Care-home outbreaks of COVID-19 in Scotland March to May 2020: National linked data cohort analysis.

Autor:	Burton JK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G31 2ER, UK., McMinn M; Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK., Vaughan JE; School of Informatics, University of Edinburgh, Edinburgh EH8 9AB, UK., Fleuriot J; School of Informatics, University of Edinburgh, Edinburgh EH8 9AB, UK., Guthrie B; Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK.; Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh EH8 9AG, UK.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2021 Sep 11; Vol. 50 (5), pp. 1482-1492.
DOI:	10.1093/ageing/afab099
Abstrakt:	Background: understanding care-home outbreaks of COVID-19 is a key public health priority in the ongoing pandemic to help protect vulnerable residents. Objective: to describe all outbreaks of COVID-19 infection in Scottish care-homes for older people between 01/03/2020 and 31/03/2020, with follow-up to 30/06/2020. Design and Setting: National linked data cohort analysis of Scottish care-homes for older people. Methods: data linkage was used to identify outbreaks of COVID-19 in care-homes. Care-home characteristics associated with the presence of an outbreak were examined using logistic regression. Size of outbreaks was modelled using negative binomial regression. Results: 334 (41%) Scottish care-homes for older people experienced an outbreak, with heterogeneity in outbreak size (1-63 cases; median = 6) and duration (1-94 days, median = 31.5 days). Four distinct patterns of outbreak were identified: 'typical' (38% of outbreaks, mean 11.2 cases and 48 days duration), severe (11%, mean 29.7 cases and 60 days), contained (37%, mean 3.5 cases and 13 days) and late-onset (14%, mean 5.4 cases and 17 days). Risk of a COVID-19 outbreak increased with increasing care-home size (for ≥90 beds vs <20, adjusted OR = 55.4, 95% CI 15.0-251.7) and rising community prevalence (OR = 1.2 [1.0-1.4] per 100 cases/100,000 population increase). No routinely available care-home characteristic was associated with outbreak size. Conclusions: reducing community prevalence of COVID-19 infection is essential to protect those living in care-homes. More systematic national data collection to understand care-home residents and the homes in which they live is a priority in ensuring we can respond more effectively in future. (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society.)
Databáze:	MEDLINE
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