Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: a population-level cohort study

被引：24

作者：

Costa, Andrew P. ^{[1
,2
,3
,4
,5
,6
]}

Manis, Derek R. ^{[1
,6
]}

Jones, Aaron ^{[1
,5
]}

Stall, Nathan M. ^{[5
,7
,8
,9
,10
,11
,12
]}

Brown, Kevin A. ^{[13
,14
]}

Boscart, Veronique ^{[4
,15
]}

Castellino, Adriane ^{[16
]}

Heckman, George A. ^{[4
,17
]}

Hillmer, Michael P. ^{[10
,18
]}

Ma, Chloe ^{[16
]}

Pham, Paul ^{[16
]}

Rais, Saad ^{[18
]}

Sinha, Samir K. ^{[7
,8
,9
,10
,12
]}

Poss, Jeffrey W. ^{[1
,17
]}

机构：

[1] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[2] McMaster Univ, Dept Med, Hamilton, ON, Canada

[3] St Josephs Hlth Syst, Ctr Integrated Care, Hamilton, ON, Canada

[4] Schlegel Res Inst Aging, Waterloo, ON, Canada

[5] Inst Clin Evaluat Sci IC ES, Toronto, ON, Canada

[6] St Josephs Hlth Syst, Ctr Hlth Econ & Policy Anal, Hamilton, ON, Canada

[7] Sinai Hlth, Div Gen Internal Med & Geriatr Med, Toronto, ON, Canada

[8] Univ Hlth Network, Toronto, ON, Canada

[9] Univ Toronto, Dept Med, Toronto, ON, Canada

[10] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[11] Ryerson Univ, Womens Coll Hosp, Womens Coll Res Inst, Toronto, ON, Canada

[12] Ryerson Univ, Natl Inst Ageing, Toronto, ON, Canada

[13] Publ Hlth Ontario, Infect Prevent & Control, Toronto, ON, Canada

[14] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[15] Conestoga Coll, Inst Technol & Adv Learning, Kitchener, ON, Canada

[16] Retirement Homes Regulatory Author RHRA, Toronto, ON, Canada

[17] Univ Waterloo, Sch Publ Hlth & Hlth Syst, Waterloo, ON, Canada

[18] Ontario Minist Hlth, Capac Planning & Analyt, Toronto, ON, Canada

来源：

CANADIAN MEDICAL ASSOCIATION JOURNAL | 2021年 / 193卷 / 19期

关键词：

COVID-19;

D O I：

10.1503/cmaj.202756

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: The epidemiology of SARS-CoV-2 infection in retirement homes (also known as assisted living facilities) is largely unknown. We examined the association between home-and community-level characteristics and the risk of outbreaks of SARS-CoV-2 infection in retirement homes since the beginning of the first wave of the COVID-19 pandemic. METHODS: We conducted a population-based, retrospective cohort study of licensed retirement homes in Ontario, Canada, from Mar. 1 to Dec. 18, 2020. Our primary outcome was an outbreak of SARS-CoV-2 infection (>= 1 resident or staff case confirmed by validated nucleic acid amplification assay). We used time-dependent proportional hazards methods to model the associations between retirement home- and community-level characteristics and outbreaks of SARS-CoV-2 infection. RESULTS: Our cohort included all 770 licensed retirement homes in Ontario, which housed 56 491 residents. There were 273 (35.5%) retirement homes with 1 or more outbreaks of SARS-CoV-2 infection, involving 1944 (3.5%) residents and 1101 staff (3.0%). Cases of SARS-CoV-2 infection were distributed unevenly across retirement homes, with 2487 (81.7%) resident and staff cases occurring in 77 (10%) homes. The adjusted hazard of an outbreak of SARS-CoV-2 infection in a retirement home was positively associated with homes that had a large resident capacity, were co-located with a long-term care facility, were part of larger chains, offered many services onsite, saw increases in regional incidence of SARS-CoV-2 infection, and were located in a region with a higher community-level ethnic concentration. INTERPRETATION: Readily identifiable characteristics of retirement homes are independently associated with outbreaks of SARS-CoV-2 infection and can support risk identification and priority for vaccination.

引用

页码：E672 / E680

页数：9

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