Incidence and Outcomes of SARS-CoV-2 in Post-Acute Skilled Nursing Facility Care.
Ashley Z Ritter, Cyrus M Kosar, Elizabeth M White and 3 others
PMID 35718000WHAT IT FOUND
Across 45,094 post-acute nursing home admissions in 2020, 5.7% tested positive for SARS-CoV-2 within 100 days.
Infection risk was highest in residents with significant cognitive and functional impairment, those admitted during community surges, and those staying longer than 30 days.
Key findings
01Residents with greater cognitive and functional impairment had a 1.45 to 1.92 times higher risk of contracting SARS-CoV-2 compared with the least impaired group.
02The overall infection rate was 5.7%, but more than half of these infections occurred more than 30 days after admission, suggesting longer stays carry prolonged exposure risk.
03While only 0.8% of all patients contracted SARS-CoV-2 and died, those who were infected had nearly double the rate of death compared to those who were not infected.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
Data came from a single SNF operator, so findings may not generalize to all nursing homes nationally. Post-acute patients during the pandemic may have been more functionally impaired than usual, potentially skewing risk factors. Lack of testing capacity early in the pandemic likely undercounted asymptomatic cases. The study did not compare outcomes for patients who went home for post-acute care instead of a SNF. Deaths occurring outside the SNF, such as in hospitals, were likely undercounted.
The easy way to misread this
Do not interpret the hazard ratios as causal proof that impairment itself causes infection. The authors state these are observational associations, and the higher risk likely stems from the need for close-contact care and difficulty adhering to mitigation measures like masking and distancing.