Paap Kelly C, van Loon Anouk M, van Rijs Sarian M, Helmich Esther, Buurman Bianca M, Smalbrugge Martin, Hertogh Cees M P M
Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Amsta Healthcare Organisation, Amsterdam, The Netherlands.
Gerontol Geriatr Med. 2021 Nov 11;7:23337214211055338. doi: 10.1177/23337214211055338. eCollection 2021 Jan-Dec.
Nursing homes (NH) residents with COVID-19 can either be tested because of presence of core symptoms (S-based) or because of transmission prevention (TP-based). The investigated study sample included all NH residents who underwent SARS-CoV-2 RT-PCR testing between March 16, 2020 and May 31, 2020 ( = 380). Clinical symptoms, temperature, and oxygen saturation were extracted from medical records, 7 days before to 14 days after testing. COVID-19 was confirmed in 81 (21%) residents; 36 (44%) S-based and 45 (56%) TP-based: 45. Cycle threshold (CT) values did not differ between the groups. In the 7 days prior to the test falling (32%), somnolence (25%) and fatigue (21%) occurred in both groups. Two days before the test, we observed a stronger decrease in oxygen saturation and an increase in temperature for the S-based group compared to the T-based group that remained up to 10 days after testing. Residents within the S-based group were 2.5 times more likely to increased mortality within 30 days than residents in the TP-based group (HR, 2.56; 95% 1.3-5.2). Although, 73% of the T-based group did eventually develop core symptoms. Thus, attention to falling and daily measures of temperature and oxygen saturation can contribute to earlier detection.
患有新冠肺炎的养老院居民接受检测的原因，要么是出现了核心症状（基于症状），要么是为了预防传播（基于预防传播）。所调查的研究样本包括2020年3月16日至2020年5月31日期间接受严重急性呼吸综合征冠状病毒2逆转录聚合酶链反应检测的所有养老院居民（n = 380）。从检测前7天至检测后14天的病历中提取临床症状、体温和血氧饱和度。81名（21%）居民确诊感染新冠肺炎；基于症状的36名（44%），基于预防传播的45名（56%）：45。两组的循环阈值（CT）值没有差异。在检测前7天内，两组均出现嗜睡（32%）、嗜睡（25%）和疲劳（21%）。检测前两天，我们观察到，与基于预防传播的组相比，基于症状的组血氧饱和度下降更明显，体温升高，且检测后10天内一直如此。基于症状的组居民在30天内死亡的可能性是基于预防传播组居民的2.5倍（风险比，2.56；95%可信区间1.3 - 5.2）。尽管如此，基于预防传播的组中有73%最终确实出现了核心症状。因此，关注跌倒以及日常测量体温和血氧饱和度有助于早期发现。
