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Sacco et al. (2020):
“This monocentric observational study contributes to emerging understanding of the presentation and trajectory of COVID-19 in nursing-home residents. This case series showed that frail older adults exhibit relatively few symptoms, and notably less often fever, cough, and ENT signs than younger adults. In this sense, our results are consistent with the few previous studies on symptoms met in older adults infected with COVID-19. It is also consistent with the clinical presentation of other viral infections in older adults such as influenza. Here, the residents exhibited both general and respiratory signs (59% hyperthermia, 49% cough, 42% polypnea) together with gastro-intestinal signs (12 % diarrhoea) and geriatric syndromes (15% falls, 1 % altered consciousness). Surprisingly, delirium was less frequent compared to one previous report in adults aged 70 and over (7% here versus 26.7 % previously). This may be explained by the characteristics of the present sample, which involved mainly frail older residents with major neurocognitive disorders and behavioural disturbances. Delirium is commonly under-recognized when superimposed to major neurocognitive disorders, especially during the severe stages of the disease since a clear distinction between symptoms attributable to delirium or to underlying dementia proves difficult” (p. 49).
Attachments:
6648733_1_UGRC-210-SEM-1-OFFSITE-ONLINE-EXAM-2020-2021.docx

Sacco et al. (2020):
“This monocentric observational study contributes to emerging understanding of the presentation and trajectory of COVID-19 in nursing-home residents. This case series showed that frail older adults exhibit relatively few symptoms, and notably less often fever, cough, and ENT signs than younger adults. In this sense, our results are consistent with the few previous studies on symptoms met in older adults infected with COVID-19. It is also consistent with the clinical presentation of other viral infections in older adults such as influenza. Here, the residents exhibited both general and respiratory signs (59% hyperthermia, 49% cough, 42% polypnea) together with gastro-intestinal signs (12 % diarrhoea) and geriatric syndromes (15% falls, 1 % altered consciousness). Surprisingly, delirium was less frequent compared to one previous report in adults aged 70 and over (7% here versus 26.7 % previously). This may be explained by the characteristics of the present sample, which involved mainly frail older residents with major neurocognitive disorders and behavioural disturbances. Delirium is commonly under-recognized when superimposed to major neurocognitive disorders, especially during the severe stages of the disease since a clear distinction between symptoms attributable to delirium or to underlying dementia proves difficult” (p. 49).
(Reference Information: Journal:
Maturitas.
Volume
141
. Pages
46–52
.
Title of paper:
COVID-19 in seniors: Findings and lessons from mass screening in a nursing home.
Authors:
Guillaume Sacco, Gonzague Foucault, Olivier Briere,
and
Ce´dric Annweiler. Year of publication: 2020.)
Sugg et al. (2021):
“Our spatial-based approach compiled nearly 130 variables from multiple sources to capture geographic variability in nursing homes, community-level socioeconomic characteristics, and cumulative COVID-19 incidence. Results demonstrated that county-level COVID-19 rates, per-capita income, average household size, population square miles, unemployment, and a higher percentage of African Americans, in combination with nursing home staffing levels (LPNs and total staff) and number of fines issued in 2020 were associated with an increased risk of COVID-19 transmission in nursing homes. Findings from regional models suggested a robust positive relationship between cumulative COVID-19 incidence and county-level per capita income and COVID-19 rates. Our spatial results are confirmed with prior research, which found a higher risk of COVID-19 among nursing home residents in the North-eastern US and parts of the South-eastern US, all locations that were early epidemic emergers in the U.S” (p. 4).
(Reference Information: Authors:
Margaret M. Sugg, Trent J. Spaulding, Sandi J. Lane, Jennifer D. Runkle, Stella R. Harden, Adam Hege,
and
Lakshmi S. Iyer.
Volume 752, pages 1 to 9. Title of paper:
Mapping community-level determinants of COVID-19 transmission in nursing homes: A multi-scale approach.
Journal: Science of the Total Environment. Year of publication: 2021.)
Attachments:
6648738_1_UGRC-210-SEM-1-OFFSITE-ONLINE-EXAM-2020-2021.docx

The case notes that the Nationwide had in mind a simple goal, but faced a difficult challenge. Why was this so difficult?

Sacco et al. (2020):
“This monocentric observational study contributes to emerging understanding of the presentation and trajectory of COVID-19 in nursing-home residents. This case series showed that frail older adults exhibit relatively few symptoms, and notably less often fever, cough, and ENT signs than younger adults. In this sense, our results are consistent with the few previous studies on symptoms met in older adults infected with COVID-19. It is also consistent with the clinical presentation of other viral infections in older adults such as influenza. Here, the residents exhibited both general and respiratory signs (59% hyperthermia, 49% cough, 42% polypnea) together with gastro-intestinal signs (12 % diarrhoea) and geriatric syndromes (15% falls, 1 % altered consciousness). Surprisingly, delirium was less frequent compared to one previous report in adults aged 70 and over (7% here versus 26.7 % previously). This may be explained by the characteristics of the present sample, which involved mainly frail older residents with major neurocognitive disorders and behavioural disturbances. Delirium is commonly under-recognized when superimposed to major neurocognitive disorders, especially during the severe stages of the disease since a clear distinction between symptoms attributable to delirium or to underlying dementia proves difficult” (p. 49).
(Reference Information: Journal:
Maturitas.
Volume
141
. Pages
46–52
.
Title of paper:
COVID-19 in seniors: Findings and lessons from mass screening in a nursing home.
Authors:
Guillaume Sacco, Gonzague Foucault, Olivier Briere,
and
Ce´dric Annweiler. Year of publication: 2020.)
Sugg et al. (2021):
“Our spatial-based approach compiled nearly 130 variables from multiple sources to capture geographic variability in nursing homes, community-level socioeconomic characteristics, and cumulative COVID-19 incidence. Results demonstrated that county-level COVID-19 rates, per-capita income, average household size, population square miles, unemployment, and a higher percentage of African Americans, in combination with nursing home staffing levels (LPNs and total staff) and number of fines issued in 2020 were associated with an increased risk of COVID-19 transmission in nursing homes. Findings from regional models suggested a robust positive relationship between cumulative COVID-19 incidence and county-level per capita income and COVID-19 rates. Our spatial results are confirmed with prior research, which found a higher risk of COVID-19 among nursing home residents in the North-eastern US and parts of the South-eastern US, all locations that were early epidemic emergers in the U.S” (p. 4).
(Reference Information: Authors:
Margaret M. Sugg, Trent J. Spaulding, Sandi J. Lane, Jennifer D. Runkle, Stella R. Harden, Adam Hege,
and
Lakshmi S. Iyer.
Volume 752, pages 1 to 9. Title of paper:
Mapping community-level determinants of COVID-19 transmission in nursing homes: A multi-scale approach.
Journal: Science of the Total Environment. Year of publication: 2021.)
Attachments:
6649039_1_UGRC-210-SEM-1-OFFSITE-ONLINE-EXAM-2020-2021.docx