Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review
Abstract Background The coronavirus 2019 (COVID-19) pandemic has led to a high rate of infections, frequent outbreaks, and high mortality rates in nursing homes (NH) worldwide. To protect and improve the treatment and care of the vulnerable NH population, it is pivotal to systematise and synthesise...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-03826-0 |
| _version_ | 1797863602183471104 |
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| author | Anita Nilsen Bjørn Lichtwarck Siren Eriksen Anne Marie Mork Rokstad |
| author_facet | Anita Nilsen Bjørn Lichtwarck Siren Eriksen Anne Marie Mork Rokstad |
| author_sort | Anita Nilsen |
| collection | DOAJ |
| description | Abstract Background The coronavirus 2019 (COVID-19) pandemic has led to a high rate of infections, frequent outbreaks, and high mortality rates in nursing homes (NH) worldwide. To protect and improve the treatment and care of the vulnerable NH population, it is pivotal to systematise and synthesise data from cases of COVID-19 among NH residents. In our systematic review, we therefore aimed to describe the clinical expressions, characteristics, and treatments of NH residents confirmed to have COVID-19. Methods We conducted two comprehensive literature searches in several electronic databases: (1) PubMed, (2) CINAHL, (3) AgeLine, (4) Embase, and (5) PsycINFO in April and July 2021. Of the 438 articles screened, 19 were included in our sample, and we used the Newcastle–Ottawa Assessment Scale to assess the quality of the reported studies. A weighted mean (M weighted), was calculated to account for the large variation in sample sizes of the studies, and due to heterogeneity among the studies, we report our findings in a narrative synthesis. Results According to the mean weights (M weighted), common symptoms and signs in NH residents confirmed to have COVID-19 were fever (53.7%), cough (56.5%), hypoxia (32.3%), and delirium or confusion (31.2%). Common comorbidities were hypertension (78.6%), dementia or cognitive impairment (55.3%), and cardiovascular diseases (52.0%). Six studies presented data concerning medical and pharmacological treatments, such as inhalers, oxygen supplementation, anticoagulation, and parenteral/enteral fluids or nutrition. The treatments were used to improve outcomes, as part of palliative care, or as end-of-life treatment. Transfers to hospital for NH residents with confirmed COVID-19 were reported in six of the included studies, and the rate of hospital transfers ranged from 6.9% to 50% in this population. In the 17 studies reporting mortality, 40.2% of the NH residents died during the studies’ observation periods. Conclusions Our systematic review allowed us to summarise important clinical findings about COVID-19 among NH residents and to identify the population’s risk factors for serious illness and death caused by the disease. However, the treatment and care of NH residents with severe COVID-19 warrant further investigation. |
| first_indexed | 2024-04-09T22:38:05Z |
| format | Article |
| id | doaj.art-5120025979eb400c9846d32887edcffe |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-09T22:38:05Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-5120025979eb400c9846d32887edcffe2023-03-22T12:19:15ZengBMCBMC Geriatrics1471-23182023-02-0123112510.1186/s12877-023-03826-0Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic reviewAnita Nilsen0Bjørn Lichtwarck1Siren Eriksen2Anne Marie Mork Rokstad3Faculty of Health Sciences and Social Care, Molde University CollegeThe Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital TrustNorwegian National Centre for Ageing and Health, Vestfold Hospital TrustFaculty of Health Sciences and Social Care, Molde University CollegeAbstract Background The coronavirus 2019 (COVID-19) pandemic has led to a high rate of infections, frequent outbreaks, and high mortality rates in nursing homes (NH) worldwide. To protect and improve the treatment and care of the vulnerable NH population, it is pivotal to systematise and synthesise data from cases of COVID-19 among NH residents. In our systematic review, we therefore aimed to describe the clinical expressions, characteristics, and treatments of NH residents confirmed to have COVID-19. Methods We conducted two comprehensive literature searches in several electronic databases: (1) PubMed, (2) CINAHL, (3) AgeLine, (4) Embase, and (5) PsycINFO in April and July 2021. Of the 438 articles screened, 19 were included in our sample, and we used the Newcastle–Ottawa Assessment Scale to assess the quality of the reported studies. A weighted mean (M weighted), was calculated to account for the large variation in sample sizes of the studies, and due to heterogeneity among the studies, we report our findings in a narrative synthesis. Results According to the mean weights (M weighted), common symptoms and signs in NH residents confirmed to have COVID-19 were fever (53.7%), cough (56.5%), hypoxia (32.3%), and delirium or confusion (31.2%). Common comorbidities were hypertension (78.6%), dementia or cognitive impairment (55.3%), and cardiovascular diseases (52.0%). Six studies presented data concerning medical and pharmacological treatments, such as inhalers, oxygen supplementation, anticoagulation, and parenteral/enteral fluids or nutrition. The treatments were used to improve outcomes, as part of palliative care, or as end-of-life treatment. Transfers to hospital for NH residents with confirmed COVID-19 were reported in six of the included studies, and the rate of hospital transfers ranged from 6.9% to 50% in this population. In the 17 studies reporting mortality, 40.2% of the NH residents died during the studies’ observation periods. Conclusions Our systematic review allowed us to summarise important clinical findings about COVID-19 among NH residents and to identify the population’s risk factors for serious illness and death caused by the disease. However, the treatment and care of NH residents with severe COVID-19 warrant further investigation.https://doi.org/10.1186/s12877-023-03826-0COVID-19Nursing homeOlder adultSymptomComorbidityMortality |
| spellingShingle | Anita Nilsen Bjørn Lichtwarck Siren Eriksen Anne Marie Mork Rokstad Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review BMC Geriatrics COVID-19 Nursing home Older adult Symptom Comorbidity Mortality |
| title | Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review |
| title_full | Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review |
| title_fullStr | Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review |
| title_full_unstemmed | Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review |
| title_short | Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review |
| title_sort | clinical expressions characteristics and treatments of confirmed covid 19 in nursing home residents a systematic review |
| topic | COVID-19 Nursing home Older adult Symptom Comorbidity Mortality |
| url | https://doi.org/10.1186/s12877-023-03826-0 |
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