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Clinical and Epidemiological Features of 34 Nursing Home Elderly with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: An Observational Cohort Study
33 Pages Posted: 12 May 2020
More...Abstract
Background: Since December, 2019, an outbreak of coronavirus disease 2019 (COVID-19) has spread globally. Little is known about the epidemiological and clinical features of the Nursing home patients with COVID-19.
Methods: We retrospectively retrieved data for nursing home patients (aged 60~100 years) with confirmed COVID-19 from electronic medical records in two hospitals in Wuhan, China. We recorded patients’ epidemiological and clinical features.
Findings: From Jan 01 to April 3, 2020, 34 nursing home (mean age 82.79 [SD 7.41] years) were identified to be infected with severe acute respiratory syndrome coronavirus. The route of transmission was by close contact with nursing family members (34 [100%]) or a history of exposure to the epidemic area (34 [100%]), all of them (100%) had both exposures. 25 (73.52%) patients had moderate clinical type with pneumonia; 6 (17.64%) had mild clinical type and 3 (8.82%) had critically severe clinical type and either were moderate (25 [82.35%]) or had acute upper respiratory symptoms (9[26.47%]). Common symptoms on admission were dyspnoea or tachypnoea (9 [26.47%]) and dry cough (9 [26.47%]). typical abnormal laboratory findings were decreased lymphocytes (4 [11.76%]), leucopenia (6 [17.64%]), and elevated procalcitonin (3[8.82%]). Besides radiographic presentations, variables that were associated significantly with severity of COVID-19 were decreased lymphocytes, elevated body temperature, and high levels of procalcitonin, D-dimer. 27 (79.41%) Nursing home needed oxygen inhalation,11(32.35%) received interferon alpha by aerosolisation twice a day, no one received lopinavir–ritonavir therapy, and 18 (52.94%) received chinese medicine therapy. Mean time in hospital was 19.56 (SD 12) days. By April 3, 2020, except one patient died, the others were cured and discharged.
Interpretation: Although our sample was limited and the majority of patients with clinically common COVID-19 were infected in the same nursing home, 100% of the samples were infected. In the limited sample data, epidemiological history showed that they were in contact with the confirmed infected patients, leading to a dangerous situation in old people's home acquired infections.
Funding Statement: This research was supported by a grant (No.81772345) from the National Natural Science Foundation of China; National Key Research & Development Program of China (No.2018YFC2001502, 2018YFB1105705); National Health Commission of the People’s Republic of China (No. ZX-01-018，ZX-01-C2016153); and the Health Commission of Hubei Province (No. WJ2019Z009).
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: This study was approved by the ethics committee of Wuhan Union Hospital and followed the Declaration of Helsinki. Written consent was obtained from the guardians of the patients.
Keywords: nursing home; elderly; coronavirus disease 2019 (COVID-19)
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