The COVID-19 pandemic caused increased mortality in nursing homes due to its quick spread and the age-related high lethality.
Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests
Cangiano, B., Fatti, L. M., Danesi, L., Gazzano, G., Croci, M., Vitale, G., Gilardini, L., Bonadonna, S., Chiodini, I., Caparello, C. F., Conti, A., Persani, L., Stramba-Badiale, M., & Bonomi, M. (2020). Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests. Aging, 12(24), 24522–24534. https://doi.org/10.18632/aging.202307
Results: We observed two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation, and worse “activities of daily living (ADL)” scores, such as Barthel index, Tinetti scale, and S.OS.I.A. classification.
Conclusion: Our data confirm a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and low sensitivity of the swab test in poorly compliant subjects. Male gender, older age, and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation.
Design: In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.