Department of Anaesthesiology and Intensive Care, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Department of Orthopedics, Linköping University Hospital, Linköping, Sweden.
Prim Health Care Res Dev. 2022 Nov 18;23:e75. doi: 10.1017/S1463423622000640.
Older and frail individuals are at high risk of dying from COVID-19, and residents in nursing homes (NHs) are overrepresented in death rates. We explored four different periods during the COVID-19 pandemic to analyze the effects of improved preventive routines and vaccinations, respectively, on mortality in NHs.
We undertook a population-based systematic retrospective chart review comprising 136 NH facilities in southeast Sweden. All residents, among these facilities, who died within 30 days after a laboratory-verified COVID-19 diagnosis during four separate 92-day periods representing early pandemic (second quarter 2020), middle of the pandemic (fourth quarter 2020), early post-vaccination phase (first quarter 2021), and the following post-vaccination phase (second quarter 2021). Mortality together with electronic chart data on demographic variables, comorbidity, frailty, and cause of death was collected.
The number of deaths during the four periods was 104, 120, 34 and 4, respectively, with a significant reduction in the two post-vaccination periods ( < 0.001). COVID-19 was assessed as the dominant cause of death in 20 (19%), 19 (16%), 4 (12%) and 1 (3%) residents in each period ( < 0.01). The respective median age in the four studied periods varied between 87and 89 years, and three or more diagnoses besides COVID-19 were present in 70-90% of the respective periods' study population. Considerable or severe frailty was found in all residents.
Vaccination against COVID-19 seems associated with a reduced number of deaths in NHs. We could not demonstrate an effect on mortality merely from the protective routines that were undertaken.
年老体弱的人感染 COVID-19 后死亡的风险较高，而疗养院（NHs）的居民在死亡率方面的比例过高。我们探讨了 COVID-19 大流行期间的四个不同时期，分别分析了改进的预防措施和疫苗接种对 NH 死亡率的影响。
我们进行了一项基于人群的系统回顾性图表审查，涵盖了瑞典东南部的 136 个 NH 设施。在四个不同的 92 天期间内，对每个设施中在实验室确诊 COVID-19 后 30 天内死亡的所有居民进行了分析，这四个时期分别代表大流行早期（2020 年第二季度）、大流行中期（2020 年第四季度）、疫苗接种早期阶段（2021 年第一季度）和随后的疫苗接种阶段（2021 年第二季度）。收集了死亡率以及人口统计学变量、合并症、虚弱和死亡原因的电子图表数据。
四个时期的死亡人数分别为 104、120、34 和 4，两个疫苗接种后时期的死亡率显著降低（<0.001）。在每个时期，COVID-19 被评估为 20（19%）、19（16%）、4（12%）和 1（3%）居民的主要死亡原因（<0.01）。四个研究期的中位年龄分别在 87 至 89 岁之间，70-90%的研究人群除 COVID-19 外还有三个或更多的诊断。所有居民都有相当程度或严重的虚弱。
接种 COVID-19 疫苗似乎与 NH 中死亡人数减少有关。我们无法证明仅仅通过采取的保护措施就能对死亡率产生影响。
