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Risk of Death Nearly Doubled Among Patients in SNFs Who Contract COVID-19
When assessing patients’ risk of contracting COVID-19 while staying at a postacute skilled nursing facility (SNF) and the correlation to mortality rates, study authors found infected individuals rate of death nearly doubled compared to noninfected patients.
Researchers compiled electronic health record data and Minimum Data Set from a large multi-state long-term care provider, which included all new admissions to 286 SNFs between January 1, 2020 and December 31, 2020.
If a patient was known to be infected with COVID-19 at time of admission, they were excluded from the study. Testing positive for COVID-19 during the postacute SNF stay and death of infected patients were primary outcomes.
To measure the association of patient demographic factors, clinical characteristics, and month of admission with testing positive for COVID-19, study authors utilized a parametric survival model with SNF random effects.
Of the postacute SNF admissions during study period, 45,094 were included in the sample. Within 100 days of admission, 5.7% of patients tested positive for COVID-19, with 1% testing positive between 1 to 14 days, 1.4% within 15 to 30 days, and 3.4% within 31 to 100 days.
Rates for newly admitted patients were observed to be .8% for those who contracted COVID-19 and died, but 6.7% for those who died without known infection.
Patients admitted during the first and third US pandemic waves saw higher rates of infection and subsequent risk of death.
Finally, a 1.45 to 1.82 higher risk of contracting COVID-19 was found in patients with greater functional and cognitive impairment when compared to patients with less impairment.
Nearly double the rate of death was found among patients who contracted COVID-19 during their stay at an SNF compared to noninfected patients.
“Findings from this study provide context for people requiring post-acute care, and their support systems, in navigating decisions around SNF admission during the SARS-CoV-2 pandemic,” concluded researchers.
Reference:
Ritter AZ, Kosar CM, White EM, Feifer RA, Blackman C, Mor V. Incidence and outcomes of SARS-CoV-2 in post-acute skilled nursing facility care. J Am Med Dir Assoc. Published online May 23, 2022. doi:10.1016/j.jamda.2022.05.014
