Evidence map›Paper›PMID 39391999›Full record

ArticleEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin2024

Association between delayed outbreak identification and SARS-CoV-2 infection and mortality among long-term care home residents, Ontario, Canada, March to November 2020: a cohort study.

Kevin A Brown, Sarah A Buchan, Adrienne K Chan, Andrew Costa, Nick Daneman, Gary Garber, Michael Hillmer, Aaron Jones, James M Johnson, Dylan Kain and 6 more

Abstract read
In one paragraph

Article in Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Kevin A BrownPublic Health Ontario, Toronto, Canada.
Sarah A BuchanPublic Health Ontario, Toronto, Canada.
Adrienne K ChanDalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Andrew CostaMcMaster University, Hamilton, Canada.
Nick DanemanPublic Health Ontario, Toronto, Canada.
Gary GarberSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
Michael HillmerThe Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Aaron JonesMcMaster University, Hamilton, Canada.
James M JohnsonPublic Health Ontario, Toronto, Canada.
Dylan KainDepartment of Medicine, University of Toronto, Toronto, Canada.
Kamil MalikovOntario Ministry of Health, Toronto, Canada.
Richard G MatherPublic Health Ontario, Toronto, Canada.
Allison McGeerSinai Health, Toronto, Canada.
Kevin L SchwartzPublic Health Ontario, Toronto, Canada.
Nathan M StallSinai Health, Toronto, Canada.
Jennie JohnstoneSinai Health, Toronto, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BackgroundLate outbreak identification is a common risk factor mentioned in case reports of large respiratory infection outbreaks in long-term care (LTC) homes.AimTo systematically measure the association between late SARS-CoV-2 outbreak identification and secondary SARS-CoV-2 infection and mortality in residents of LTC homes.MethodsWe studied SARS-CoV-2 outbreaks across LTC homes in Ontario, Canada from March to November 2020, before the COVID-19 vaccine rollout. Our exposure (late outbreak identification) was based on cumulative infection pressure (the number of infectious resident-days) on the outbreak identification date (early: ≤ 2 infectious resident-days, late: ≥ 3 infectious resident-days), where the infectious window was -2 to +8 days around onset. Our outcome consisted of 30-day incidence of secondary infection and mortality, based on the proportion of at-risk residents with a laboratory-confirmed SARS-CoV-2 infection with onset within 30 days of the outbreak identification date.ResultsWe identified 632 SARS-CoV-2 outbreaks across 623 LTC homes. Of these, 36.4% (230/632) outbreaks were identified late. Outbreaks identified late had more secondary infections (10.3%; 4,437/42,953) and higher mortality (3.2%; 1,374/42,953) compared with outbreaks identified early (infections: 3.3%; 2,015/61,714; p < 0.001, mortality: 0.9%; 579/61,714; p < 0.001). After adjustment for 12 LTC home covariates, the incidence of secondary infections in outbreaks identified late was 2.90-fold larger than that of outbreaks identified early (OR: 2.90; 95% CI: 2.04-4.13).ConclusionsThe timeliness of outbreak identification could be used to predict the trajectory of an outbreak, plan outbreak measures and retrospectively provide feedback for quality improvement, with the objective of reducing the impacts of respiratory infections in LTC home residents.

Indexed as

COVID-19Disease OutbreaksLong-Term CareNursing HomesSARS-CoV-2AgedAged, 80 and overCohort StudiesFemaleHomes for the AgedHumansIncidenceMaleOntarioRisk Factorsaged care facilitiesinfection prevention and controllong term care facilityLTCFnursing homesoutbreakSARS-CoV-2timeliness

Identifiers

PMID39391999
PMCPMC11484918

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.