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COVID-19 risk factors amongst 14,786 care home residents: an observational longitudinal analysis including daily community positive test rates of COVID-19, hospital stays and vaccination status in Wales (UK) between 1 September 20...

Joe Hollinghurst, ROBYN HOLLINGHURST, Laura North, Amy Mizen Orcid Logo, Ashley Akbari Orcid Logo, Sara Long, Ronan Lyons Orcid Logo, Rich Fry Orcid Logo

Age and Ageing, Volume: 51, Issue: 5

Swansea University Authors: Joe Hollinghurst, ROBYN HOLLINGHURST, Laura North, Amy Mizen Orcid Logo, Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo, Rich Fry Orcid Logo

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DOI (Published version): 10.1093/ageing/afac084

Abstract

BackgroundCOVID-19 vaccinations have been prioritised for high risk individuals.AimDetermine individual-level risk factors for care home residents testing positive for SARS-CoV-2.Study designLongitudinal observational cohort study using individual-level linked data from the Secure Anonymised Informa...

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Published in: Age and Ageing
ISSN: 0002-0729 1468-2834
Published: Oxford University Press (OUP) 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa58262
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Abstract: BackgroundCOVID-19 vaccinations have been prioritised for high risk individuals.AimDetermine individual-level risk factors for care home residents testing positive for SARS-CoV-2.Study designLongitudinal observational cohort study using individual-level linked data from the Secure Anonymised Information Linkage (SAIL) databank.SettingFourteen thousand seven hundred and eighty-six older care home residents (aged 65+) living in Wales between 1 September 2020 and 1 May 2021. Our dataset consisted of 2,613,341 individual-level daily observations within 697 care homes.MethodsWe estimated odds ratios (ORs [95% confidence interval]) using multilevel logistic regression models. Our outcome of interest was a positive SARS-CoV-2 PCR test. We included time-dependent covariates for the estimated community positive test rate of COVID-19, hospital inpatient status, vaccination status and frailty. Additional covariates were included for age, sex and specialist care home services.ResultsThe multivariable regression model indicated an increase in age (OR 1.01 [1.00,1.01] per year), community positive test rate (OR 1.13 [1.12,1.13] per percent increase), hospital inpatients (OR 7.40 [6.54,8.36]), and residents in care homes with non-specialist dementia care (OR 1.42 [1.01,1.99]) had an increased odds of a positive test. Having a positive test prior to the observation period (OR 0.58 [0.49,0.68]) and either one or two doses of a vaccine (0.21 [0.17,0.25] and 0.05 [0.02,0.09], respectively) were associated with a decreased odds.ConclusionsCare providers need to remain vigilant despite the vaccination rollout, and extra precautions should be taken when caring for the most vulnerable. Minimising potential COVID-19 infection for care home residents when admitted to hospital should be prioritised.
Keywords: COVID-19, care homes, vaccination, PCR tests, hospital infection, older people
College: Swansea University Medical School
Funders: This work was supported by the Medical Research Council [MR/V028367/1]; Health and Care Research Wales [Project: SCF-18-1504]; Health Data Research UK [HDR-9006] which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; and Administrative Data Research UK which is funded by the Economic and Social Research Council [grant ES/S007393/1].
Issue: 5