COVID-19 Infections and Mortality in Long-term Care Facilities During the First Wave

The medical charts of all COVID-19 cases (n=1200) from 17 long-term care facilities in Montreal, Canada will be reviewed, to compare patients who survived to patients who did not survive. Through multilevel logistic regression, the risk of death will be estimated for institutional predictors of mortality, while controlling for individual risk factors.

Individual covariates include clinical features (age, sex, Charlston comorbidity index, SMAF autonomy score, severity criteria) and medical treatments (IV fluids, anticoagulation, oxygen, regular opiates, corticosteroids). Aggregate covariates include epidemiological data (attack rates, timing of outbreak) and institutional characteristics (number of beds, air exchange per hour, presence of a dedicated COVID-19 unit at the time of outbreak, staff compliance to infection control measures, staff infection rates, understaffing, proportion of semi-private rooms, proportion of wandering wards and other special units).

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Key information

Conditions

Covid19 Alzheimer Disease Brain Diseases COVID-19 Central Nervous System Diseases Coronaviridae Infections Coronavirus Infections Death Dementia Elderly Infection Epidemic Disease Infection Viral Infection, Coronavirus Infections Infections, Respiratory Lung Diseases Mental Disorders Nervous System Diseases Neurocognitive Disorders Neurodegenerative Diseases Nidovirales Infections Old Age; Dementia Pathologic Processes Pathological Conditions, Signs and Symptoms Pneumonia Pneumonia, Viral RNA Virus Infections Respiratory Tract Diseases Respiratory Tract Infections Tauopathies Virus Diseases

Sex eligibility

All sexes

Study type

Observational

Primary location

CIUSSS Centre-Sud-de-l'Île-de-Montréal

Montreal, Quebec, H2L 4M1, Canada

About this study

A lot has been written about individual risk factors for COVID-19 death, mostly in the hospitalized population. However, even though most deaths around the world have occurred among the frail and elderly, little is known about the risk factors specific to the long-term care population.

In this retrospective cohort study, the investigators will review the medical charts of all COVID-19 cases (n=1200) from 17 long-term care facilities in Montreal, Canada, to compare patients who survived to patients who did not survive. Through multilevel logistic regression, the risk of death will be estimated for institutional predictors of mortality, while controlling for individual risk factors. The objective is to influence local and national policies in long-term care facilities, in the hopes of avoiding the tragic spring 2020 outcomes during subsequent waves of COVID-19 or future pandemics.

Covariates in the models will be drawn from a review of the medical literature and known risk factors for COVID-19 death. Individual-level covariates include clinical features (age, sex, Charlston comorbidity index, SMAF autonomy score, severity criteria) as well as medical treatments (IV fluids, anticoagulation, oxygen, regular opiates, corticosteroids). Aggregate-level covariates include epidemiological data (attack rates, timing of outbreak) and institutional characteristics (number of beds, air exchange per hour, presence of a dedicated COVID-19 unit at the time of outbreak, staff compliance to infection control measures, staff infection rates, understaffing, proportion of semi-private rooms, proportion of wandering wards and other special units).

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Resident of a long-term care facility within the CIUSSS Centre-Sud-de-l'Île-de-Montréal
Nosocomial COVID-19 infection diagnosis between March 23rd and July 11th 2020

Exclusion criteria

Admission to the long-term care facility after July 11th 2020
COVID-19 infection which was not acquired within the long-term care facility

Treatment and study plan

COVID-19 infection

Other

Case of nosocomial infection within the long-term care facility

Primary outcomes

Death

Time frame: 28 days

COVID-19 as a primary or secondary cause of death

Sponsors and collaborators

Lead sponsor

Centre integre universitaire de sante et de services sociaux du Centre-Sud-de-l'Île-de-Montréal

Other Gov

Collaborators

Université de Montréal

Registry information

Official study title

COVID-19 Infections and Mortality in Montreal Long-term Care Facilities During the First Wave: a Retrospective Cohort Study

Important dates

Study start: 2021
Primary completion: 2021
Study completion: 2021
First posted: Mar 4, 2021
Registry last updated: Jul 28, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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