柏林-新科隆养老院的 COVID-19 流行病学

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2024-09-20 DOI:10.1016/j.jiph.2024.102546

Alexandra Roth , Lena Gehre , Jonas Gerke , Maja Lutz , Georgianna Manafa , Tillman Schmitz , Christoph Lambio , Sida Zhuang , Jeffrey Butler , Tobia Lakes , Nicolai Savaskan

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引用次数: 0

摘要

背景COVID-19大流行以不同的方式影响着不同的城市人群。早期的研究表明，严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）对疗养院居民的影响尤为严重，增加了病毒暴露后的发病率和死亡率。然而，人们对这种疾病的流行病学知之甚少。因此，本研究的目的是分析 COVID-19 大流行在德国柏林-新科隆地区 14 家养老院的发展情况，时间跨度为大流行第 1 波至第 5 波（2020 年 2 月至 2022 年 5 月）。方法从 SORMAS 数据库中提取向新科隆公共卫生部报告的与养老院有关的 COVID-19 病例数据。计算了病例死亡率 (CFR) 以及人口统计学参数、流行变异株 (VOC) 和疫苗可用性的几率比 (OR)。结果从提供依赖年龄的身体护理的疗养院收集到的数据显示，在研究期间，柏林-新科隆登记的 108,600 例病例中有 1.9% 与 14 家机构中的一家有关。与新科隆的普通人群相比，疗养院的 CFR 增加了 20 倍。值得注意的是，与规模较小的养老院相比，床位数较多的养老院的 CFR 更大。同样，住在疗养院的老年居民的死亡率也远远高于住在医疗机构外的老年居民（OR = 3.5）。原始野生型 SARS-CoV-2 株系的直接影响最为严重，CFR 为 16.7%，相比之下，养老院中的α（CFR = 6.9%）、δ（CFR = 10.2%）和Ω（CFR = 2.8%）变种的直接影响最为严重。有趣的是，接种疫苗后感染人数有所增加，但与此同时，死亡人数从每周 2.6 例降至 1.1 例。因此，CFR 从 18.4 显著下降到 5.5，但仍高于新科隆普通人群的平均 CFR。我们的研究结果揭示了在五次大流行中疫情爆发频率和严重程度的变化模式，并强调了为居民、员工、访客和第三方服务机构提供快速疫苗接种计划在保护疗养院方面的关键作用。此外，在疫苗接种前的情况下，改进遏制和集群策略对于防止长期护理机构中的老年人今后受到感染至关重要。所提供的数据强调了为我们社会中最脆弱的人群之一量身定制保护措施的重要性。

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Epidemiology of COVID-19 in Berlin-Neukölln nursing homes

Background

The COVID-19 pandemic has affected various urban population groups in different ways. Earlier studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disproportionally impacts nursing home residents by increasing morbidity and mortality following viral exposure. However, little is known about the epidemiology of this disease in detail. Therefore, the objective of this study is to analyze the development of the COVID-19 pandemic in 14 nursing homes across Berlin-Neukölln, Germany, during pandemic waves 1 to 5 (Feb 2020 - May 2022).

Methods

Reporting data to the Neukölln Department of Public Health on COVID-19 cases in connection with nursing homes were extracted from the SORMAS database. The case fatality rates (CFRs) and odds ratios (ORs) of demographic parameters, prevalent variants of concern (VOCs) and vaccine availability were calculated. In addition, the temporal course in waves 1–5 in Neukölln and the relevant government measures were examined.

Results

Data collected from nursing homes providing age-dependent physical care revealed that 1.9 % of the total 108,600 cases registered in Berlin-Neukölln during the study period were related one of the 14 facilities. Compared to the general population in Neukölln, nursing homes exhibited a 20-fold increase in the CFR. Notably, nursing homes with higher bed capacities displayed a greater CFR than did smaller nursing homes. Similarly, elderly residents living in nursing homes faced a much greater mortality rate than did their counterparts living outside of medical settings (OR = 3.5). The original wild-type SARS-CoV-2 strain had the most severe direct impact, with a CFR of 16.7 %, compared to the alpha (CFR = 6.9 %), delta (CFR = 10.2 %) and omicron (CFR = 2.8 %) variants in nursing homes. Interestingly, the number of infections increased following vaccination campaigns, but this trend was accompanied by a decrease in the number of deaths from 2.6 to 1.1 per week. As a result, the CFR significantly decreased from 18.4 to 5.5, while still exceeding the mean CFR compared to that of the general population of Neukölln.

Conclusions

Our findings reveal the changing patterns of outbreak frequency and severity across the five pandemic waves. They highlight the crucial role of rapid vaccination programs for residents, staff, visitors, and third-party services in safeguarding nursing homes. Additionally, improvements in containment and cluster strategies are essential in prevaccination scenarios to prevent future infection traps for elderly individuals in long-term care facilities. The presented data highlight the importance of tailored protection measures for one of the most vulnerable populations in our society.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.