New study helps close information gap between mortality rates in nursing homes and those in the general US population – ScienceDaily

COVID-19 pandemics have had devastating effects in U.S. nursing homes and long-term care facilities, resulting in approximately 1.2 million infections and 147,000 deaths by the beginning of 2021. But even if mortality rates in the general population have declined over time, little evidence has been found to determine whether there has been a similar reduction in nursing home accommodation.

Now, new data collected and analyzed by researchers at Brown University show that mortality rates among nursing home residents with COVID-19 decreased from March to November 2020, and that the deadliest time for nursing home residents continued when the pandemic hit, when the virus came. spike in spring 2020.

The information fills an important evidence gap in reporting nursing home death rates from COVID over time, the researchers say.

“Understanding the risk of death from COVID-19 among nursing home residents is critical to identifying the mechanisms that most impact health outcomes in this vulnerable population,” Cyrus said Kosar, lead author of research and doctoral candidate in health services, policy and practice at Brown School of Public Health.

Kosar conducted the analysis with lead researcher and professor Brown Vincent Mor, who has been studying the effects of COVID-19 in nursing homes since the outbreak began the pandemic.

Long-term care residents have accounted for about 40% of total U.S. deaths from COVID-19. Although data showed that mortality rates from the virus in the general population have declined overall, there was no evidence that nursing homes had turned a corner. In addition, the researchers say, some of the factors contributing to lower mortality rates in the general population, such as improved COVID-19 therapy and supportive care, are lacking. the hospitals, relevant to nursing home residents, who are often treated in the facilities where they live rather than being admitted to the hospital.

“There are many different reasons why mortality rates may decrease in the general population,” Kosar said. “We wanted to find out specifically what was going on in the nursing home setting – especially as it is difficult to argue that there is any greater risk for COVID-19 infection and death than there is. the nursing home. “

The new study, published online on Thursday, March 11, will appear in the April issue of Health Issues, analyzed nursing home data in major providers of postpartum and long-term care services in 24 states through November 15, 2020. The authors found, among 12,271 foster home residents with COVID-19 , 30-day mortality rates declined from a high of 20.9% in early April to 11.2% in early November.

The proportion of COVID-19 cases diagnosed asymptomatic (and therefore less serious diseases with a lower risk of death) increased over time, the researchers say, due to improvements in research trials. routine and wider access to personal protective equipment. Nonetheless, the researchers found that mortality risk was declining both for sympathetic and asymptomatic residents, and also for patients with high and low baseline sensitivity levels.

What was happening, then? Kosar says that when the pandemic first hit nursing homes, the infectious nature of the virus quickly overwhelmed facilities, leaving them unprepared, without PPE and treating a high number of patients who were to math ill.

“This has not been empirically proven, but my explanation is that COVID-19 at the onset of the pandemic was a real attraction to the U.S. health care system and nursing homes in particular,” Kosar said. “And that panic, unfortunately, costs a lot of lives.”

Although more research is needed, the authors note in the study that mortality decreased with the improvements in PPE provision, staff adoption and skill with PPE and knowledge of clinical governance of COVID. -19.

“The dramatic reduction in deaths we have seen among nursing home residents, even as the risk of infection across the country has increased, speaks to the fact that nursing homes have a better ability to protect residents with more use of PPE and more frequent and faster testing, “says Mor.” This is a very progressive development. “

Other Brown researchers involved in this study include Elizabeth White, Stefan Gravenstein, Orestis Panagiotou and Kevin McConeghy. This study was funded by a grant from the National Institute on Aging (Grant No. 3P01AG027296-11S1).