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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, 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/cronfa59978
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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: WT_/Wellcome Trust/United Kingdom, BHF_/British Heart Foundation/United Kingdom, MR/V028367/1/MRC_/Medical Research Council/United Kingdom.
Issue: 5