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Multicenter Study
. 2020 Oct 27;15(10):e0241030.
doi: 10.1371/journal.pone.0241030. eCollection 2020.

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn

Marta Mas Romero  1 , Almudena Avendaño Céspedes  1   2 , María Teresa Tabernero Sahuquillo  1 , Elisa Belén Cortés Zamora  1 , Cristina Gómez Ballesteros  1 , Victoria Sánchez-Flor Alfaro  1 , Rita López Bru  1 , Melisa López Utiel  1 , Sara Celaya Cifuentes  1 , Luz María Peña Longobardo  3 , Antonio Murillo Romero  4 , Laura Plaza Carmona  1 , Borja Gil García  1 , Ana Pérez Fernández-Rius  1 , Rubén Alcantud Córcoles  1 , Belén Roldán García  1 , Luis Romero Rizos  1   2 , Pedro Manuel Sánchez Jurado  1   2 , Matilde León Ortiz  1 , Pilar Atienzar Núñez  1 , Alicia Noguerón García  1 , María Fe Ruiz García  5 , Rafael García Molina  1 , Juan de Dios Estrella Cazalla  1   2   5 , Juan Oliva Moreno  3 , Pedro Abizanda  1   2
Affiliations
Multicenter Study

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn

Marta Mas Romero et al. PLoS One. .

Abstract

Background/objectives: To analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain.

Design: Epidemiological study.

Setting: Six open LTCFs in Albacete (Spain).

Participants: 198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents.

Measurements: Baseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed.

Results: The pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals.

Conclusion: The COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Timeline showing long-term care facilities outbreak in Albacete.
PCR: Polymerase Chain Reaction. LTCF: Long-term care facilities. SESCAM: Healthcare Service of Castilla-La Mancha region. BOE: Boletín Oficial del Estado (Spanish Government bulletin for Laws).
See this image and copyright information in PMC

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