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COVID-19 Mortality Rates Among Nursing Home Residents Declined From March To November 2020.

Authors
  • Kosar, Cyrus M1
  • White, Elizabeth M2
  • Feifer, Richard A3
  • Blackman, Carolyn4
  • Gravenstein, Stefan5
  • Panagiotou, Orestis A6
  • McConeghy, Kevin7
  • Mor, Vincent8
  • 1 Cyrus M. Kosar ([email protected]) is a doctoral candidate in the Department of Health Services, Policy, and Practice, Brown University School of Public Health, in Providence, Rhode Island.
  • 2 Elizabeth M. White is an investigator in the Center for Gerontology and Healthcare Research, Brown University School of Public Health.
  • 3 Richard A. Feifer is the chief medical officer of Genesis Physician Services at Genesis HealthCare, in Kennett Square, Pennsylvania.
  • 4 Carolyn Blackman is the Northeast Region vice president for medical affairs of Genesis Physician Services at Genesis HealthCare.
  • 5 Stefan Gravenstein is the director of the Division of Geriatrics and Palliative Medicine, Department of Medicine, Warren Alpert Medical School, Brown University, in Providence.
  • 6 Orestis A. Panagiotou is an assistant professor in the Department of Health Services, Policy, and Practice and the Center for Gerontology and Healthcare Research, Brown University School of Public Health.
  • 7 Kevin McConeghy is a doctoral student in the Department of Health Services, Policy, and Practice, Brown University School of Public Health.
  • 8 Vincent Mor is the Florence Pirce Grant University Professor in the Department of Health Services, Policy, and Practice and the Center for Gerontology and Healthcare Research, Brown University School of Public Health, and a research health scientist at the Providence Veterans Affairs Medical Center.
Type
Published Article
Journal
Health affairs (Project Hope)
Publication Date
Mar 11, 2021
Identifiers
DOI: 10.1377/hlthaff.2020.02191
PMID: 33705204
Source
Medline
Language
English
License
Unknown

Abstract

Improved therapeutics and supportive care in hospitals have helped reduce mortality from COVID-19. However, there is limited evidence as to whether nursing home residents, who account for a disproportionate share of COVID-19 deaths and are often managed conservatively in the nursing home instead of being admitted to the hospital, have experienced similar mortality reductions. In this study we examined changes in thirty-day mortality rates between March and November 2020 among 12,271 nursing home residents with COVID-19. We found that adjusted mortality rates significantly declined from a high of 20.9 percent in early April to 11.2 percent in early November. Mortality risk declined for residents with both symptomatic and asymptomatic infections and for residents with both high and low clinical complexity. The mechanisms driving these trends are not entirely understood, but they may include improved clinical management within nursing homes, improved personal protective equipment supply and use, and genetic changes in the virus.

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