Mortality and characteristics of older people dying with COVID‑19 in Lombardy nursing homes, Italy: An observational cohort study

Background: The aim of the study was to describe the epidemiological characteristics of Nursing Homes (NHs) residents infected by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection and to compute the related case‑fatality rate. Materials and Methods: The outcomes were mortality and case‑fatality rate with related epidemiological characteristics (age, sex, comorbidity, and frailty). Results: During the COVID‑19 outbreak lasted from March 1 to May 7, 2020, 330 residents died in Fondazione Don Gnocchi NHs bringing the mortality rate to 27% with a dramatic increase compared to the same period of 2019, when it was 7.5%. Naso/oropharyngeal swabs resulted positive for COVID‑19 in 315 (71%) of the 441of the symptomatic/exposed residents tested. The COVID‑19 population was 75% female, with a 17% overall fatality rate and sex‑specific fatality rates of 19% and 13% for females and males, respectively. Fifty‑six percent of deaths presented SARS‑CoV‑2‑associated pneumonia, 15% cardiovascular, and 29% miscellaneous pathologies. Conclusion: Patients’ complexity and frailty might influence SARS‑CoV‑2 infection case‑fatality rate estimates. A COVID‑19 register is needed to study COVID‑19 frail patients’ epidemiology and characteristics.