Symptom based and transmission-prevention based testing in long-term care facilities: Symptomatology, clinical course and mortality for residents with COVID-19
| Autor: | Paap, KC, van Loon, AM, van Rijs, SM, Helmich, Esther, Buurman-van Es, BM, Smalbrugge, M, Hertogh, CMPM |
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| Přispěvatelé: | General practice, APH - Aging & Later Life, APH - Quality of Care |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Zdroj: | MedRxIv Paap, KC, van Loon, AM, van Rijs, SM, Helmich, E, Buurman-van Es, BM, Smalbrugge, M & Hertogh, CMPM 2020, ' Symptom based and transmission-prevention based testing in long-term care facilities: Symptomatology, clinical course and mortality for residents with COVID-19 ', MedRxIv . |
| Popis: | Objectives Initially, for preventing COVID-19 transmission in long-term care facilities (LTCF) primarily rely on presence of core symptoms (fever, cough, dyspnea), but LTCF residents may also show an atypical course of a SARS-CoV-2 infection. We described the clinical presentation and course of COVID-19 in LTCF residents who were tested either because of presence of core symptoms (S-based) or because of transmission prevention (TP-based)Design Retrospective cohort study.Setting and participants Amsta (Amsterdam, The Netherlands), is a 1185-bed LTCF. All LTCF residents who underwent SARS-CoV-2 RT-PCR testing between March 16, 2020 and May 31, 2020 were included (n = 380).Measures Clinical symptoms, temperature and oxygen saturation were extracted from medical records, 7 days before testing up to 14 days after testing.Results SARS-CoV-2 was confirmed in 81 (21%) residents. Of these 81, 36 (44%) residents were tested S-based and 45 (56%) residents were tested TP-based. Yet, CT-values did not differ between the groups. In the 7 days prior to the test the most common symptoms in both groups were: falling (32%), somnolence (25%) and fatigue (21%). Two days before the test, we observed a stronger decrease in oxygen saturation and an increase in temperature for the S-based group compared to the T-based group that remained up to 10 days after testing. Residents with in the S-based group were 2.5 times more likely to decease within 30 days than residents in the TP-based group (HR, 2.56; 95% 1.3 to 5.2). Even though, 73% of the T-based group did eventually developed core symptoms.Conclusion and implications Many LTCF residents with a positive PCR did not have core symptoms when tested but had other signs/symptoms in the week before the positive test. Testing policies should therefore be adjusted to prevent transmission. Daily measures of temperature and oxygen saturation can contribute to earlier detection. |
| Databáze: | OpenAIRE |
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