Investigation of SARS-CoV-2 outbreaks in six care homes in London, April 2020

Background: Care homes are experiencing large outbreaks of COVID-19 associated with high case-fatality rates. We conducted detailed investigations in six London care homes reporting suspected COVID-19 outbreaks during April 2020. Methods: Residents and staff had nasal swabs for SARS CoV-2 testing us...

Full description

Saved in:
Bibliographic Details
Published in:EClinicalMedicine 2020-09, Vol.26, p.100533-100533, Article 100533
Main Authors: Ladhani, Shamez N, Chow, J.Yimmy, Janarthanan, Roshni, Fok, Jonathan, Crawley-Boevey, Emma, Vusirikala, Amoolya, Fernandez, Elena, Perez, Marina Sanchez, Tang, Suzanne, Dun-Campbell, Kate, Evans, Edward Wynne, Bell, Anita, Patel, Bharat, Amin-Chowdhury, Zahin, Aiano, Felicity, Paranthaman, Karthik, Ma, Thomas, Saavedra-Campos, Maria, Myers, Richard, Ellis, Joanna, Lackenby, Angie, Gopal, Robin, Patel, Monika, Brown, Colin, Chand, Meera, Brown, Kevin, Ramsay, Mary E, Hopkins, Susan, Shetty, Nandini, Zambon, Maria
Format: Article
Language:English
Subjects:
Care homes
Case-fatality rate
Covid-19
Research Paper
Symptoms
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Care homes are experiencing large outbreaks of COVID-19 associated with high case-fatality rates. We conducted detailed investigations in six London care homes reporting suspected COVID-19 outbreaks during April 2020. Methods: Residents and staff had nasal swabs for SARS CoV-2 testing using RT-PCR and were followed-up for 14 days. They were categorized as symptomatic, post-symptomatic or pre-symptomatic if they had symptoms at the time of testing, in the two weeks before or two weeks after testing, respectively, or asymptomatic throughout. Virus isolation and whole genome sequencing (WGS) was also performed. Findings: Across the six care homes, 105/264 (39.8%) residents were SARS CoV-2 positive, including 28 (26.7%) symptomatic, 10 (9.5%) post-symptomatic, 21 (20.0%) pre-symptomatic and 46 (43.8%) who remained asymptomatic. Case-fatality at 14-day follow-up was highest among symptomatic SARS-CoV-2 positive residents (10/28, 35.7%) compared to asymptomatic (2/46, 4.3%), post-symptomatic (2/10, 20.0%) or pre-symptomatic (3/21,14.3%) residents. Among staff, 53/254 (20.9%) were SARS-CoV-2 positive and 26/53 (49.1%) remained asymptomatic. RT-PCR cycle-thresholds and live-virus recovery were similar between symptomatic/asymptomatic residents/staff. Higher RT-PCR cycle threshold values (lower virus load) samples were associated with exponentially decreasing ability to recover infectious virus (P
ISSN:2589-5370
2589-5370
DOI:10.1016/j.eclinm.2020.100533