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Risk Factors Associated with Nursing Home COVID-19 Outbreaks: A Retrospective Cohort Study

Author

Listed:
  • Lucia Cazzoletti

    (Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
    These authors contributed equally to this work.)

  • Maria Elisabetta Zanolin

    (Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
    These authors contributed equally to this work.)

  • Ilaria Tocco Tussardi

    (Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy)

  • Mulubirhan Assefa Alemayohu

    (Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy)

  • Ernesto Zanetel

    (Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy)

  • Donatella Visentin

    (Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy)

  • Luca Fabbri

    (Azienda Provinciale per i Servizi Sanitari, Autonomous Province of Trento, 38123 Trento, Italy)

  • Massimo Giordani

    (Unione Provinciale Istituzioni per l’Assistenza, Autonomous Province of Trento, 38122 Trento, Italy)

  • Giancarlo Ruscitti

    (Department of Health and Social Policies, Autonomous Province of Trento, 38122 Trento, Italy)

  • Pier Paolo Benetollo

    (Azienda Provinciale per i Servizi Sanitari, Autonomous Province of Trento, 38123 Trento, Italy)

  • Stefano Tardivo

    (Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy)

  • Emanuele Torri

    (Department of Health and Social Policies, Autonomous Province of Trento, 38122 Trento, Italy)

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic had a devastating impact on nursing homes/long-term care facilities. This study examined the relationship between geography, size, design, organizational characteristics, and implementation of infection prevention and control (IPC) measures and the extent of COVID-19 outbreaks in nursing homes in the Autonomous Province of Trento (Italy) during the time frame of March-May 2020. Methods: The analysis included 57 nursing homes (5145 beds). The association between median cumulative incidence of COVID-19 cases among residents and characteristics of nursing homes was assessed by Mann–Whitney U test, Kruskal–Wallis test or Spearman rho. To evaluate the potential confounding of geographical area, a 2-level random intercept logistic model was fitted, with level 1 units (patients in nursing homes) nested into level 2 units (nursing homes), and “being a COVID-19 case” as the dependent variable. Results: Median cumulative incidence was not significantly associated with any of the variables, except for geographical region ( p = 0.002). COVID-19 cases clustered in the part of the province bordering the Italian region most affected by the pandemic (Lombardy) (45.2% median cumulative incidence). Conclusions: Structural/organizational factors and standard IPC measures may not predict the epidemiology of COVID-19 outbreaks and be sufficient alone to protect nursing homes against them.

Suggested Citation

  • Lucia Cazzoletti & Maria Elisabetta Zanolin & Ilaria Tocco Tussardi & Mulubirhan Assefa Alemayohu & Ernesto Zanetel & Donatella Visentin & Luca Fabbri & Massimo Giordani & Giancarlo Ruscitti & Pier Pa, 2021. "Risk Factors Associated with Nursing Home COVID-19 Outbreaks: A Retrospective Cohort Study," IJERPH, MDPI, vol. 18(16), pages 1-17, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8434-:d:611661
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    References listed on IDEAS

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    1. Giovanni Gabutti & Erica d’Anchera & Francesco De Motoli & Marta Savio & Armando Stefanati, 2021. "The Epidemiological Characteristics of the COVID-19 Pandemic in Europe: Focus on Italy," IJERPH, MDPI, vol. 18(6), pages 1-14, March.
    2. Matteo Bolcato & Marco Trabucco Aurilio & Giulio Di Mizio & Andrea Piccioni & Alessandro Feola & Alessandro Bonsignore & Camilla Tettamanti & Rosagemma Ciliberti & Daniele Rodriguez & Anna Aprile, 2021. "The Difficult Balance between Ensuring the Right of Nursing Home Residents to Communication and Their Safety," IJERPH, MDPI, vol. 18(5), pages 1-11, March.
    3. Alessandro Camerotto & Andrea Sartorio & Anna Mazzetto & Milena Gusella & Ornella Luppi & Domenica Lucianò & Olga Sofritti & Cristiano Pelati & Emilia Munno & Andrea Tessari & Simone Bedendo & Margher, 2020. "Early Phase Management of the SARS-CoV-2 Pandemic in the Geographic Area of the Veneto Region, in One of the World’s Oldest Populations," IJERPH, MDPI, vol. 17(23), pages 1-17, December.
    4. Emanuele Torri & Luca Gino Sbrogiò & Enrico Di Rosa & Sandro Cinquetti & Fausto Francia & Antonio Ferro, 2020. "Italian Public Health Response to the COVID-19 Pandemic: Case Report from the Field, Insights and Challenges for the Department of Prevention," IJERPH, MDPI, vol. 17(10), pages 1-12, May.
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    Cited by:

    1. Fermina Rojo-Perez & Vicente Rodriguez-Rodriguez & Gloria Fernandez-Mayoralas & Diego Sánchez-González & Carmen Perez de Arenaza Escribano & Jose-Manuel Rojo-Abuin & Maria João Forjaz & María-Ángeles , 2022. "Residential Environment Assessment by Older Adults in Nursing Homes during COVID-19 Outbreak," IJERPH, MDPI, vol. 19(23), pages 1-19, December.
    2. Fabrice Mbalayen & Valentine Dutheillet-de-Lamothe & Aude Letty & Solenn Le Bruchec & Manon Pondjikli & Gilles Berrut & Lamia Benatia & Biné Mariam Ndiongue & Marie-Anne Fourrier & Didier Armaingaud &, 2022. "The COVID-19 Pandemic and Responses in Nursing Homes: A Cross-Sectional Study in Four European Countries," IJERPH, MDPI, vol. 19(22), pages 1-8, November.

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