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. 2021 Sep 11;50(5):1473-1481.
doi: 10.1093/ageing/afab098.

Magnitude, change over time, demographic characteristics and geographic distribution of excess deaths among nursing home residents during the first wave of COVID-19 in France: a nationwide cohort study

Florence Canouï-Poitrine  1   2 , Antoine Rachas  3 , Martine Thomas  3 , Laure Carcaillon-Bentata  4 , Roméo Fontaine  5 , Gaëtan Gavazzi  6   7 , Marie Laurent  1   8 , Jean-Marie Robine  5   9   10   11
Affiliations

Magnitude, change over time, demographic characteristics and geographic distribution of excess deaths among nursing home residents during the first wave of COVID-19 in France: a nationwide cohort study

Florence Canouï-Poitrine et al. Age Ageing. .

Abstract

Background: The objectives were to assess the excess deaths among Nursing Home (NH) residents during the first wave of the COVID-19 pandemic, to determine their part in the total excess deaths and whether there was a mortality displacement.

Methods: We studied a cohort of 494,753 adults in 6,515 NHs in France exposed to COVID-19 pandemic (from 1 March to 31 May 2020) and compared with the 2014-2019 cohorts using data from the French National Health Data System. The main outcome was death. Excess deaths and standardized mortality ratios (SMRs) were estimated.

Result: There were 13,505 excess deaths. Mortality increased by 43% (SMR: 1.43). The mortality excess was higher among males than females (SMR: 1.51 and 1.38) and decreased with increasing age (SMRs in females: 1.61 in the 60-74 age group, 1.58 for 75-84, 1.41 for 85-94 and 1.31 for 95 or over; males: SMRs: 1.59 for 60-74, 1.69 for 75-84, 1.47 for 85-94 and 1.41 for 95 or over). No mortality displacement effect was observed up until 30 August 2020. By extrapolating to all NH residents nationally (N = 570,003), we estimated that they accounted for 51% of the general population excess deaths (N = 15,114 out of 29,563).

Conclusion: NH residents accounted for half of the total excess deaths in France during the first wave of the COVID-19 pandemic. The excess death rate was higher among males than females and among younger than older residents.

Keywords: COVID-19; excess deaths; nursing home; older adults.

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Figures

Figure 1
Figure 1
The weekly observed and expected deaths (A), mortality rates (B), weekly excess death (C) and standardized mortality ratios (D).
Figure 2
Figure 2
The weekly standardized mortality ratio in females aged 60–74 (A), 75–84(B), 85–94(C), and 95 or over (D).
Figure 3
Figure 3
Standardized mortality ratios per level of territorial unit (defined according to the Nomenclature of Territorial Unit for Statistics).
See this image and copyright information in PMC

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