ArticleAge and ageing2021
COVID-19 infection and attributable mortality in UK care homes: cohort study using active surveillance and electronic records (March-June 2020).
Article in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- A rapid systematic review of measures to protect older people in long-term care facilities from COVID-19.BMJ open · 2021Pooled it
- Non-pharmacological measures implemented in the setting of long-term care facilities to prevent SARS-CoV-2 infections and their consequences: a rapid review.The Cochrane database of systematic reviews · 2021Pooled it
- Dietary nitrate supplementation for preventing and reducing the severity of winter infections, including COVID-19, in care homes (BEET-Winter): a randomised placebo-controlled feasibility trial.European geriatric medicine · 2022Trial
- Characteristics, all-cause healthcare resource utilisation, and costs among high-risk adults with long COVID during Omicron predominance, 2022-2023: a retrospective cohort study using UK primary care data.BMC health services research · 2026Article
- COVID-19 infections in German long-term care facilities: a descriptive three-level analysis using claims and infection statistics data from October 2020 to March 2021.BMC public health · 2026Article
- Disentangling the force of infection of SARS-CoV-2 in Dutch long-term care facilities.BMC public health · 2025Article
- Household crowding and mortality before and during the COVID-19 pandemic among adults: Findings from longitudinal population surveillance data in rural and peri-urban settings in Limpopo, South Africa.Population health metrics · 2025Article
- Protective Measures Taken in Residential Care Homes in England During the COVID-19 Pandemic. An Assessment of the Change in Mortality Rates Before and During the COVID-19 Pandemic Years.Infectious diseases and therapy · 2025Article
- Evaluation of COVID-19 Diagnosis Codes for Identification of SARS-CoV-2 Infections in a Nursing Home Cohort, 2022-2023.Journal of the American Medical Directors Association · 2025Article
- Mass testing for discovery and control of COVID-19 outbreaks in adult social care: an observational study and cost-effectiveness analysis of 14 805 care homes in England.BMJ public health · 2025Article
- Impact of SARS-CoV-2 viral load on restrictive spirometry patterns in mild COVID-19 recovered middle-aged individuals: a six-month prospective study.BMC infectious diseases · 2024Article
- Long term care facilities in England during the COVID-19 pandemic-a scoping review of guidelines, policy and recommendations.BMC geriatrics · 2024Article
- Analysis of the impact of COVID-19 on Scotland's care-homes from March 2020 to October 2021: national linked data cohort analysis.Age and ageing · 2024Observational
- Built Environment and SARS-CoV-2 Transmission in Long-Term Care Facilities: Cross-Sectional Survey and Data Linkage.Journal of the American Medical Directors Association · 2024Article
- Patient-facing job role is associated with SARS-CoV-2 positivity among healthcare workers in long term care facilities in Minnesota, August-December, 2020.Infection control and hospital epidemiology · 2023Article
- SARS-CoV-2 in Nursing Homes: Analysis of Routine Surveillance Data in Four European Countries.Aging and disease · 2023Article
- [Long-term care facilities-the COVID-19 pandemic as an urgent call: infection prevention, control measures, and factors influencing the health of residents].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2023Review
- Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic.Aging and disease · 2023Article
- Strong peak immunogenicity but rapid antibody waning following third vaccine dose in older residents of care homes.Nature aging · 2023Observational
- Developing a care home data platform in Scotland: a mixed methods study of data routinely collected in care homes.Age and ageing · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundepidemiological data on COVID-19 infection in care homes are scarce. We analysed data from a large provider of long-term care for older people to investigate infection and mortality during the first wave of the pandemic.
methodscohort study of 179 UK care homes with 9,339 residents and 11,604 staff. We used manager-reported daily tallies to estimate the incidence of suspected and confirmed infection and mortality in staff and residents. Individual-level electronic health records from 8,713 residents were used to model risk factors for confirmed infection, mortality and estimate attributable mortality.
results2,075/9,339 residents developed COVID-19 symptoms (22.2% [95% confidence interval: 21.4%; 23.1%]), while 951 residents (10.2% [9.6%; 10.8%]) and 585 staff (5.0% [4.7%; 5.5%]) had laboratory-confirmed infections. The incidence of confirmed infection was 152.6 [143.1; 162.6] and 62.3 [57.3; 67.5] per 100,000 person-days in residents and staff, respectively. Sixty-eight percent (121/179) of care homes had at least one COVID-19 infection or COVID-19-related death. Lower staffing ratios and higher occupancy rates were independent risk factors for infection.Out of 607 residents with confirmed infection, 217 died (case fatality rate: 35.7% [31.9%; 39.7%]). Mortality in residents with no direct evidence of infection was twofold higher in care homes with outbreaks versus those without (adjusted hazard ratio: 2.2 [1.8; 2.6]).
conclusionsfindings suggest many deaths occurred in people who were infected with COVID-19, but not tested. Higher occupancy and lower staffing levels were independently associated with risks of infection. Protecting staff and residents from infection requires regular testing for COVID-19 and fundamental changes to staffing and care home occupancy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.