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Risk Factors for COVID-19 Deaths Among Elderly Nursing Home Medicare Beneficiaries in the Prevaccine Period.
Lu, Yun; Jiao, Yixin; Graham, David J; Wu, Yue; Wang, Jing; Menis, Mikhail; Chillarige, Yoganand; Wernecke, Michael; Kelman, Jeffrey; Forshee, Richard A; Izurieta, Hector S.
Afiliación
  • Lu Y; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Jiao Y; Acumen LLC, Burlingame, California, USA.
  • Graham DJ; Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Wu Y; Acumen LLC, Burlingame, California, USA.
  • Wang J; Acumen LLC, Burlingame, California, USA.
  • Menis M; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Chillarige Y; Acumen LLC, Burlingame, California, USA.
  • Wernecke M; Acumen LLC, Burlingame, California, USA.
  • Kelman J; Centers for Medicare and Medicaid Services, Washington, District of Columbia, USA.
  • Forshee RA; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
  • Izurieta HS; Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA.
J Infect Dis ; 225(4): 567-577, 2022 02 15.
Article en En | MEDLINE | ID: mdl-34618896
ABSTRACT

BACKGROUND:

We evaluated prevaccine pandemic period COVID-19 death risk factors among nursing home (NH) residents.

METHODS:

In a retrospective cohort study covering Medicare fee-for-service beneficiaries aged ≥65 years residing in US NHs, we estimated adjusted hazard ratios (HRs) using multivariate Cox proportional hazards regressions.

RESULTS:

Among 608251 elderly NH residents, 57398 (9.4%) died of COVID-19-related illness 1 April to 22 December 2020; 46.9% (26893) of these deaths occurred without prior COVID-19 hospitalizations. We observed a consistently increasing age trend for COVID-19 deaths. Racial/ethnic minorities shared similarly high risk of NH COVID-19 deaths with whites. NH facility characteristics for-profit ownership and low health inspection ratings were associated with higher death risk. Resident characteristics (male [HR, 1.69], end-stage renal disease [HR, 1.42], cognitive impairment [HR, 1.34], and immunocompromised status [HR, 1.20]) were death risk factors. Other individual-level characteristics were less predictive of death than in community-dwelling population.

CONCLUSIONS:

Low NH health inspection ratings and private ownership contributed to COVID-19 death risks. Nearly half of NH COVID-19 deaths occurred without prior COVID-19 hospitalization and older residents were less likely to get hospitalized with COVID-19. No substantial differences were observed by race/ethnicity and socioeconomic status for NH COVID-19 deaths.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 4_TD / 6_ODS3_enfermedades_notrasmisibles Problema de salud: 4_pneumonia / 6_other_respiratory_diseases Asunto principal: COVID-19 / Casas de Salud Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Infect Dis Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Contexto en salud: 4_TD / 6_ODS3_enfermedades_notrasmisibles Problema de salud: 4_pneumonia / 6_other_respiratory_diseases Asunto principal: COVID-19 / Casas de Salud Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: J Infect Dis Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos
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