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Abstract

Background

Adults aged ≥65 years and those with underlying medical conditions, including residents of long-term care facilities (LTCF), are at increased risk for COVID-19-associated hospitalizations and other severe outcomes.

Methods

Hospitalizations among LTCF residents aged ≥ 65 years from March 2020–January 2022 were described using data on a representative sample of hospitalizations from the CDC’s COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a population-based surveillance network of > 250 acute care hospitals in 99 counties across 14 states. A Poisson regression model adjusting for age, race/ethnicity, underlying medical conditions, vaccination status, month of admission, and do-not-resuscitate/intubate-or-provide comfort-measures-only (DNR/DNI/CMO) code status examined the relationship of LTCF residency to death during COVID-19-associated hospitalization.

Results
Of 11,901 hospitalizations among adults aged ≥ 65 years reported during the study period, 2,965 (24.9%) were LTCF residents; most resided in nursing homes (53.8%) or assisted living facilities (26.8%). LTCF residents hospitalized with COVID-19 were older and more likely to have cardiovascular disease, congestive heart failure, a neurologic condition, dementia, or ≥ 3 underlying medical conditions than non-residents (Figure). The proportion of LTCF residents vs non-residents who required intensive care unit admission or invasive mechanical ventilation were not statistically different (23.2% vs 23.5% and 10.7 vs 13.5%, respectively). The proportion of in-hospital death was higher among LTCF residents than non-residents (22.8% vs 14.4%, p < 0.01). More LTCF residents have a DNR/DNI/CMO code status (48%) compared to non-residents (19%). The fully adjusted regression model found the risk ratio for death was 1.03 (95% CI, 1.01–1.05) among LTCF residents compared to non-residents.
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Conclusion

Compared to non-residents, LTCF residents were older, had more underlying conditions, and had a higher risk of in-hospital death. After adjusting for multiple potential confounders, results suggest that LTCF residency is a weak but significant independent risk factor for death during COVID-19-associated hospitalization.

Disclosures

All Authors: No reported disclosures.

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Author notes

Session: 223. COVID-19: Epidemiology and Screening

Saturday, October 22, 2022: 12:15 PM

© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
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