ArticleThe lancet. Healthy longevity2020
Evolution and effects of COVID-19 outbreaks in care homes: a population analysis in 189 care homes in one geographical region of the UK.
Article in The lancet. Healthy longevity, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 3 of them syntheses that pooled it.
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Who cites it
109 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Update prognostic potency of surfactant protein D (SP-D) in the COVID-19 landscape: an In-depth meta-analytical exploration.Biomarkers in medicine · 2024Pooled it
- A rapid systematic review of measures to protect older people in long-term care facilities from COVID-19.BMJ open · 2021Pooled it
- A systematic review of the associations between care home ownership and COVID-19 outbreaks, infections and mortality.Nature aging · 2021Pooled it
- The Impact of a Leadership Support Programme on Care Home Residents and Their Families: A Qualitative Study From the Perspective of Participating Care Home Leaders.International journal of older people nursing · 2025Article
- Predicting COVID-19 progression in hospitalized patients in Kurdistan Province using a multi-state model.Journal of diabetes and metabolic disorders · 2025Article
- Death risk in nursing homes between the prepandemic period and the COVID-19 era: a retrospective cohort study in Murcia Region, Spain.BMJ public health · 2025Article
- COVID-19 outbreak management in Western Sydney residential aged care homes: A mixed-methods Donabedian evaluation.PloS one · 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
- Patterns and drivers of excess mortality during the COVID-19 pandemic in 13 Western European countries.BMC global and public health · 2024Article
- End-of-Life Care during the COVID-19 Pandemic: Decreased Hospitalization of Nursing Home Residents at the End of Life.Healthcare (Basel, Switzerland) · 2024Article
- Long term care facilities in England during the COVID-19 pandemic-a scoping review of guidelines, policy and recommendations.BMC geriatrics · 2024Article
- Involuntary closures of for-profit care homes in England by the Care Quality Commission.The lancet. Healthy longevity · 2024Review
- 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
- Care home resident identification: A comparison of address matching methods with Natural Language Processing.PloS one · 2024Article
- Attribution of nosocomial seeding to long-term care facility COVID-19 outbreaks.Epidemiology and infection · 2023Article
- Factors influencing staff attitudes to COVID-19 vaccination in care homes in England: a qualitative study.BMC health services research · 2023Article
- Challenges and improvements associated with transitions between hospitals and care homes during the COVID-19 pandemic: a qualitative study with care home and healthcare staff in England.Age and ageing · 2023Article
- Monitoring the burden of COVID-19 and impact of hospital transfer policies on Australian aged-care residents in residential aged-care facilities in 2020.BMC geriatrics · 2023Article
- Impact of the first COVID-19 epidemic wave in a large French network of nursing homes: a cross-sectional study.BMC geriatrics · 2023Observational
- Findings in Danish long-term care facilities in the first year of the SARS-CoV-2 pandemic.European geriatric medicine · 2023Article
49 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCOVID-19 has affected care home residents internationally, but detailed information on outbreaks is scarce. We aimed to describe the evolution of outbreaks of COVID-19 in all care homes in one large health region in Scotland.
methodsWe did a population analysis of testing, cases, and deaths in care homes in the National Health Service (NHS) Lothian health region of the UK. We obtained data for COVID-19 testing (PCR testing of nasopharyngeal swabs for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) and deaths (COVID-19-related and non-COVID-19-related), and we analysed data by several variables including type of care home, number of beds, and locality. Outcome measures were timing of outbreaks, number of confirmed cases of COVID-19 in care home residents, care home characteristics associated with the presence of an outbreak, and deaths of residents in both care homes and hospitals. We calculated excess deaths (both COVID-19-related and non-COVID-19-related), which we defined as the sum of deaths over and above the historical average in the same period over the past 5 years.
findingsBetween March 10 and Aug 2, 2020, residents at 189 care homes (5843 beds) were tested for COVID-19 when symptomatic. A COVID-19 outbreak was confirmed at 69 (37%) care homes, of which 66 (96%) were care homes for older people. The size of care homes for older people was strongly associated with a COVID-19 outbreak (odds ratio per 20-bed increase 3·35, 95% CI 1·99-5·63). 907 confirmed cases of SARS-CoV-2 infection were recorded during the study period, and 432 COVID-19-related deaths. 229 (25%) COVID-19-related cases and 99 (24%) COVID-related deaths occurred in five (3%) of 189 care homes, and 441 (49%) cases and 207 (50%) deaths were in 13 (7%) care homes. 411 (95%) COVID-19-related deaths occurred in the 69 care homes with a confirmed COVID-19 outbreak, 19 (4%) deaths were in hospital, and two (<1%) were in one of the 120 care homes without a confirmed COVID-19 outbreak. At the 69 care homes with a confirmed COVID-19 outbreak, 74 excess non-COVID-19-related deaths were reported, whereas ten non-COVID-19-related excess deaths were observed in the 120 care homes without a confirmed COVID-19 outbreak. 32 fewer non-COVID-19-related deaths than expected were reported among care home residents in hospital.
interpretationThe effect of COVID-19 on care homes has been substantial but concentrated in care homes with known outbreaks. A key implication from our findings is that, if community incidence of COVID-19 increases again, many care home residents will be susceptible. Shielding care home residents from potential sources of SARS-CoV-2 infection, and ensuring rapid action to minimise outbreak size if infection is introduced, will be important for any second wave.
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