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Asymptomatic SARS-CoV-2 Infection and COVID-19 Mortality During an Outbreak Investigation in a Skilled Nursing Facility.
Patel, Mahesh C; Chaisson, Lelia H; Borgetti, Scott; Burdsall, Deborah; Chugh, Rashmi K; Hoff, Christopher R; Murphy, Elizabeth B; Murskyj, Emily A; Wilson, Shannon; Ramos, Joe; Akker, Lynn; Bryars, Debra; Thomas-Smith, Evonda; Bleasdale, Susan C; Ezike, Ngozi O.
Afiliación
  • Patel MC; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
  • Chaisson LH; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
  • Borgetti S; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
  • Burdsall D; Illinois Department of Public Health, Chicago, Illinois, USA.
  • Chugh RK; DuPage County Health Department, Wheaton, Illinois, USA.
  • Hoff CR; DuPage County Health Department, Wheaton, Illinois, USA.
  • Murphy EB; DuPage County Health Department, Wheaton, Illinois, USA.
  • Murskyj EA; DuPage County Health Department, Wheaton, Illinois, USA.
  • Wilson S; Illinois Department of Public Health, Chicago, Illinois, USA.
  • Ramos J; Illinois Department of Public Health, Chicago, Illinois, USA.
  • Akker L; Illinois Department of Public Health, Chicago, Illinois, USA.
  • Bryars D; Illinois Department of Public Health, Chicago, Illinois, USA.
  • Thomas-Smith E; Illinois Department of Public Health, Chicago, Illinois, USA.
  • Bleasdale SC; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
  • Ezike NO; Illinois Department of Public Health, Chicago, Illinois, USA.
Clin Infect Dis ; 71(11): 2920-2926, 2020 12 31.
Article en En | MEDLINE | ID: mdl-32548628
BACKGROUND: Outbreaks of coronavirus disease 2019 (COVID-19) have been reported in nursing homes and assisted living facilities; however, the extent of asymptomatic and presymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this high-risk population remains unclear. METHODS: We conducted an investigation of the first known outbreak of SARS-CoV-2 at a skilled nursing facility (SNF) in Illinois on 15 March 2020 and followed residents for 30 days. We tested 126/127 residents for SARS-CoV-2 via reverse-transcription polymerase chain reaction and performed symptom assessments. We calculated the point prevalence of SARS-CoV-2 and assessed symptom onset over 30-day follow-up to determine: (1) the proportion of cases who were symptomatic, presymptomatic, and asymptomatic and (2) incidence of symptoms among those who tested negative. We used the Kaplan-Meier method to determine the 30-day probability of death for cases. RESULTS: Of 126 residents tested, 33 had confirmed SARS-CoV-2 on 15 March. Nineteen (58%) had symptoms at the time of testing, 1 (3%) developed symptoms over follow-up, and 13 (39%) remained asymptomatic. Thirty-five residents who tested negative on 15 March developed symptoms over follow-up; of these, 3 were re-tested and 2 were positive. The 30-day probability of death among cases was 29%. CONCLUSIONS: SNFs are particularly vulnerable to SARS-CoV-2, and residents are at risk of severe outcomes. Attention must be paid to preventing outbreaks in these and other congregate care settings. Widespread testing and infection control are key to help prevent COVID-19 morbidity and mortality in these high-risk populations.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: SARS-CoV-2 / COVID-19 Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: SARS-CoV-2 / COVID-19 Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos