Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid

Objectives: To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020. Design: This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care...

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Autores: Bielza Galindo, Rafael, Zambrana Tevar, Francisco, Arias Muñana, Estefanía, Malmierca Corral, Eduardo, Portillo Horcajada, Laura, Thuissard Vasallo, Israel John, Andreu Vázquez, Cristina, López López, José Manuel, Esteban Ortega, María del Mar, Vaquero Pérez, María Antonia, Gómez Cerezo, Jorge Francisco, Et al.
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Europea (UEM)
Repositorio:ABACUS. Repositorio de Producción Científica
Idioma:inglés
OAI Identifier:oai:abacus.universidadeuropea.com:11268/9896
Acceso en línea:http://hdl.handle.net/11268/9896
Access Level:acceso abierto
Palabra clave:Infecciones por Coronavirus
Virología
Enfermedad transmisible
Gerontología
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spelling Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of MadridBielza Galindo, RafaelZambrana Tevar, FranciscoArias Muñana, EstefaníaMalmierca Corral, EduardoPortillo Horcajada, LauraThuissard Vasallo, Israel JohnAndreu Vázquez, CristinaLópez López, José ManuelEsteban Ortega, María del MarVaquero Pérez, María AntoniaGómez Cerezo, Jorge FranciscoEt al.Infecciones por CoronavirusVirologíaEnfermedad transmisibleGerontologíaObjectives: To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020. Design: This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care of older people living in NHs from the hospital. Setting and participants: A total of 630 patients aged 70 and older with Coronavirus Disease 2019 COVID-19 living in 55 NHs. Methods: A logistic regression was performed to analyze the factors associated with mortality. In addition, Kaplan-Meier curves were applied according to mortality and its associated factors using the log-rank Mantel-Cox test. Results: The diagnosis of COVID-19 was mainly made by clinical compatibility (N = 430). Median age was 87 years, 64.6% were women and 45.9% were transferred to be cared for at the hospital. A total of 282 patients died (44.7%) within the 30 days of first attention by the team. A severe form of COVID-19 occurred in 473 patients, and the most frequent symptoms were dyspnea (n = 332) and altered level of consciousness (n = 301). According to multiple logistic regression, male sex (P = .019), the Clinical Frailty Score (CFS) ≥6 (P = .004), dementia (P = .012), dyspnea (P < .001), and having a severe form of COVID-19 (P = .001), were associated with mortality, whereas age and care setting were not. Conclusions and implications: Mortality of the residents living in NHs with COVID-19 was almost 45%. The altered level of consciousness as an atypical presentation of COVID-19 should be considered in this population. A severe form of the disease, present in more than three-quarters of patients, was associated with mortality, apart from the male sex, CFS ≥6, dementia, and dyspnea, whereas age and care setting were not. These findings may also help to recognize patients in which the Advance Care Planning process is especially urgent to assist in the decisions about their care.20212021-03-0920212021-01-0120212021-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articlehttp://hdl.handle.net/11268/9896reponame:ABACUS. Repositorio de Producción Científicainstname:Universidad Europea (UEM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:abacus.universidadeuropea.com:11268/98962026-06-11T12:41:27Z
dc.title.none.fl_str_mv Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
title Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
spellingShingle Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
Bielza Galindo, Rafael
Infecciones por Coronavirus
Virología
Enfermedad transmisible
Gerontología
title_short Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
title_full Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
title_fullStr Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
title_full_unstemmed Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
title_sort Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
dc.creator.none.fl_str_mv Bielza Galindo, Rafael
Zambrana Tevar, Francisco
Arias Muñana, Estefanía
Malmierca Corral, Eduardo
Portillo Horcajada, Laura
Thuissard Vasallo, Israel John
Andreu Vázquez, Cristina
López López, José Manuel
Esteban Ortega, María del Mar
Vaquero Pérez, María Antonia
Gómez Cerezo, Jorge Francisco
Et al.
author Bielza Galindo, Rafael
author_facet Bielza Galindo, Rafael
Zambrana Tevar, Francisco
Arias Muñana, Estefanía
Malmierca Corral, Eduardo
Portillo Horcajada, Laura
Thuissard Vasallo, Israel John
Andreu Vázquez, Cristina
López López, José Manuel
Esteban Ortega, María del Mar
Vaquero Pérez, María Antonia
Gómez Cerezo, Jorge Francisco
Et al.
author_role author
author2 Zambrana Tevar, Francisco
Arias Muñana, Estefanía
Malmierca Corral, Eduardo
Portillo Horcajada, Laura
Thuissard Vasallo, Israel John
Andreu Vázquez, Cristina
López López, José Manuel
Esteban Ortega, María del Mar
Vaquero Pérez, María Antonia
Gómez Cerezo, Jorge Francisco
Et al.
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Infecciones por Coronavirus
Virología
Enfermedad transmisible
Gerontología
topic Infecciones por Coronavirus
Virología
Enfermedad transmisible
Gerontología
description Objectives: To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020. Design: This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care of older people living in NHs from the hospital. Setting and participants: A total of 630 patients aged 70 and older with Coronavirus Disease 2019 COVID-19 living in 55 NHs. Methods: A logistic regression was performed to analyze the factors associated with mortality. In addition, Kaplan-Meier curves were applied according to mortality and its associated factors using the log-rank Mantel-Cox test. Results: The diagnosis of COVID-19 was mainly made by clinical compatibility (N = 430). Median age was 87 years, 64.6% were women and 45.9% were transferred to be cared for at the hospital. A total of 282 patients died (44.7%) within the 30 days of first attention by the team. A severe form of COVID-19 occurred in 473 patients, and the most frequent symptoms were dyspnea (n = 332) and altered level of consciousness (n = 301). According to multiple logistic regression, male sex (P = .019), the Clinical Frailty Score (CFS) ≥6 (P = .004), dementia (P = .012), dyspnea (P < .001), and having a severe form of COVID-19 (P = .001), were associated with mortality, whereas age and care setting were not. Conclusions and implications: Mortality of the residents living in NHs with COVID-19 was almost 45%. The altered level of consciousness as an atypical presentation of COVID-19 should be considered in this population. A severe form of the disease, present in more than three-quarters of patients, was associated with mortality, apart from the male sex, CFS ≥6, dementia, and dyspnea, whereas age and care setting were not. These findings may also help to recognize patients in which the Advance Care Planning process is especially urgent to assist in the decisions about their care.
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-03-09
2021
2021-01-01
2021
2021-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/11268/9896
url http://hdl.handle.net/11268/9896
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:ABACUS. Repositorio de Producción Científica
instname:Universidad Europea (UEM)
instname_str Universidad Europea (UEM)
reponame_str ABACUS. Repositorio de Producción Científica
collection ABACUS. Repositorio de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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