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Coronavirus Disease 2019 in French Residential Care Facilities: A Nationwide Study

Joël Belmin¹, Scarlett Georges², Florian Franke²

¹Service de gériatrie à orientation cardiovasculaire et neuropsychogériatrique, Hôpital Charles Foix, Ivry-sur-Seine, France; Sorbonne Université, Paris, France.

Journal of the American Medical Directors Association

|April 18, 2021

Abstract

Objectives:

The Coronavirus 2019 (COVID-19) pandemic caused a considerable mortality in long-term care facilities (LTCFs), including residential care setting and nursing homes. This study aimed to estimate COVID-19 incidence and mortality in residential care facilities and to compare them with those recorded in nursing homes.

Design:

Nationwide observational study conducted by French health authorities.

Settings And Participants:

Since March 1, 2020, all LTCFs in France reported all COVID-19 cases and COVID-19-related deaths among their residents.

Methods:

Possible cases were those with COVID-19-related symptoms without laboratory confirmation and confirmed cases those with a reverse transcriptase polymerase chain reaction test or serology positive for SARS-CoV-2. We included facilities with at least 1 confirmed case of COVID-19 and estimated the cumulative incidence of COVID-19 cases and mortality due to COVID-19 reported until June 30, 2020, using the maximum bed capacity as a denominator.

Results:

Of the 2288 residential care facilities, 310 (14%) and, of the 7688 nursing homes, 3110 (40%) reported COVID-19 cases among residents (P < .001). The cumulative incidence of COVID-19 was significantly lower in residential care facilities as compared with nursing homes (1.10 vs 9.97 per 100 beds, P < .001). Mortality due to COVID-19 was also lower in residential care facilities compared with nursing homes (0.07 vs 1.29 per 100 beds, P < .001). Case fatality was lower in residential care facilities (6.49% vs 12.93%, P < .001).

Conclusion And Implications:

French residential care facilities experienced a much lower burden from COVID-19 than nursing homes. Our findings may inform the implementation of better infection control practices in these settings.

Keywords:

COVID-19 Long-term care facilities case-fatality ratio mortality nursing homes residential care

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