Efficacy of a Test-Retest Strategy in Residents and Health Care Personnel of a Nursing Home Facing a COVID-19 Outbreak.
Antibodies, Viral
/ analysis
COVID-19
COVID-19 Testing
COVID-19 Vaccines
Clinical Laboratory Techniques
/ methods
Contact Tracing
/ methods
Coronavirus Infections
/ diagnosis
DNA, Viral
/ analysis
Disease Outbreaks
/ prevention & control
Female
Health Personnel
/ statistics & numerical data
Humans
Infectious Disease Transmission, Vertical
/ prevention & control
Male
Nursing Homes
/ organization & administration
Occupational Health
/ statistics & numerical data
Outcome Assessment, Health Care
Pandemics
Patient Safety
/ statistics & numerical data
Pneumonia, Viral
/ diagnosis
Real-Time Polymerase Chain Reaction
/ methods
Skilled Nursing Facilities
/ organization & administration
United States
/ epidemiology
COVID-19
antibodies against SARS-CoV-2
nursing home
rRT-PCR
Journal
Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
28
05
2020
revised:
07
06
2020
accepted:
08
06
2020
entrez:
18
7
2020
pubmed:
18
7
2020
medline:
31
7
2020
Statut:
ppublish
Résumé
To assess the American Testing Guidance for Nursing Homes (NHs)-updated May 19, 2020-with a new COVID-19 case. Case investigation. All 79 residents and 34 health care personnel (HCP) of an NH. Seven days after identification of a COVID-19 resident, all residents and HCP underwent real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) testing for SARS-CoV-2 with nasopharyngeal swabs. This was repeated weekly in all previously negative subjects until the testing identified no new cases, and in all positive subjects until the testing was negative. COVID-19 infection prevention and control (IPC) measures were implemented in all residents and HCP with positive testing or with COVID-19 symptoms. Standard IPC was also implemented in all HCP. Six weeks after initial testing, all residents underwent testing for enzyme-linked immunosorbent assay-based IgG antibodies directed against the SARS-CoV-2. Symptoms were serially recorded in residents and HCP. A total of 36 residents had a positive rRT-PCR at baseline and 2 at day 7. Six HCP had a positive rRT-PCR at baseline and 2 at day 7. No new COVID-19 cases were diagnosed later. Among the SARS-CoV-2-positive cases, 6 residents (16%) and 3 HCP (37%) were asymptomatic during the 14 days before testing. Twenty-five residents (92.3%) and all 8 HCP (100%) with a positive rRT-PCR developed IgG antibodies against SARS-CoV-2. Among the residents and HCP always having tested negative, 2 (5%) and 5 (11.5%), respectively, developed IgG antibodies against SARS-CoV-2. These 2 residents had typical COVID-19 symptoms before and after testing and 2/5 HCP were asymptomatic before and after testing. This study shows the validity of the updated American Testing Guidance for Nursing Homes (NHs). It suggests implementing COVID-19 IPC in both residents and HCP with positive testing or COVID-19 symptoms and warns that asymptomatic HCP with repeated negative rRT-PCR testing can develop antibodies against SARS-CoV-2.
Identifiants
pubmed: 32674822
pii: S1525-8610(20)30518-1
doi: 10.1016/j.jamda.2020.06.013
pmc: PMC7287418
pii:
doi:
Substances chimiques
Antibodies, Viral
0
COVID-19 Vaccines
0
Covid-19 aAPC vaccine
0
DNA, Viral
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
933-936Informations de copyright
Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Références
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