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COVID-19 related mortality and hospital admissions in the VIVALDI study cohort: October 2020-March 2023

Stirrup, Oliver; Krutikov, Maria; Azmi, Borscha; Monakhov, Igor; Hayward, Andrew; Copas, Andrew; Shallcross, Laura; (2024) COVID-19 related mortality and hospital admissions in the VIVALDI study cohort: October 2020-March 2023. Journal of Hospital Infection , 143 pp. 105-112. 10.1016/j.jhin.2023.10.021. Green open access

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Abstract

Background: Long-term care facilities (LTCFs) were heavily affected by COVID-19 early in the pandemic, but the impact of the virus has reduced over time with vaccination campaigns and build-up of immunity from prior infection. // Objectives: To evaluate the mortality and hospital admissions associated with SARS-CoV-2 in LTCFs in England over the course of the VIVALDI study, from October 2020 to March 2023. // Methods: We included residents aged ≥65 years of participating LTCFs who had available follow-up time within the analysis period. We calculated incidence rates (IR) of COVID-19 linked mortality and hospital admissions per calendar quarter, along with infection fatality ratios (IFR, within 28d) and infection hospitalisation ratios (IHR, within 14d) following positive SARS-CoV-2 test. // Results: A total of 26286 residents were included, with at least one positive test for SARS-CoV-2 in 8513 (32.4%). The IR of COVID-19 related mortality peaked in the first quarter (Q1) 2021 at 0.47 per 1000 person-days (1kpd) (around a third of all deaths), in comparison to 0.10 per 1kpd for Q1 2023 which had a similar IR of SARS-CoV-2 infections. There was a fall in observed IFR for SARS-CoV-2 infections from 24.9% to 6.7% between these periods, with a fall in IHR from 12.1% to 8.8%. The population had high overall IRs for mortality for each quarter evaluated, corresponding to annual mortality probability of 28.8-41.3%. // Conclusions: Standardised real-time monitoring of hospitalisation and mortality following infection in LTCFs could inform policy on the need for non-pharmaceutical interventions to prevent transmission.

Type: Article
Title: COVID-19 related mortality and hospital admissions in the VIVALDI study cohort: October 2020-March 2023
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jhin.2023.10.021
Publisher version: https://doi.org/10.1016/j.jhin.2023.10.021
Language: English
Additional information: Copyright © 2023 The Authors. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: Care homes; COVID-19; infection fatality ratio; infection hospitalisation ratio; SARS-CoV-2
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10181278
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