RT Journal Article
SR Electronic
T1 Comparison of hospitalized patients with COVID-19 who did and did not live in residential care facilities in Montréal: a retrospective case series
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E718
OP E727
DO 10.9778/cmajo.20200244
VO 9
IS 3
A1 Mah, Jordan
A1 Lieu, Anthony
A1 Palayew, Mark
A1 Alipour, Pouria
A1 Kong, Ling Yuan
A1 Song, Sunny
A1 Palayew, Adam
A1 Tutt-Guérette, Marc Antoine
A1 Yang, Stephen Su
A1 Wilchesky, Machelle
A1 Lipes, Jed
A1 Azoulay, Laurent
A1 Greenaway, Christina
YR 2021
UL http://www.cmajopen.ca/content/9/3/E718.abstract
AB Background: As in other jurisdictions, the demographics of people infected with SARS-CoV-2 changed in Quebec over the course of the first COVID-19 pandemic wave, and affected those living in residential care facilities (RCFs) disproportionately. We evaluated the association between clinical characteristics and outcomes of hospitalized patients with COVID-19, comparing those did or did not live in RCFs.Methods: We conducted a retrospective case series of all consecutive adults (≥ 18 yr) admitted to the Jewish General Hospital in Montréal with laboratory-confirmed SARS-CoV-2 infection from Mar. 4 to June 30, 2020, with in-hospital follow-up until Aug. 6, 2020. We collected patient demographics, comorbidities and outcomes (i.e., admission to the intensive care unit, mechanical ventilation and death) from medical and laboratory records and compared patients who did or did not live in public and private RCFs. We evaluated factors associated with the risk of in-hospital death with a Cox proportional hazard model.Results: In total, 656 patients were hospitalized between March and June 2020, including 303 patients who lived in RCFs and 353 patients who did not. The mean age was 72.9 (standard deviation 18.3) years (range 21 to 106 yr); 349 (53.2%) were female and 118 (18.0%) were admitted to the intensive care unit. The overall mortality rate was 23.8% (156/656), but was higher among patients living in RCFs (36.6% [111/303]) compared with those not living in RCFs (12.7% [45/353]). Increased risk of death was associated with age 80 years and older (hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.35–4.24), male sex (HR 1.74, 95% CI 1.25–2.41), the presence of 4 or more comorbidities (HR 2.01, 95% CI 1.18–3.42) and living in an RCF (HR 1.62, 95% CI 1.09–2.39).Interpretation: During the first wave of the COVID-19 epidemic in Montréal, more than one-third of RCF residents hospitalized with SARS-CoV-2 infection died during hospitalization. Policies and practices that prevent future outbreaks of SARS-CoV-2 infection in this setting must be implemented to prevent high mortality in this vulnerable population.