@article{discovery10105498,
            year = {2020},
         journal = {Journal of Infection},
           title = {SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes},
            note = {This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.},
             url = {https://doi.org/10.1016/j.jinf.2020.05.073},
          author = {Graham, NSN and Junghans, C and Downes, R and Sendall, C and Lai, H and McKirdy, A and Elliott, P and Howard, R and Wingfield, D and Priestman, M and Ciechonska, M and Cameron, L and Storch, M and Crone, MA and Freemont, PS and Randell, P and McLaren, R and Lang, N and Ladhani, S and Sanderson, F and Sharp, DJ},
        abstract = {OBJECTIVES: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents. METHODS: An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing. RESULTS: Overall, 26\% (95\% CI 22-31) of residents died over the two-month period. All-cause mortality increased by 203\% (95\% CI 70-336) compared with previous years. Systematic testing identified 40\% (95\% CI 35-46) of residents as positive for SARS-CoV-2, and of these 43\% (95\% CI 34-52) were asymptomatic and 18\% (95\% CI 11-24) had only atypical symptoms; 4\% (95\% CI -1 to 9) of asymptomatic staff also tested positive. CONCLUSIONS: The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or had no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.},
        keywords = {COVID-19, Care home, Coronavirus, Diagnostic testing, Nursing home, SARS-CoV-2},
            issn = {1532-2742}
}