Mortality and characteristics of older people dying with COVID19 in Lombardy nursing homes Italy An observational cohort study

The aim of the study was to describe the epidemiological characteristics of Nursing Homes (NHs) residents infected by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection and to compute the related case‑fatality rate.

The outcomes were mortality and case‑fatality rate with related epidemiological characteristics (age, sex, comorbidity, and frailty).

During the COVID‑19 outbreak lasted from March 1 to May 7, 2020, 330 residents died in Fondazione Don Gnocchi NHs bringing the mortality rate to 27% with a dramatic increase compared to the same period of 2019, when it was 7.5%. Naso/oropharyngeal swabs resulted positive for COVID‑19 in 315 (71%) of the 441of the symptomatic/exposed residents tested. The COVID‑19 population was 75% female, with a 17% overall fatality rate and sex‑specific fatality rates of 19% and 13% for females and males, respectively. Fifty‑six percent of deaths presented SARS‑CoV‑2‑associated pneumonia, 15% cardiovascular, and 29% miscellaneous pathologies.

Patients’ complexity and frailty might influence SARS‑CoV‑2 infection case‑fatality rate estimates. A COVID‑19 register is needed to study COVID‑19 frail patients’ epidemiology and characteristics.