Overview of the Epidemiological Situation and Risk Factors for Severe COVID-19 in Long-Term Care Facilities in the World and Russia

Background: Residents of long-term care facilities are at higher risk of the severe course and outcomes of COVID-19. Objective: To describe the epidemiological situation and risk factors for severe COVID-19 in nursing homes in the world and Russia.
Materials and methods: We reviewed Russian and English-language papers published in March 2020 to October 2022 and found in such resources as eLIBRARY.ru, Web of Science, PubMed, Google Academy, and Scopus using the following keywords: long-term care facilities, nursing homes, COVID-19 morbidity in nursing homes, COVID-19 mortality in nursing homes, and COVID-19 risk factors in nursing homes. Availability of information on morbidity and mortality among residents and employees of long-term care facilities in Russia, Europe and the USA and about the risk factors for severe course and adverse outcomes of COVID-19 was the inclusion criterion. Of 1,013 articles initially identified, 40 publications were included in the review.
Results: The analysis of the worldwide epidemiological situation has shown that COVID-19 incidence and mortality rates in nursing homes fluctuate, and, as of October 2022, cases of the disease among residents, including multiple cases within a facility, were still registered. In most countries, the highest incidence of COVID-19 in long-term care facilities was observed in January – March 2022, while the lowest was noted in May – July 2021. The number of deaths has decreased significantly over time and remains low. Risk factors for a severe course and death from the novel coronavirus disease include age, male sex, and concomitant diseases. We established, however, that disease severity was also affected by the staff-to-resident ratio, availability of paid sick leave of the personnel, patient isolation opportunities, division of the working area, type of ownership (private), and COVID-19 incidence rates in the local community.
Conclusion: We have analyzed the epidemiological situation and risk factors for severe COVID-19 in long-term care facilities at the national and global levels. As of October 2022, the novel coronavirus disease remains a challenge for nursing facilities. The severity of the infection is influenced by personal characteristics of patients and external factors related to the residential care facility

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