Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 10;18(16):8434.
doi: 10.3390/ijerph18168434.

Risk Factors Associated with Nursing Home COVID-19 Outbreaks: A Retrospective Cohort Study

Lucia Cazzoletti  1 , Maria Elisabetta Zanolin  1 , Ilaria Tocco Tussardi  1 , Mulubirhan Assefa Alemayohu  1 , Ernesto Zanetel  1 , Donatella Visentin  1 , Luca Fabbri  2 , Massimo Giordani  3 , Giancarlo Ruscitti  4 , Pier Paolo Benetollo  2 , Stefano Tardivo  1 , Emanuele Torri  4
Affiliations

Risk Factors Associated with Nursing Home COVID-19 Outbreaks: A Retrospective Cohort Study

Lucia Cazzoletti et al. Int J Environ Res Public Health. .

Erratum in

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic had a devastating impact on nursing homes/long-term care facilities. This study examined the relationship between geography, size, design, organizational characteristics, and implementation of infection prevention and control (IPC) measures and the extent of COVID-19 outbreaks in nursing homes in the Autonomous Province of Trento (Italy) during the time frame of March-May 2020.

Methods: The analysis included 57 nursing homes (5145 beds). The association between median cumulative incidence of COVID-19 cases among residents and characteristics of nursing homes was assessed by Mann-Whitney U test, Kruskal-Wallis test or Spearman rho. To evaluate the potential confounding of geographical area, a 2-level random intercept logistic model was fitted, with level 1 units (patients in nursing homes) nested into level 2 units (nursing homes), and "being a COVID-19 case" as the dependent variable.

Results: Median cumulative incidence was not significantly associated with any of the variables, except for geographical region (p = 0.002). COVID-19 cases clustered in the part of the province bordering the Italian region most affected by the pandemic (Lombardy) (45.2% median cumulative incidence).

Conclusions: Structural/organizational factors and standard IPC measures may not predict the epidemiology of COVID-19 outbreaks and be sufficient alone to protect nursing homes against them.

Keywords: COVID-19; Italy; epidemic risk; infection prevention and control; long-term care; nursing home; outbreak.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Geographical areas of the Province of Trento, Italy, and their aggregation according to South, West, North and East.
Figure 2
Figure 2
Percentage of LTC homes implementing infection control measures by presence of at least one COVID-19 confirmed case.
Figure 3
Figure 3
Percentage of LTC homes with official documents/guidelines by presence of at least one COVID-19 confirmed case.
See this image and copyright information in PMC

References

    1. Shi S.M., Bakaev I., Chen H., Travison T.G., Berry S.D. Risk Factors, Presentation, and Course of Coronavirus Disease 2019 in a Large, Academic Long-Term Care Facility. J. Am. Med. Dir. Assoc. 2020;2:1378–1383. doi: 10.1016/j.jamda.2020.08.027. - DOI - PMC - PubMed
    1. Thompson D.C., Barbu M.G., Beiu C., Popa L.G., Mihai M.M., Berteanu M., Popescu M.N. The Impact of COVID-19 Pandemic on Long-Term Care Facilities Worldwide: An Overview on International Issues. BioMed Res. Int. 2020;2020:8870249. doi: 10.1155/2020/8870249. - DOI - PMC - PubMed
    1. Hashan M.R., Smoll N., King C., Ockenden-Muldoon A., Walker J., Wattiaux A., Graham J., Booy R., Khandaker G. Epidemiology and clinical features of COVID-19 outbreaks in aged care facilities: A systematic review and meta-analysis. E Clin. Med. 2021;33:100771. - PMC - PubMed
    1. European Centre for Disease Prevention and Control (ECDC) Surveillance of COVID-19 in Long-Term Care Facilities in the EU/EEA. ECDC; Stockholm, Sweden: May 19, 2020. [(accessed on 20 May 2021)]. Available online: https://www.ecdc.europa.eu/en/publications-data/surveillance-COVID-19-lo....
    1. Cassone M., Mody L. Measuring the outsized impact of COVID-19 in the evolving setting of aged care facilities. E Clin. Med. 2021;34:100825. - PMC - PubMed