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COVID-19 related mortality and spread of disease in long-term care: a living systematic review of emerging evidence

Policy responses to mitigate the impact of the COVID-19 pandemic on long-term care (LTC) require robust and timely evidence on mortality and spread of the disease in these settings. The aim of this living systematic review is to synthesise early international evidence on mortality rates and incidence of COVID-19 among people who use and provide LTC.

We report findings of a living systematic review, including studies identified through database searches up to 26/06/20.

54 study reports for 49 unique primary studies or outbreak reports were included. Outbreak investigations in LTC facilities found:
COVID-19 incidence rates 0.0%-71.7% among residents and 0.4%-64.0% among staff at affected facilities.
Mortality rates 0.0%-17.1% of all residents at outbreak facilities, with case fatality rates between 0.0% and 33.7%.
In included studies of outbreaks, no LTC staff members had died.
Studies of wider LTC populations found 0.4%-40.8% users, and 4.0%-23.8% of staff were infected. There was limited information on the impact of COVID-19 on LTC in the community.

Long-term care users have been particularly vulnerable to the COVID-19 pandemic. However, we found wide variation in spread of disease and mortality rates between outbreaks at individual LTC facilities. Further research into the factors determining successful prevention and containment of COVID-19 outbreaks is needed to protect long-term care users and staff.

Original content: https://web.www.healthdatagateway.org/paper/4810659557121588