TY - JOUR
T1 - Symptom- and Prevention-Based Testing of COVID-19 in Nursing Home Residents
T2 - A Retrospective Cohort Study
AU - Paap, Kelly C.
AU - van Loon, Anouk M.
AU - van Rijs, Sarian M.
AU - Helmich, Esther
AU - Buurman, Bianca M.
AU - Smalbrugge, Martin
AU - Hertogh, Cees M. P. M.
N1 - Funding Information: We thank the NH residents; the physicians and healthcare professionals for their ongoing efforts to provide care in the face of these challenges; M.D. Stijn Besseling and M.D. Thomas van Zijl for their help with data collection. M.D. Fleur Koene for proofreading our article and input on the CT values. The author(s) received no financial support for the research, authorship, and/or publication of this article. Publisher Copyright: © The Author(s) 2021.
PY - 2021
Y1 - 2021
N2 - Nursing homes (NH) residents with COVID-19 can either be tested because of presence of core symptoms (S-based) or because of transmission prevention (TP-based). The investigated study sample included all NH residents who underwent SARS-CoV-2 RT-PCR testing between March 16, 2020 and May 31, 2020 (n = 380). Clinical symptoms, temperature, and oxygen saturation were extracted from medical records, 7 days before to 14 days after testing. COVID-19 was confirmed in 81 (21%) residents; 36 (44%) S-based and 45 (56%) TP-based: 45. Cycle threshold (CT) values did not differ between the groups. In the 7 days prior to the test falling (32%), somnolence (25%) and fatigue (21%) occurred in both groups. 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 within the S-based group were 2.5 times more likely to increased mortality within 30 days than residents in the TP-based group (HR, 2.56; 95% 1.3–5.2). Although, 73% of the T-based group did eventually develop core symptoms. Thus, attention to falling and daily measures of temperature and oxygen saturation can contribute to earlier detection.
AB - Nursing homes (NH) residents with COVID-19 can either be tested because of presence of core symptoms (S-based) or because of transmission prevention (TP-based). The investigated study sample included all NH residents who underwent SARS-CoV-2 RT-PCR testing between March 16, 2020 and May 31, 2020 (n = 380). Clinical symptoms, temperature, and oxygen saturation were extracted from medical records, 7 days before to 14 days after testing. COVID-19 was confirmed in 81 (21%) residents; 36 (44%) S-based and 45 (56%) TP-based: 45. Cycle threshold (CT) values did not differ between the groups. In the 7 days prior to the test falling (32%), somnolence (25%) and fatigue (21%) occurred in both groups. 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 within the S-based group were 2.5 times more likely to increased mortality within 30 days than residents in the TP-based group (HR, 2.56; 95% 1.3–5.2). Although, 73% of the T-based group did eventually develop core symptoms. Thus, attention to falling and daily measures of temperature and oxygen saturation can contribute to earlier detection.
KW - SARS-CoV-2
KW - cycle threshold value
KW - long-term care facilities
KW - older adults
KW - oxygen saturation
UR - http://www.scopus.com/inward/record.url?scp=85118973457&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/23337214211055338
DO - https://doi.org/10.1177/23337214211055338
M3 - Article
C2 - 34790840
SN - 2333-7214
VL - 7
JO - Gerontology & geriatric medicine
JF - Gerontology & geriatric medicine
ER -