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Observational Study
. 2021 Jun;22(6):1142-1145.
doi: 10.1016/j.jamda.2021.03.013. Epub 2021 Mar 20.

Coronavirus Disease 2019 in French Residential Care Facilities: A Nationwide Study

Joël Belmin  1 , Scarlett Georges  2 , Florian Franke  2 , Come Daniau  2 , Amandine Cochet  2 , Cécile Durand  2 , Ursula Noury  2 , Maria Eugênia Gomes do Espirito Santo  2 , Laure Fonteneau  2 , Sylvie Pariel  3 , Carmelo Lafuente-Lafuente  4 , Kostas Danis  2
Affiliations
Observational Study

Coronavirus Disease 2019 in French Residential Care Facilities: A Nationwide Study

Joël Belmin et al. J Am Med Dir Assoc. 2021 Jun.

Abstract

Objectives: The Coronavirus 2019 (COVID-19) pandemic caused a considerable mortality in long-term care facilities (LTCFs), including residential care setting and nursing homes. This study aimed to estimate COVID-19 incidence and mortality in residential care facilities and to compare them with those recorded in nursing homes.

Design: Nationwide observational study conducted by French health authorities.

Settings and participants: Since March 1, 2020, all LTCFs in France reported all COVID-19 cases and COVID-19-related deaths among their residents.

Methods: Possible cases were those with COVID-19-related symptoms without laboratory confirmation and confirmed cases those with a reverse transcriptase polymerase chain reaction test or serology positive for SARS-CoV-2. We included facilities with at least 1 confirmed case of COVID-19 and estimated the cumulative incidence of COVID-19 cases and mortality due to COVID-19 reported until June 30, 2020, using the maximum bed capacity as a denominator.

Results: Of the 2288 residential care facilities, 310 (14%) and, of the 7688 nursing homes, 3110 (40%) reported COVID-19 cases among residents (P < .001). The cumulative incidence of COVID-19 was significantly lower in residential care facilities as compared with nursing homes (1.10 vs 9.97 per 100 beds, P < .001). Mortality due to COVID-19 was also lower in residential care facilities compared with nursing homes (0.07 vs 1.29 per 100 beds, P < .001). Case fatality was lower in residential care facilities (6.49% vs 12.93%, P < .001).

Conclusion and implications: French residential care facilities experienced a much lower burden from COVID-19 than nursing homes. Our findings may inform the implementation of better infection control practices in these settings.

Keywords: COVID-19; Long-term care facilities; case-fatality ratio; mortality; nursing homes; residential care.

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Figures

Fig. 1
Fig. 1
Cumulative incidence of nonfatal and fatal cases of COVID-19 among the residents of French long-term care facilities, by type of facility and regional level of COVID-19 incidence. The differences in incidence between residential care facilities (RCFs) and nursing homes (NHs) were significant in each type of regions.
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