Mauriz Elba, Fernández-Vázquez José P, Díez-Flecha Cristina, Reguero-Celada Sofía, Fernández-Villa Tania, Fernández-Somoano Ana, Caylà Joan A, Lozano-García Jesús A, Vázquez-Casares Ana M, Martín-Sánchez Vicente
ALINS, Food Nutrition and Safety Group, ICTAL Universidad de León, 24007 Leon, Spain.
Department of Nursing and Physiotherapy, Campus de Vegazana, Universidad de León, s/n, 24071 Leon, Spain.
Vaccines (Basel). 2023 Aug 19;11(8):1382. doi: 10.3390/vaccines11081382.
Elderly care home residents are particularly vulnerable to COVID-19 due to immune-senescence, pre-existing medical conditions, and the risk of transmission from staff and visitors. This study aimed to describe the outcomes of a COVID-19 outbreak in a long-term care facility for elderly persons following the initial vaccination. A single-center, retrospective, observational design was used to analyze the variables associated with hospitalization and death rate by logistic regression. Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated. Sixty-eight residents received the first dose of the COVID-19 vaccine. Despite being negative six days after vaccination, the performance of a second test 4 days later revealed 51 positives (75.0%) among residents and 18 among workers (56.3%). A total of 65 of the 68 residents (95.58%) had positive results with symptoms, whereas 34.9% required hospitalization, and 25.8% died. The best-fitting model to explain the distribution of cases reflects three points at the time of infection.. The time from vaccination to symptom onset explains the hospitalization and mortality rates since a day elapsed halves the risk of hospitalization (aOR = 0.57; CI = 0.38-0.75) and the risk of death by a quarter (aOR = 0.74; CI = 0.63-0.88). Nursing homes present an elevated risk of transmission and severity of SARS-CoV-2 infection. Although vaccination reduces the risk of hospitalization and death, extreme prevention and control measures are essential in these institutions despite the high vaccination coverage.
由于免疫衰老、既往存在的医疗状况以及工作人员和访客传播的风险,养老院居民特别容易感染新冠病毒。本研究旨在描述一家老年人长期护理机构在首次接种疫苗后新冠病毒爆发的结果。采用单中心、回顾性、观察性设计,通过逻辑回归分析与住院率和死亡率相关的变量。计算调整后的优势比(aOR)及其95%置信区间(CI)。68名居民接种了第一剂新冠疫苗。尽管接种疫苗6天后检测结果为阴性,但4天后再次检测发现居民中有51人呈阳性(75.0%),工作人员中有18人呈阳性(56.3%)。68名居民中共有65人(95.58%)出现症状且检测结果呈阳性,其中34.9%需要住院治疗,25.8%死亡。解释病例分布的最佳拟合模型反映了感染时的三个时间点。从接种疫苗到出现症状的时间可以解释住院率和死亡率,因为每过一天,住院风险减半(aOR = 0.57;CI = 0.38 - 0.75),死亡风险降低四分之一(aOR = 0.74;CI = 0.63 - 0.88)。养老院存在较高的新冠病毒传播风险和感染严重程度。尽管接种疫苗可降低住院和死亡风险,但尽管疫苗接种覆盖率很高,这些机构仍必须采取极端的防控措施。