Rajlic Gordana, Sorensen Janice M, Mithani Akber
Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, BC, Canada.
Gerontol Geriatr Med. 2024 Oct 23;10:23337214241291739. doi: 10.1177/23337214241291739. eCollection 2024 Jan-Dec.
The most adverse outcomes of the COVID-19 pandemic include high post-infection mortality among long-term care (LTC) home residents. Research about mortality over a longer period after contracting COVID-19 and in different pandemic years is limited. In the current study, we examined outcomes for 1,596 LTC residents from the day of a positive COVID-19 test until January 31, 2023. We reported all-cause mortality 30 days after contracting COVID-19 and monthly throughout the follow-up, up to 35 months after the pandemic start. We also examined mortality among 2,724 residents residing in the same LTC homes, with no history of COVID-19 during the same period. The results underscored a large number of deaths in the first month post-infection, with 30-day mortality substantially decreasing over the years-from 28% (95% CI [24.3, 31.8]) among residents contracting COVID-19 in 2020, to 8.3% (95% CI [7.4, 9.2]) in the 2022 cohort. Observed over longer periods, monthly mortality among residents with a COVID-19 history was similar to mortality in the No-COVID residents, and no evidence was found of increased mortality risk in the COVID group beyond the first post-infection month. We discuss mortality in LTC during the pandemic and a continuing need to reduce mortality in the acute phase of COVID-19.
新冠疫情最不利的后果包括长期护理（LTC）机构居民感染后的高死亡率。关于感染新冠病毒后较长时期以及不同疫情年份死亡率的研究有限。在本研究中，我们对1596名长期护理机构居民进行了调查，从新冠病毒检测呈阳性之日起至2023年1月31日。我们报告了感染新冠病毒30天后的全因死亡率，并在整个随访期间每月报告一次，直至疫情开始后35个月。我们还调查了同一长期护理机构中2724名同期无新冠病毒感染史居民的死亡率。结果显示，感染后的第一个月死亡人数众多，多年来30天死亡率大幅下降——从2020年感染新冠病毒的居民中的28%（95%置信区间[24.3, 31.8]）降至2022年队列中的8.3%（95%置信区间[7.4, 9.2]）。在更长时间段内观察发现，有新冠病毒感染史居民的月死亡率与无新冠病毒感染居民的死亡率相似，且未发现新冠病毒感染组在感染后第一个月之后存在死亡风险增加的证据。我们讨论了疫情期间长期护理机构中的死亡率以及持续降低新冠病毒感染急性期死亡率的必要性。
