Figure 2 shows the Venn diagram of those themes. 8 articles related to COVID-19 disease characteristics (asymptomatic transmission), 24 to resident-related factors (comorbidities, nutrition, cognition), 13 to facility characteristics (physical space, occupancy, for-profit status), 21 to staffing (staffing levels, staff-to-resident ratio, staff multi-employment), and 10 to external factors (community rates, availability of personal protective equipment, prevailing health and social care policies). 1, 76 were included in the thematic review.
Following the application of the exclusion criteria detailed in Fig. The initial search retrieved 348 articles, of which 1 was a duplicate. In the aftermath of the devastating impact of the COVID-19 pandemic on nursing homes, we undertook a scoping review of the literature to describe factors that contributed to the spread and mortality of COVID-19 in nursing homes and provided an overview of responses that were implemented to try to overcome such challenges. Indeed, learnings on the latter could improve future pandemic preparedness. īeyond non-modifiable risk factors, such as residents’ age and sex, public and scientific discussions, soon followed considering if the high rate of dissemination and mortality in nursing homes could have also been related to potentially modifiable factors. In addition, male sex was soon identified as a risk factor for COVID-19 mortality. In Spain, a study noted that while the overall infection fatality ratio for the general population was about 0.8%, it remained close to zero for individuals aged below 50. In the US, it was reported that about 80% of deaths from COVID-19 were in individuals over the age of 65. Soon into the pandemic, advancing age was identified as a strong risk factor for COVID-19 mortality. Nursing homes provide care to the oldest-old in societies. In May 2020, it was estimated that about half of the COVID-19 deaths in France and Ireland were from nursing homes, with even higher proportions reported in the US and Canada, and high numbers of excess deaths in nursing homes reported in England and Wales. The proportion of COVID-19 deaths that occurred in nursing homes is high. Understanding the unique characteristics of the nursing home population is important because in some European countries, the population of nursing home residents is projected to increase by up to 127% by 2050. Nursing home residents very often require care and support that is of intimate nature, which makes them vulnerable to contracting easily spreadable infections such as COVID-19. Nursing homes are facilities purposefully built for the residential and/or nursing care of older people living with advanced physical and/or cognitive disabilities. Nursing homes have been one of the largest hotspots for the dissemination and mortality of the COVID-19 pandemic throughout the year of 2020.
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