Elsevier

Journal of Infection

Volume 81, Issue 3, September 2020, Pages 411-419
Journal of Infection

SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes

https://doi.org/10.1016/j.jinf.2020.05.073Get rights and content
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open access

Summary

Objectives

To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents.

Methods

An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing.

Results

Overall, 26% (95% CI 22–31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70–336) compared with previous years. Systematic testing identified 40% (95% CI 35–46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34–52) were asymptomatic and 18% (95% CI 11–24) had only atypical symptoms; 4% (95% CI −1 to 9) of asymptomatic staff also tested positive.

Conclusions

The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or had no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.

Keywords

Coronavirus
COVID-19
SARS-CoV-2
Nursing home
Care home
Diagnostic testing

Cited by (0)

1

These authors contributed equally (joint 1st author).

2

These authors contributed equally (joint senior author).