Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brazil.
Braz J Infect Dis. 2024 May-Jun;28(3):103748. doi: 10.1016/j.bjid.2024.103748. Epub 2024 May 4.
The COVID-19 pandemic has disproportionately affected individuals residing in Long-Term Care Facilities (LTCFs), necessitating tailored strategies to manage outbreaks. This study examines the outcomes of the ILPI BH project, a collaborative effort between the Municipal Health Department and the Hospital das Clínicas of the Federal University of Minas Gerais, designed to mitigate COVID-19 spread within LTCFs.
Prospective cohort of secondary data: 1,794 old residents in 99 long-term care facilities of Belo Horizonte, Brazil, were followed from May 2020 to January 2021. The study analyzed the prevention strategies, residents' clinical data, and the characteristics of the long-term care facilities, correlating these variables with the number of infections, hospitalizations, and deaths from COVID-19. It checked absolute numbers and rates of incidence, hospitalization, mortality, and lethality.
There have been 58 COVID-19 outbreaks in long-term care facilities. There were 399 cases among residents, 96 hospitalizations for COVID-19 and 48 deaths from COVID-19 (2.7 % of the cohort), with a case fatality rate of 12 %. After multivariate analysis, the intrinsic variables to residents associated with higher mortality risk were higher degree of frailty (OR=1.08; p = 0.004) and the fact of living in a long-term care facility with a considerable proportion of residents' coverage by health plans (OR = 1.01; p = 0.028). Early geriatric follow-up showed an association with a reduction in the number of hospitalizations due to COVID-19.
The correct classification of the degree of frailty of institutionalized older people seems to have been relevant for predicting mortality from COVID-19. The extensive assistance by private health plans, contrary to what is supposed, did not result in better health protection. Early geriatric follow-up was beneficial and may be an attractive strategy in the face of health emergencies that affect long-term care facilities to reduce hospital admissions.
COVID-19 大流行对长期护理机构（LTCF）中的居民造成了不成比例的影响，因此需要制定专门的策略来管理疫情爆发。本研究考察了 ILPI BH 项目的结果，该项目是市卫生局和米纳斯吉拉斯联邦大学临床医院之间的合作项目，旨在减轻 LTCF 中 COVID-19 的传播。
前瞻性二次数据队列：巴西贝洛奥里藏特的 99 个长期护理机构中的 1794 名老年居民从 2020 年 5 月至 2021 年 1 月进行了随访。该研究分析了预防策略、居民的临床数据以及长期护理机构的特征，并将这些变量与 COVID-19 的感染、住院和死亡人数相关联。它检查了绝对数量和发病率、住院率、死亡率和病死率的发生率。
长期护理机构共发生 58 起 COVID-19 疫情。居民中有 399 例病例，96 例 COVID-19 住院治疗，48 例 COVID-19 死亡（队列的 2.7%），病死率为 12%。多变量分析后，与居民死亡率较高相关的内在变量是较高的虚弱程度（OR=1.08；p=0.004）和居住在长期护理机构的事实，该机构的居民中有相当比例的人通过健康计划覆盖（OR=1.01；p=0.028）。早期老年科随访与因 COVID-19 住院人数减少有关。
正确分类机构化老年人的虚弱程度似乎与预测 COVID-19 死亡率有关。私人健康计划的广泛援助，与人们的设想相反，并没有带来更好的健康保护。早期老年科随访是有益的，在面对影响长期护理机构的卫生紧急情况时，可能是一种减少住院的有吸引力的策略。
