Impact of a COVID-19 Outbreak in an Elderly Care Home after Primary Vaccination

Author:

Mauriz Elba12ORCID,Fernández-Vázquez José P.3,Díez-Flecha Cristina4,Reguero-Celada Sofía5,Fernández-Villa Tania67ORCID,Fernández-Somoano Ana789ORCID,Caylà Joan A.10,Lozano-García Jesús A.11,Vázquez-Casares Ana M.2ORCID,Martín-Sánchez Vicente67ORCID

Affiliation:

1. ALINS, Food Nutrition and Safety Group, ICTAL Universidad de León, 24007 Leon, Spain

2. Department of Nursing and Physiotherapy, Campus de Vegazana, Universidad de León, s/n, 24071 Leon, Spain

3. Health Center Valencia de Don Juan, Primary Health Care Management, 24200 Leon, Spain

4. Primary Health Care Management, 24008 Leon, Spain

5. Health Center San Andrés de Rabanedo, Primary Health Care Management SACYL, 24191 Leon, Spain

6. Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), Universidad de León, 24071 Leon, Spain

7. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain

8. IUOPA–Department of Medicine, University of Oviedo, Julián Clavería Street s/n, 33006 Oviedo, Spain

9. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain

10. Tuberculosis Research Unit Foundation of Barcelona, 08008 Barcelona, Spain

11. MC MUTUAL Group, 24002 Barcelona, Spain

Abstract

Elderly care home residents are particularly vulnerable to COVID-19 due to immune-senescence, pre-existing medical conditions, and the risk of transmission from staff and visitors. This study aimed to describe the outcomes of a COVID-19 outbreak in a long-term care facility for elderly persons following the initial vaccination. A single-center, retrospective, observational design was used to analyze the variables associated with hospitalization and death rate by logistic regression. Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated. Sixty-eight residents received the first dose of the COVID-19 vaccine. Despite being negative six days after vaccination, the performance of a second test 4 days later revealed 51 positives (75.0%) among residents and 18 among workers (56.3%). A total of 65 of the 68 residents (95.58%) had positive results with symptoms, whereas 34.9% required hospitalization, and 25.8% died. The best-fitting model to explain the distribution of cases reflects three points at the time of infection.. The time from vaccination to symptom onset explains the hospitalization and mortality rates since a day elapsed halves the risk of hospitalization (aOR = 0.57; CI = 0.38−0.75) and the risk of death by a quarter (aOR = 0.74; CI = 0.63−0.88). Nursing homes present an elevated risk of transmission and severity of SARS-CoV-2 infection. Although vaccination reduces the risk of hospitalization and death, extreme prevention and control measures are essential in these institutions despite the high vaccination coverage.

Publisher

MDPI AG

Subject

Pharmacology (medical),Infectious Diseases,Drug Discovery,Pharmacology,Immunology

Reference40 articles.

1. COVID-19 Outbreak in an Elderly Care Home: Very Low Vaccine Effectiveness and Late Impact of Booster Vaccination Campaign;Hazelhorst;Vaccine,2022

2. European Centre for Disease Prevention and Control (2020). European Surveillance of COVID-19 in Long-Term Care Facilities in the EU/EEA: Aggregate Data Reporting: Surveillance Protocol Version 1.1., Publications Office.

3. (2023, June 15). Long-Term Care Facilities|CDC, Available online: https://www.cdc.gov/longtermcare/index.html.

4. (2023, August 04). COVID-19 y Servicios Sociales. Available online: https://imserso.es/el-imserso/mas-informacion/covid-19-servicios-sociales.

5. Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic;Popovska;Aging Dis.,2023

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