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Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic

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2023
Three_Outbreaks_of_COVID-19_in_a_Single_Nursing_Home_PUB_2023.pdf (820.1Kb)
Authors
Čokić, Vladan
Popovska, Zorana
Lijeskić, Olivera
Šabić, Ljiljana
Đurković-Đaković, Olgica
Article (Published version)
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Abstract
Older people in nursing homes (NH) have been hit particularly hard by the COVID-19 pandemic. We conducted a retrospective study of three outbreaks of COVID-19, occurring during the waves of the initial pre-Alpha, Delta and Omicron SARS-CoV-2 variants, in one NH in suburban Belgrade, Serbia. All staff and 95% residents were vaccinated in February 2021, mostly with BBIBP-CorV, and two thirds were boosted with a third dose in August 2021. COVID-19 was diagnosed by positive PCR and/or antigen test. After the first outbreak, 80 affected individuals were tested for SARS-CoV-2 specific antibodies. The first outbreak involved 64/126 (50.8%) residents and 45/64 (70.3%) staff, the second 22/75 (29.3%) residents and 3/40 (7.5%) staff, and the third involved 36/110 (32.7%) residents and 19/56 (33.9%) staff. Clinical presentation ranged from asymptomatic to severe, with severe cases referred to hospital ICUs. Deaths occurred only in residents, and the case fatality rate was 31.2%, 9.1% and 0%, resp...ectively in outbreaks 1, 2 and 3. Specific IgG antibodies were detected in all 35 residents and 44 of the 45 staff, and higher IgG levels were detected in the residents (417.3±273.5) than in the staff (201.9±192.9, p<0.0001) despite a double difference in age (79.0±7.4 vs. 40.1±11.5 years). Outbreaks 2 and 3 involved four and 23 breakthrough infections, respectively. Older individuals mounted a good immunological response to SARS-CoV-2 infection and vaccination, which prevented significant mortality and severe morbidity in the subsequent outbreaks, despite a significant number of breakthrough infections.

Keywords:
COVID-19 / SARS CoV-2 variants / nursing home / residents / staff / outcome / case fatality rate / sex-related differences / SARS-CoV-2 specific antibodies
Source:
Aging and disease, 2023, 14, 1, 99-111
Publisher:
  • International Society on Aging and Disease
Funding / projects:
  • CASHMIR-C19 – Androgen dependent SARS-CoV-2 stimulation of hyperinflammatory response in COVID-19 (RS-7547934)
  • Ministry of Education, Science and Technological Development, Republic of Serbia, Grant no. 200015 (University of Belgrade, Institute for Medical Research) (RS-200015)

DOI: 10.14336/AD.2022.0624

ISSN: 2152-5250

[ Google Scholar ]
URI
http://rimi.imi.bg.ac.rs/handle/123456789/1317
Collections
  • Radovi istraživača / Researchers' publications
Institution/Community
Institut za medicinska istraživanja
TY  - JOUR
AU  - Čokić, Vladan
AU  - Popovska, Zorana
AU  - Lijeskić, Olivera
AU  - Šabić, Ljiljana
AU  - Đurković-Đaković, Olgica
PY  - 2023
UR  - http://rimi.imi.bg.ac.rs/handle/123456789/1317
AB  - Older people in nursing homes (NH) have been hit particularly hard by the COVID-19 pandemic. We conducted a retrospective study of three outbreaks of COVID-19, occurring during the waves of the initial pre-Alpha, Delta and Omicron SARS-CoV-2 variants, in one NH in suburban Belgrade, Serbia. All staff and 95% residents were vaccinated in February 2021, mostly with BBIBP-CorV, and two thirds were boosted with a third dose in August 2021. COVID-19 was diagnosed by positive PCR and/or antigen test. After the first outbreak, 80 affected individuals were tested for SARS-CoV-2 specific antibodies. The first outbreak involved 64/126 (50.8%) residents and 45/64 (70.3%) staff, the second 22/75 (29.3%) residents and 3/40 (7.5%) staff, and the third involved 36/110 (32.7%) residents and 19/56 (33.9%) staff. Clinical presentation ranged from asymptomatic to severe, with severe cases referred to hospital ICUs. Deaths occurred only in residents, and the case fatality rate was 31.2%, 9.1% and 0%, respectively in outbreaks 1, 2 and 3. Specific IgG antibodies were detected in all 35 residents and 44 of the 45 staff, and higher IgG levels were detected in the residents (417.3±273.5) than in the staff (201.9±192.9, p<0.0001) despite a double difference in age (79.0±7.4 vs. 40.1±11.5 years). Outbreaks 2 and 3 involved four and 23 breakthrough infections, respectively. Older individuals mounted a good immunological response to SARS-CoV-2 infection and vaccination, which prevented significant mortality and severe morbidity in the subsequent outbreaks, despite a significant number of breakthrough infections.
PB  - International Society on Aging and Disease
T2  - Aging and disease
T2  - Aging and diseaseAging and disease
T1  - Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic
EP  - 111
IS  - 1
SP  - 99
VL  - 14
DO  - 10.14336/AD.2022.0624
ER  - 
@article{
author = "Čokić, Vladan and Popovska, Zorana and Lijeskić, Olivera and Šabić, Ljiljana and Đurković-Đaković, Olgica",
year = "2023",
abstract = "Older people in nursing homes (NH) have been hit particularly hard by the COVID-19 pandemic. We conducted a retrospective study of three outbreaks of COVID-19, occurring during the waves of the initial pre-Alpha, Delta and Omicron SARS-CoV-2 variants, in one NH in suburban Belgrade, Serbia. All staff and 95% residents were vaccinated in February 2021, mostly with BBIBP-CorV, and two thirds were boosted with a third dose in August 2021. COVID-19 was diagnosed by positive PCR and/or antigen test. After the first outbreak, 80 affected individuals were tested for SARS-CoV-2 specific antibodies. The first outbreak involved 64/126 (50.8%) residents and 45/64 (70.3%) staff, the second 22/75 (29.3%) residents and 3/40 (7.5%) staff, and the third involved 36/110 (32.7%) residents and 19/56 (33.9%) staff. Clinical presentation ranged from asymptomatic to severe, with severe cases referred to hospital ICUs. Deaths occurred only in residents, and the case fatality rate was 31.2%, 9.1% and 0%, respectively in outbreaks 1, 2 and 3. Specific IgG antibodies were detected in all 35 residents and 44 of the 45 staff, and higher IgG levels were detected in the residents (417.3±273.5) than in the staff (201.9±192.9, p<0.0001) despite a double difference in age (79.0±7.4 vs. 40.1±11.5 years). Outbreaks 2 and 3 involved four and 23 breakthrough infections, respectively. Older individuals mounted a good immunological response to SARS-CoV-2 infection and vaccination, which prevented significant mortality and severe morbidity in the subsequent outbreaks, despite a significant number of breakthrough infections.",
publisher = "International Society on Aging and Disease",
journal = "Aging and disease, Aging and diseaseAging and disease",
title = "Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic",
pages = "111-99",
number = "1",
volume = "14",
doi = "10.14336/AD.2022.0624"
}
Čokić, V., Popovska, Z., Lijeskić, O., Šabić, L.,& Đurković-Đaković, O.. (2023). Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic. in Aging and disease
International Society on Aging and Disease., 14(1), 99-111.
https://doi.org/10.14336/AD.2022.0624
Čokić V, Popovska Z, Lijeskić O, Šabić L, Đurković-Đaković O. Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic. in Aging and disease. 2023;14(1):99-111.
doi:10.14336/AD.2022.0624 .
Čokić, Vladan, Popovska, Zorana, Lijeskić, Olivera, Šabić, Ljiljana, Đurković-Đaković, Olgica, "Three Outbreaks of COVID-19 in a Single Nursing Home over Two Years of the SARS-CoV-2 Pandemic" in Aging and disease, 14, no. 1 (2023):99-111,
https://doi.org/10.14336/AD.2022.0624 . .

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