医学
接种疫苗
逻辑回归
回顾性队列研究
优势比
人口学
队列研究
队列
可能性
人口
2019年冠状病毒病(COVID-19)
置信区间
儿科
老年学
内科学
免疫学
环境卫生
疾病
社会学
传染病(医学专业)
作者
Darly Dash,Fabrice Mowbray,Jeffrey W. Poss,Komal Aryal,Nathan M. Stall,John P. Hirdes,Michael Hillmer,George A. Heckman,Dawn M. E. Bowdish,Andrew P. Costa,Aaron Jones
出处
期刊:Age and Ageing
[Oxford University Press]
日期:2023-12-01
卷期号:52 (12)
标识
DOI:10.1093/ageing/afad229
摘要
The relative contributions of long-term care (LTC) resident frailty and home-level characteristics on COVID-19 mortality has not been well studied. We examined the association between resident frailty and home-level characteristics with 30-day COVID-19 mortality before and after the availability of SARS-CoV-2 vaccination in LTC.We conducted a population-based retrospective cohort study of LTC residents with confirmed SARS-CoV-2 infection in Ontario, Canada. We used multi-level multivariable logistic regression to examine associations between 30-day COVID-19 mortality, the Hubbard Frailty Index (FI), and resident and home-level characteristics. We compared explanatory models before and after vaccine availability.There were 11,179 and 3,655 COVID-19 cases in the pre- and post-vaccine period, respectively. The 30-day COVID-19 mortality was 25.9 and 20.0% during the same periods. The median odds ratios for 30-day COVID-19 mortality between LTC homes were 1.50 (95% credible interval [CrI]: 1.41-1.65) and 1.62 (95% CrI: 1.46-1.96), respectively. In the pre-vaccine period, 30-day COVID-19 mortality was higher for males and those of greater age. For every 0.1 increase in the Hubbard FI, the odds of death were 1.49 (95% CI: 1.42-1.56) times higher. The association between frailty and mortality remained consistent in the post-vaccine period, but sex and age were partly attenuated. Despite the substantial home-level variation, no home-level characteristic examined was significantly associated with 30-day COVID-19 mortality during either period.Frailty is consistently associated with COVID-19 mortality before and after the availability of SARS-CoV-2 vaccination. Home-level characteristics previously attributed to COVID-19 outcomes do not explain significant home-to-home variation in COVID-19 mortality.
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