Between the spring 2020 U.S. pandemic lockdowns and November, mortality rates due to COVID-19 in nursing homes declined significantly — well before a vaccine was approved to treat the disease, according to a new study.
Investigators examined changes in 30-day mortality rates among 12,271 nursing home residents who had tested positive for COVID-19. Although the decline does not compare with the steep dip in cases and rates after the COVID-19 vaccine rollout (and was soon overshadowed by new outbreaks around the winter holidays), the reduction in adjusted mortality from early April (21%) to November (11%) was notable, said lead author Vincent Mor, Ph.D., of Brown University. It occurred in residents with symptomatic and asymptomatic infections, and in residents with both high and low clinical complexity as well, he reported.
“The mechanisms driving these trends are not entirely understood, but they may include improved clinical management within nursing homes, improved personal protective equipment supply and use, and genetic changes in the virus,” Mor and colleagues wrote.
Reduced COVID-19 mortality was also seen in the hospital setting pre-vaccine. Treatment and infection control gradually improved as clinicians became more experienced with the disease and new treatment possibilities arose, the authors said. The current study may show a parallel drop in COVID-19 deaths among nursing home residents, whose conditions often are managed conservatively within the facility rather than with a hospital transfer, they said.
Nursing home residents have accounted for a disproportionate share of U.S. COVID-19 deaths — at least 40% in the first nine months of the pandemic.
The study was published online ahead of print in Health Affairs.
