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Geriatr Gerontol Int . Clusters of COVID-19 in Long-Term Care Hospitals and Facilities - Japan, Jan 15-May 9, 2020

tetano

Editor, Senior Moderator
Geriatr Gerontol Int


. 2020 Jul 7.
doi: 10.1111/ggi.13973. Online ahead of print.
Clusters of COVID-19 in Long-Term Care Hospitals and Facilities - Japan, Jan 15-May 9, 2020


Osamu Iritani[SUP] 1 [/SUP], Tazuo Okuno[SUP] 1 [/SUP], Daisuke Hama[SUP] 1 [/SUP], Asami Kane[SUP] 1 [/SUP], Kumie Kodera[SUP] 1 [/SUP], Kozue Morigaki[SUP] 1 [/SUP], Toshio Terai[SUP] 1 [/SUP], Norie Maeno[SUP] 1 [/SUP], Shigeto Morimoto[SUP] 1 [/SUP]



Affiliations

Abstract

Aim: To clarify the association of cluster number and size of coronavirus disease 2019 (COVID-19) in long-term care (LTC) hospitals/facilities, general medical/welfare facilities, and non-medical/welfare facilities, with morbidity and mortality in 47 prefectures during Jan 15 - May 9, 2020 in Japan.
Methods: Information on COVID-19 clusters (n >2) and morbidity and mortality of COVID-19 was collected.
Results: A total of 381 clusters with 3,786 infected cases were collected, accounting for 23.9% of 15,852 cumulated cases on May 9, 2020. Although the cluster number (/10[SUP]7[/SUP] subjects) in LTC hospitals/facilities was significantly smaller compared to those in the other two groups, the cluster size in LTC hospitals/facilities was significantly larger than that in non-medical/welfare facilities. Cluster numbers in general medical/welfare facilities and in non-medical/welfare facilities were significantly positively correlated with morbidity (/10[SUP]5[/SUP] ), indicating relatively early identification of clusters in these facilities. Unlike in these facilities, cluster size in LTC hospitals/facilities was significantly positively correlated with morbidity, indicating that clusters in LCT hospitals/facilities were finally identified after already having grown to a large size in areas where infection was prevalent. Multivariate logistic regression analysis revealed that both cluster number and cluster size only in LTC hospitals/facilities were independently associated with higher mortality (> median: 0.64/10[SUP]5[/SUP] subjects) after adjustment.
Conclusions: Preventive efforts against COVID-19 outbreaks even at the early phase of the epidemic are critically important in LTC hospitals/facilities, since both larger number and size of cluster only in LTC hospitals/facilities were independently linked to higher mortality in prefectures in Japan. <248 words>.

Keywords: COVID-19; cluster; long-term care facility; morbidity; mortality.
 
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