Evidence map›Paper›PMID 38065220›Full record

ArticleJournal of the American Medical Directors Association2024

Built Environment and SARS-CoV-2 Transmission in Long-Term Care Facilities: Cross-Sectional Survey and Data Linkage.

Maria Krutikov, Oliver Stirrup, Chris Fuller, Natalie Adams, Borscha Azmi, Aidan Irwin-Singer, Niyathi Sethu, Andrew Hayward, Hector Altamirano, Andrew Copas and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Maria KrutikovInstitute of Health Informatics, University College London, London, UK. Electronic address: m.krutikov@ucl.ac.uk.
Oliver StirrupInstitute for Global Health, University College London, London, UK.
Chris FullerInstitute of Health Informatics, University College London, London, UK.
Natalie AdamsInstitute of Health Informatics, University College London, London, UK.
Borscha AzmiInstitute of Health Informatics, University College London, London, UK.
Aidan Irwin-SingerSurveillance Testing and Immunity, UK Health Security Agency, London, UK.
Niyathi SethuInstitute for Environmental Design and Engineering, University College London, London, UK.
Andrew HaywardInstitute of Epidemiology and Health Care, University College London, London, UK.
Hector AltamiranoInstitute for Environmental Design and Engineering, University College London, London, UK.
Andrew CopasInstitute for Global Health, University College London, London, UK.
Laura ShallcrossInstitute of Health Informatics, University College London, London, UK.
University College London · GBHealth Data Research UK · GBNational Security Agency · US

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectivesTo describe the built environment in long-term care facilities (LTCF) and its association with introduction and transmission of SARS-CoV-2 infection.

designCross-sectional survey with linkage to routine surveillance data. SETTING AND

participantsLTCFs in England caring for adults ≥65 years old, participating in the VIVALDI study (ISRCTN14447421) were eligible. Data were included from residents and staff.

methodsCross-sectional survey of the LTCF built environment with linkage to routinely collected asymptomatic and symptomatic SARS-CoV-2 testing and vaccination data between September 1, 2020, and March 31, 2022. We used individual and LTCF level Poisson and Negative Binomial regression models to identify risk factors for 4 outcomes: incidence rate of resident infections and outbreaks, outbreak size, and duration. We considered interactions with variant transmissibility (pre vs post Omicron dominance).

resultsA total of 134 of 151 (88.7%) LTCFs participated in the survey, contributing data for 13,010 residents and 17,766 staff. After adjustment and stratification, outbreak incidence (measuring infection introduction) was only associated with SARS-CoV-2 incidence in the community [incidence rate ratio (IRR) for high vs low incidence, 2.84; 95% CI, 1.85-4.36]. Characteristics of the built environment were associated with transmission outcomes and differed by variant transmissibility. For resident infection incidence, factors included number of storeys (0.64; 0.43-0.97) and bedrooms (1.04; 1.02-1.06), and purpose-built vs converted buildings (1.99; 1.08-3.69). Air quality was associated with outbreak size (dry vs just right 1.46; 1.00-2.13). Funding model (0.99; 0.99-1.00), crowding (0.98; 0.96-0.99), and bedroom temperature (1.15; 1.01-1.32) were associated with outbreak duration. CONCLUSIONS AND IMPLICATIONS: We describe previously undocumented diversity in LTCF built environments. LTCFs have limited opportunities to prevent SARS-CoV-2 introduction, which was only driven by community incidence. However, adjusting the built environment, for example by isolating infected residents or improving airflow, may reduce transmission, although data quality was limited by subjectivity. Identifying LTCF built environment modifications that prevent infection transmission should be a research priority.

Indexed as

COVID-19SARS-CoV-2AdultAgedCOVID-19 TestingCross-Sectional StudiesHumansInformation Storage and RetrievalLong-Term Carebuilt environmentCOVID-19infection prevention & controlinfection transmissionlong-term careolder adults

Identifiers

PMID38065220
PMCPMC11139658
OpenAlexW4389331795

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.