COVID-19Research Paper|Volume 12, Issue 24|pp 24522—24534

Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests

Biagio Cangiano^1,^2,³, Letizia Maria Fatti¹, Leila Danesi¹, Giacomo Gazzano⁴, Marina Croci¹, Giovanni Vitale^1,^3,⁵, Luisa Gilardini¹, Stefania Bonadonna¹, Iacopo Chiodini^1,², Chiara Francesca Caparello⁶, Antonio Conti¹, Luca Persani^1,^2,³, Marco Stramba-Badiale⁷, Marco Bonomi^1,^2,³

¹IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy
²IRCCS Istituto Auxologico Italiano, Laboratory of Endocrine and Metabolic Diseases, Cusano Milanino, Italy
³Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
⁴IRCCS Istituto Auxologico Italiano, Anatomic Pathology Unit, Milan, Italy
⁵IRCCS Istituto Auxologico Italiano, Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Milan, Italy
⁶IRCCS Istituto Auxologico Italiano, Gastroenterology and Digestive Endoscopy, Milan, Italy
⁷IRCCS Istituto Auxologico Italiano, Department of Geriatrics and Cardiovascular Medicine, Milan, Italy

* Equal contribution

# “Mons. G. Bicchierai” nursing home group: Albergati S, Anselmi G, Calloni A, Bedogni S, Cammarata G, De Iulio C, Di Stefano M, Federici S, Giancola N, Giovanelli L, Goggi G, Melzi L, Moro M, Nadiani B, Rindone A, Vannucchi G

Received: October 14, 2020Accepted: November 16, 2020Published: December 22, 2020

https://doi.org/10.18632/aging.202307

Copyright: © 2020 Cangiano et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality.

Results: We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse “activities of daily living (ADL)” scores, such as Barthel index, Tinetti scale and S.OS.I.A. classification.

Conclusion: Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation.

Design: In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.