Resident Factors Associated With Breakthrough SARS-CoV-2 Infections.
Ana Montoya, Katherine Wen, Jasmine L Travers and 4 others
PMID 36965506WHAT IT FOUND
Five percent of vaccinated nursing home residents developed breakthrough infection.
Only older age was linked to infection risk; bowel incontinence, coronary artery disease, kidney disease, and schizophrenia were linked to hospitalization or death after infection.
Key findings
01Among 23,172 residents, 1173 (5%) developed a breakthrough infection over a mean follow-up of 250 days.
02In adjusted models, older age was the only resident factor associated with higher breakthrough infection risk: compared with residents under 65, rate was 1.20 times higher for age 65 to 74, 1.24 times higher for age 75 to 84, and 1.29 times higher for age 85 or older.
03Among residents with breakthrough infection, 8.6% were hospitalized or died within 30 days; residents aged 85 or older had 2 times higher risk of that outcome than those under 65, and bowel incontinence, coronary artery disease, chronic kidney disease, and schizophrenia were also associated with higher risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was observational, so it shows associations, not proof that any factor caused infection or severe illness. Breakthrough infections were identified from ICD-10 claims codes rather than laboratory testing, which may misclassify cases. The codes cannot distinguish new infection from past infection, and residents with a documented prior or very recent infection were excluded. The observation period was March 31 to November 24, 2021, a pre-Delta and Delta period, so rates and risk factors may not reflect later variants or current nursing home conditions. Severe illness was measured only after breakthrough infection, so the study cannot directly compare hospitalization or death with uninfected residents.
Declared interests
The supplied text does not include a funding or conflict-of-interest declaration. The article is tagged as supported by NIH extramural research.
The easy way to misread this
Do not read these factors as proof that treating bowel incontinence, coronary artery disease, chronic kidney disease, or schizophrenia will prevent severe illness after breakthrough infection. The study only observed associations in vaccinated nursing home residents during a specific variant period.