Predictors of COVID-19 infection and hospitalization in group homes for individuals with intellectual and/or developmental disabilities.

COVID-19 Congregate living settings Disabilities Group homes SARS-CoV-2

Journal

Disability and health journal
ISSN: 1876-7583
Titre abrégé: Disabil Health J
Pays: United States
ID NLM: 101306633

Informations de publication

Date de publication:
05 Jun 2024
Historique:
received: 26 09 2023
revised: 16 05 2024
accepted: 31 05 2024
medline: 16 6 2024
pubmed: 16 6 2024
entrez: 15 6 2024
Statut: aheadofprint

Résumé

More than seven million people with intellectual and/or developmental disabilities (ID/DD) live in the US and may face an elevated risk for COVID-19. To identify correlates of COVID-19 and related hospitalizations among people with ID/DD in group homes in Massachusetts. We collected data during March 1, 2020-June 30, 2020 (wave 1) and July 1, 2020-March 31, 2021 (wave 2) from the Massachusetts Department of Public Health and six organizations administering 206 group homes for 1035 residents with ID/DD. The main outcomes were COVID-19 infections and related hospitalizations. We fit multilevel Cox proportional hazards models to estimate associations with observed predictors and assess contextual home- and organizational-level effects. Compared with Massachusetts residents, group home residents had a higher age-adjusted rate of COVID-19 in wave 1 (incidence rate ratio [IRR], 12.06; 95 % confidence interval [CI], 10.51-13.84) and wave 2 (IRR, 2.47; 95 % CI, 2.12-2.88) and a higher age-adjusted rate of COVID-19 hospitalizations in wave 1 (IRR, 17.64; 95 % CI, 12.59-24.70) and wave 2 (IRR, 4.95; 95 % CI, 3.23-7.60). COVID-19 infections and hospitalizations were more likely among residents aged 65+ and in group homes with 6+ resident beds and recent infection among staff and residents. Aggressive efforts to decrease resident density, staff-to-resident ratios, and staff infections through efforts such as vaccination, in addition to ongoing access to personal protective equipment and COVID-19 testing, may reduce COVID-19 and related hospitalizations in people with ID/DD living in group homes.

Sections du résumé

BACKGROUND BACKGROUND
More than seven million people with intellectual and/or developmental disabilities (ID/DD) live in the US and may face an elevated risk for COVID-19.
OBJECTIVE OBJECTIVE
To identify correlates of COVID-19 and related hospitalizations among people with ID/DD in group homes in Massachusetts.
METHODS METHODS
We collected data during March 1, 2020-June 30, 2020 (wave 1) and July 1, 2020-March 31, 2021 (wave 2) from the Massachusetts Department of Public Health and six organizations administering 206 group homes for 1035 residents with ID/DD. The main outcomes were COVID-19 infections and related hospitalizations. We fit multilevel Cox proportional hazards models to estimate associations with observed predictors and assess contextual home- and organizational-level effects.
RESULTS RESULTS
Compared with Massachusetts residents, group home residents had a higher age-adjusted rate of COVID-19 in wave 1 (incidence rate ratio [IRR], 12.06; 95 % confidence interval [CI], 10.51-13.84) and wave 2 (IRR, 2.47; 95 % CI, 2.12-2.88) and a higher age-adjusted rate of COVID-19 hospitalizations in wave 1 (IRR, 17.64; 95 % CI, 12.59-24.70) and wave 2 (IRR, 4.95; 95 % CI, 3.23-7.60). COVID-19 infections and hospitalizations were more likely among residents aged 65+ and in group homes with 6+ resident beds and recent infection among staff and residents.
CONCLUSIONS CONCLUSIONS
Aggressive efforts to decrease resident density, staff-to-resident ratios, and staff infections through efforts such as vaccination, in addition to ongoing access to personal protective equipment and COVID-19 testing, may reduce COVID-19 and related hospitalizations in people with ID/DD living in group homes.

Identifiants

DOI: 10.1016/j.dhjo.2024.101645 PMID: 38879412
pubmed: 38879412
pii: S1936-6574(24)00076-1
doi: 10.1016/j.dhjo.2024.101645
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101645

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest Dr. Levison is a medical advisor to eMED, LLC. Dr. Tsai receives a financial honorarium from Elsevier, Inc. for his work as Co-Editor in Chief of the Elsevier-owned journal SSM-Mental Health. Dr. Donelan is an unpaid board member of Bridges Associates Inc, a non-profit organization serving persons with intellectual and developmental disabilities. Dr. Becker is a current recipient of the American Academy of Child and Adolescent Psychiatry (AACAP) Junior Investigator Award supported by AACAP and Industry Sponsors (Sunovion Pharmaceuticals, Inc. and Supernus Pharmaceuticals, Inc.). Dr. Skotko occasionally consults on the topic of Down syndrome through Gerson Lehrman Group. He receives remuneration from Down syndrome non-profit organizations for speaking engagements and associated travel expenses. In the past two years, Dr. Skotko received annual royalties from Woodbine House, Inc., for the publication of his book, Fasten Your Seatbelt: A Crash Course on Down Syndrome for Brothers and Sisters. Within the past two years, he has received research funding from F. Hoffmann-La Roche, Inc., AC Immune, and LuMind Research Down Syndrome Foundation to conduct clinical trials for people with Down syndrome. Dr. Skotko is occasionally asked to serve as an expert witness for legal cases where Down syndrome is discussed. Dr. Skotko serves in a non-paid capacity on the Honorary Board of Directors for the Massachusetts Down Syndrome Congress and the Professional Advisory Committee for the National Center for Prenatal and Postnatal Down Syndrome Resources. Dr. Skotko has a sister with Down syndrome.

Auteurs

Julie H Levison (JH)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Massachusetts General Hospital, Department of Medicine, 55 Fruit St, Gray 7-730, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA. Electronic address: jlevison@mgb.org.

Vicki Fung (V)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.

Anna Wilson (A)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA.

David Cheng (D)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Massachusetts General Hospital, Biostatistics Center, 50 Staniford Street, Suite 560, Boston, MA, 02114, USA.

Karen Donelan (K)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Heller School for Social Policy and Management, Brandeis University, 415 South St, Waltham, MA, 02453, USA.

Nicolas M Oreskovic (NM)

Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Massachusetts General Hospital, Department of Pediatrics, Division of Medical Genetics and Metabolism, Down Syndrome Program, 125 Nashua Street, Suite 821, Boston, MA, 02114, USA.

Ronita Samuels (R)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA.

Paula Silverman (P)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Joey Batson (J)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Ahmed Fathi (A)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Stefanie Gamse (S)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Sibyl Holland (S)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Jessica E Becker (JE)

NYU Grossman School of Medicine and NYU Langone Health, Department of Child and Adolescent Psychiatry, 550 First Avenue, New York, NY, 10016, USA.

Kenneth A Freedberg (KA)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Massachusetts General Hospital, Department of Medicine, 55 Fruit St, Gray 7-730, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.

Lisa I Iezzoni (LI)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.

Amy Donohue (A)

Advocates, Inc. 1881 Worcester Rd, Framingham, MA, 01701, USA.

Mark Viron (M)

Advocates, Inc. 1881 Worcester Rd, Framingham, MA, 01701, USA.

Carley Lubarsky (C)

Bay Cove Human Services, 66 Canal Street, Boston, MA, 02114, USA.

Terina Keller (T)

Bay Cove Human Services, 66 Canal Street, Boston, MA, 02114, USA.

Jean-Louise Reichman (JL)

North Suffolk Mental Health Association, 301 Broadway, Chelsea, MA, 02150, USA.

Bettina Bastien (B)

Riverside Community Care, 270 Bridge Street, Suite 301, Dedham, MA, 02026, USA.

Elizabeth Ryan (E)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Alexander C Tsai (AC)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.

John Hsu (J)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Harvard Medical School, Department of Medicine, 25 Shattuck Street, Boston, MA, 02115, USA; Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue, Boston, MA, 02115, USA.

Cindy Chau (C)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA.

David Krane (D)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA.

Hao D Trieu (HD)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA.

Jessica Wolfe (J)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Kim Shellenberger (K)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Elizabeth Cella (E)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Bruce Bird (B)

Vinfen Corporation, 950 Cambridge Street, Cambridge, MA, 02141, USA.

Stephen Bartels (S)

Massachusetts General Hospital, Mongan Institute, 100 Cambridge St, Suite 1600, Boston, MA, 02114, USA; Massachusetts General Hospital, Department of Medicine, 55 Fruit St, Gray 7-730, Boston, MA, 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.

Brian G Skotko (BG)

Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Massachusetts General Hospital, Department of Pediatrics, Division of Medical Genetics and Metabolism, Down Syndrome Program, 125 Nashua Street, Suite 821, Boston, MA, 02114, USA.

Classifications MeSH