COVID-19 infections have an extended, months-long impact on nursing home residents, placing additional burdens on staff, according to new study results published in the Journal of the American Geriatrics Society.
Residents infected with COVID struggled with cognitive issues and were more dependent on staff for activities of daily living for nine months on average after infection. Researchers from the University of Michigan observed 171 residents at two facilities in the state to quantify long COVID’s effects.
Facility residents who tested positive also died at twice the rate of uninfected residents during the study period.
Few other studies have looked at the effects of long COVID in nursing homes, investigators said. This new data sheds light on how COVID affects residents and staff long after acute symptoms have passed.
“Nursing home residents who had had COVID-19 experienced new decline in their function and needed substantially more help with daily activities after their acute infection period, lasting for months,” explained Lona Mody, MD, interim chief of geriatrics and palliative medicine at UM Medical School. “This places an even greater burden on nursing home staff, who are already stretched thin.”
Sudden declines remain
Of the 171 residents studied, 90 tested positive. Researchers tested participants’ ADL and cognitive function abilities before the pandemic and compared results to ongoing quarterly test results as the pandemic progressed.
“Before the pandemic, the two groups scored about the same on both their need for help with activities of daily living, or ADL, and their cognitive status,” said Sophie Clark, MD. “But the patients who tested positive for COVID showed a sudden decline in both measurements that lasted long after their infection.”
All of the residents tested had multiple chronic health conditions and around half had dementia.
The study’s results support warnings from leading health officials that nursing home residents are particularly vulnerable to long COVID’s health effects.
On average, residents who tested positive had recovered ADL and cognitive abilities by the end of a year — putting them at the nearly same level as those who did not test positive.
But this good news is counterbalanced by the length of their ongoing COVID symptoms and the extra care that their illness requires over many months.
Looking forward
Long COVID creates additional difficulties for skilled nursing facilities already burdened by residents with complex health histories.
The researchers’ main recommendation to caregivers is to remain diligent in ensuring staff and residents (and visitors, if possible) are vaccinated since there is evidence this can reduce the severity of long COVID.
Mody emphasized that the new boosters, which were made available in September, are particularly effective.
The researchers also noted that most of the residents in the study who caught COVID did so before vaccines became available. Because nursing home populations are more protected against it now, future studies might show less steep declines in ADL and cognitive function.
The investigators concluded that future studies should test potentially effective rehabilitation methods.
