Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests

• Published in: Aging (Albany, NY.) Vol. 12; no. 24; pp. 24522 - 24534
• Main Authors: Cangiano, Biagio, Fatti, Letizia Maria, Danesi, Leila, Gazzano, Giacomo, Croci, Marina, Vitale, Giovanni, Gilardini, Luisa, Bonadonna, Stefania, Chiodini, Iacopo, Caparello, Chiara Francesca, Conti, Antonio, Persani, Luca, Stramba-Badiale, Marco, Bonomi, Marco
• Format: Journal Article
• Language: English
• Published: United States Impact Journals 31.12.2020
• Subjects: Activities of Daily Living; Age Factors; Aged; Aged, 80 and over; COVID-19 - diagnosis; COVID-19 - mortality; COVID-19 - therapy; COVID-19 - virology; Dietary Supplements; Female; Humans; Italy - epidemiology; Male; Middle Aged; Mortality; Nursing Homes; Pandemics; Research Paper; SARS-CoV-2; Sensitivity and Specificity; Sex Factors; Vitamin D - administration & dosage; Italy; COVID-19; hydroxychloroquine; nasopharyngeal swab; activities of daily living; sensitivity and specificity; serology
• ISSN: 1945-4589; 1945-4589
• DOI: 10.18632/aging.202307

The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality. We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse "activities of daily living (ADL)" scores, such as Barthel index, Tinetti scale and S.OS.I.A. Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation. In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.