs 12.93%, P < .001).
French residential care facilities experienced a much lower burden from COVID-19 than nursing homes. Our findings may inform the implementation of better infection control practices in these settings.
2019 年冠状病毒病（COVID-19）大流行导致长期护理机构（LTCF）中大量死亡，包括住宅护理环境和养老院。本研究旨在估计住宅护理设施中的 COVID-19 发病率和死亡率，并将其与养老院记录的数据进行比较。
法国卫生当局进行的全国性观察研究。
自 2020 年 3 月 1 日起，法国所有 LTCF 报告了所有居民的 COVID-19 病例和 COVID-19 相关死亡病例。
可能的病例是指具有 COVID-19 相关症状但无实验室确诊的病例，确诊病例是指逆转录酶聚合酶链反应检测或 SARS-CoV-2 血清学阳性的病例。我们纳入了至少有 1 例 COVID-19 确诊病例的设施，并使用最大床位容量作为分母，估计截至 2020 年 6 月 30 日报告的 COVID-19 病例的累积发病率和 COVID-19 死亡率。
在 2288 家住宅护理机构中，有 310 家（14%）和在 7688 家养老院中，有 3110 家（40%）报告了居民中的 COVID-19 病例（P<.001）。与养老院相比，住宅护理机构的 COVID-19 累积发病率显著较低（每 100 张床位 1.10 与 9.97，P<.001）。与养老院相比，住宅护理机构的 COVID-19 死亡率也较低（每 100 张床位 0.07 与 1.29，P<.001）。住宅护理机构的病例病死率较低（6.49%与 12.93%，P<.001）。
法国住宅护理机构受到的 COVID-19 影响远低于养老院。我们的发现可能为这些机构实施更好的感染控制措施提供信息。
