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Observational Study
. 2022 May 1;51(5):afac084.
doi: 10.1093/ageing/afac084.

COVID-19 risk factors amongst 14,786 care home residents: an observational longitudinal analysis including daily community positive test rates of COVID-19, hospital stays and vaccination status in Wales (UK) between 1 September 2020 and 1 May 2021

Joe Hollinghurst  1 , Robyn Hollinghurst  1 , Laura North  1 , Amy Mizen  1 , Ashley Akbari  1 , Sara Long  1 , Ronan A Lyons  2 , Rich Fry  1
Affiliations
Observational Study

COVID-19 risk factors amongst 14,786 care home residents: an observational longitudinal analysis including daily community positive test rates of COVID-19, hospital stays and vaccination status in Wales (UK) between 1 September 2020 and 1 May 2021

Joe Hollinghurst et al. Age Ageing. .

Abstract

Background: COVID-19 vaccinations have been prioritised for high risk individuals.

Aim: Determine individual-level risk factors for care home residents testing positive for SARS-CoV-2.

Study design: Longitudinal observational cohort study using individual-level linked data from the Secure Anonymised Information Linkage (SAIL) databank.

Setting: Fourteen thousand seven hundred and eighty-six older care home residents (aged 65+) living in Wales between 1 September 2020 and 1 May 2021. Our dataset consisted of 2,613,341 individual-level daily observations within 697 care homes.

Methods: We estimated odds ratios (ORs [95% confidence interval]) using multilevel logistic regression models. Our outcome of interest was a positive SARS-CoV-2 PCR test. We included time-dependent covariates for the estimated community positive test rate of COVID-19, hospital inpatient status, vaccination status and frailty. Additional covariates were included for age, sex and specialist care home services.

Results: The multivariable regression model indicated an increase in age (OR 1.01 [1.00,1.01] per year), community positive test rate (OR 1.13 [1.12,1.13] per percent increase), hospital inpatients (OR 7.40 [6.54,8.36]), and residents in care homes with non-specialist dementia care (OR 1.42 [1.01,1.99]) had an increased odds of a positive test. Having a positive test prior to the observation period (OR 0.58 [0.49,0.68]) and either one or two doses of a vaccine (0.21 [0.17,0.25] and 0.05 [0.02,0.09], respectively) were associated with a decreased odds.

Conclusions: Care providers need to remain vigilant despite the vaccination rollout, and extra precautions should be taken when caring for the most vulnerable. Minimising potential COVID-19 infection for care home residents when admitted to hospital should be prioritised.

Keywords: COVID-19; PCR tests; care homes; hospital infection; older people; vaccination.

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Figures

Figure 1
Figure 1
Flow diagram for the number of observations, individuals and care homes in the study.
Figure 2
Figure 2
Daily estimated community positive test rate of COVID-19 (top left), positive test rate of care home residents (top right), number of tests taken for care home residents (bottom left), and the number of positive tests for care home residents (bottom right). For privacy protection the daily total of care home residents with positive tests has been masked (removed) where there were less than five positive tests on a particular date.
See this image and copyright information in PMC

References

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    1. Public Health Wales . Vaccination Priority List - Wales. Wales (United Kingdom). 2020. Available from:https://phw.nhs.wales/topics/immunisation-and-vaccines/covid-19-vaccinat... (cited 1 February 2021).

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