COVID-19 in institutionalized elderly people: clinical repercussions and risk factors for death

Authors

DOI:

https://doi.org/10.5902/2179769291167

Keywords:

Coronavirus Infections, Aged, Homes for the Aged, Health of the Elderly, Risk Factors

Abstract

Objective: to identify clinical repercussions and risk factors for death of institutionalized elderly individuals infected with coronavirus (SARS-CoV-2). Method: quantitative, descriptive, and analytical study conducted with 201 elderly individuals in a Long-Term Care Facility in northeastern Brazil. Descriptive statistics, Pearson's Chi-square, and logistic regression were used, and p<0.05 was adopted. Results: 134 (66.7%) were confirmed with COVID-19, 44.8% presented clinical manifestations, and mortality was 6.0%. Dependent elderly individuals had a higher chance of death. Diabetes, kidney disease, referral to hospital services, and use of oxygen therapy were associated with higher mortality. Elderly individuals with dyslipidemia and diabetes had greater severity of the disease. In the multivariate logistic regression model, the variables of care dependence and diabetes mellitus remained as risk factors for death from COVID-19. Conclusion: functional dependence and comorbidities emerged as critical indicators of adverse outcomes, in addition, dyslipidemia and diabetes were associated with greater disease severity.

Downloads

Download data is not yet available.

Author Biographies

Maria Lígia Silva Nunes Cavalcante, State University of Ceará

PhD in Clinical Care in Nursing and Health from the State University of Ceará (2022). Master in Clinical Care in Nursing and Health from the State University of Ceará (2017). Specialist in Intensive Care Nursing from the State University of Ceará (2016). Nurse from the Federal University of Ceará (2014). Nursing Assistant at the Long-Term Care Institution for the Elderly Lar Torres de Melo. Professor at Maurício de Nassau University. Advisor to the Gerontological Nursing League at the Maurício de Nassau University Center. Experience in the area of ​​Nursing, with an emphasis on Elderly Health, working mainly on the following topics: Long-Term Care Institution for the Elderly (ILPI); Nursing Care; Patient Safety; Medication Systems.

Renata Kelly Lopes de Alcântara, Universidade Estadual do Ceará

Postgraduate in Intensive Care Nursing. Specialist in Gerontology (2017-2019). Nurse at Uninassau Fortaleza (2012-2017). Nursing Assistant at the Long-Term Care Institution for the Elderly Lar Torres de Melo and at the Long-Term Care Institution for the Elderly Associação da Caridade Casa São Vcente de Paulo. Experience in the area of ​​Nursing, with an emphasis on Elderly Health, working mainly on the following topics: long-term care institution, nursing care, elderly health.

João Vitor Teixeira de Sousa, State University of Ceará

Nurse, graduated from the Vale do Acaraú State University (UVA). Master in Family Health from the Federal University of Ceará (UFC). PhD student in the Postgraduate Program in Clinical Care in Nursing and Health - PPCCLIS (UECE). Postgraduate degree in Health Management and Auditing - Faculdade Padre Dourado, Specialization in Urgency, Emergency and Intensive Care Unit - Centro Universitário Ateneu. Works as a professor at the Centro Universitário Inta - UNINTA, Itapipoca campus, in the bachelor's degree in Nursing, teaching the subjects of Didactics applied to Nursing, Methodology of Scientific Research and Health Education, also developing the function of Pedagogical Manager of the referred course. He worked as a clinical nurse in the Emergency, Medical Clinic and Adult ICU sectors at Hospital e Maternidade São Vicente de Paulo - São Camilo Itapipoca, from 2019 to 2021, where he also worked as an Auditor Nurse, coordinating the Patient Safety and Quality in Health service, from 2021 to 2022. Research lines: Family Health; Patient Safety; Health Care and Health Management; Quality of health services.

Glícia Uchôa Gomes Mendonça, State University of Ceará

Graduated in Nursing from the Regional University of Cariri - URCA, residency in Intensive Care Unit from the Federal University of Bahia - UFBA and MBA in Health Management from Fundação Getúlio Vargas - FGV. Master in Technology and Innovation from the University of Fortaleza - UNIFOR. PhD student in Clinical Nursing and Health Care - UECE. Tenured professor of the Nursing Course at the Regional University of Cariri - Iguatu Campus. Has experience in the areas of intensive care, oncology, pre and post surgical care and clinical care. Research in the area of ​​patient safety.

Paulo Cesar Almeida, State University of Ceará

Graduated in Statistics from the Federal University of Ceará-UFC (1976); Specialization in Administration Planning of the Health Sector - Faculty of Public Health - USP - 1995; Master in Biostatistics - Faculty of Medicine Ribeirão Preto - USP (1981); Doctorate in Public Health - Faculty of Public Health at USP (1996); Post-doctorate - Postgraduate Program in Nursing at the Federal University of Ceará (2014). Professor. Adj. State University of Ceará (1984 -) in the Undergraduate Courses of Nutrition and Nursing, Postgraduate Program in Clinical Health Care Nursing. Professor. Collaborator of the postgraduate program in Nursing at UFC;. Professor. Faculty of Nursing and Medicine UFC (1983-1998), Prof. UFPB (1976 - 1982); Ad Hoc Advisor: Northeast Nursing Journal, Acta Paulista de Enfermagem, Latin American Nursing Journal. He has experience in the area of ​​Public Health, with an emphasis on Public Health, Nursing and Human Resources in Health, working mainly on the following topics: statistical methods applied to health, epidemiology, asthma, elderly health, violence, human resources in health, leprosy, tuberculosis.

Rhanna Emanuela Fontenele Lima de Carvalho, State University of Ceará

Professor of the undergraduate nursing course at the State University of Ceará. Coordinator of the Postgraduate Program in Clinical Care in Nursing and Health (PPCCLIS). Leader of the research group Patient Safety, Technology and Clinical Care (SETECC - UECE). Member of the Brazilian Patient Safety Network (Ceará). Associate editor of the Nursing Journal of UFSM. Reviewer of national and international journals. Visiting researcher (postdoctorate/CNPq) in the Department of Internal Medicine and Primary Care at Brigham and Women's Hospital, Boston, from Feb/2022 to Feb/2023. CNPq Research Productivity Scholarship. Main areas of activity: development and validation of technologies and patient safety.

References

Buckinx F, Peyrusqué É, Kergoat MJ, Aubertin-Leheudre M. Reference standard for the measurement of loss of autonomy and functional capacities in long-term care facilities. J Frailty Aging. 2023;12(3):236-43. doi: 10.14283/jfa.2023.4. DOI: https://doi.org/10.14283/jfa.2023.4

Comas-Herrera A, Fernandez JL, Hancock R, Hatton C, Knapp M, McDaid D, et al. COVID-19: implications for the support of people with social care needs in England. J Aging Soc Policy. 2020;32(4-5):365-372. doi:10.1080/08959420.2020.1759759. DOI: https://doi.org/10.1080/08959420.2020.1759759

Machado CJ, Pereira CCA, Viana BM, Oliveira GL, Melo DC, Carvalho JFMG, et al. Estimates of the impact of COVID-19 on mortality of institutionalized elderly in Brazil. Ciênc Saúde Colet. 2020;25(9):3437-44. doi: 10.1590/1413-232020259.14552020. DOI: https://doi.org/10.1590/1413-81232020259.14552020

Ferreira Neto PD, Rosendo CWF, Lima FAS, Bezerraq YPF, Nunes VMA, Lima SPS. O impacto da COVID-19 na saúde de pessoas institucionalizadas. Rev Ciênc Plur. 2021;7(2). doi: 10.21680/2446-7286.2021v7n2ID23604. DOI: https://doi.org/10.21680/2446-7286.2021v7n2ID23604

Hammerschmidt KSA, Santana RF. Saúde do idoso em tempos de pandemia COVID-19. Cogitare Enferm. 2020;25. doi: 10.5380/ce.v25i0.72849. DOI: https://doi.org/10.5380/ce.v25i0.72849

Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Análise em Saúde e Doenças não Transmissíveis. Guia de vigilância epidemiológica Emergência de saúde pública de Importância nacional pela Doença pelo coronavírus 2019 – covid-19 [Internet]. Brasília (DF) : Ministério da Saúde; 2020 [acesso em 2025 jul 10]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/covid-19/guia-de-vigilancia-epidemiologica-covid-19_2021.pdf/view.

D’adamo H, Yoshikawa T, Ouslander JG. Coronavirus disease 2019 in geriatrics and long-term care: the ABCDs of COVID-19. J Am Geriatr Soc. 2020;68(5):912-7. doi: 10.1111/jgs.16445. DOI: https://doi.org/10.1111/jgs.16445

Wachholz PA, Moreira VG, Oliveira D, Watanabe HAW, Boas PJFV. Estimates of infection and mortality from COVID-19 in care homes for older people in Brazil. Geriatr Gerontol Aging. 2020;14(4):290-3. doi:10.5327/Z2447-212320202000127. DOI: https://doi.org/10.5327/Z2447-212320202000127

Arons MM, Hatfield KM, Reddy SC, Kimball A, James A, Jacobs JR, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Eng J Med. 2020;382(22):2081-90. doi: 10.1056/NEJMoa2008457. DOI: https://doi.org/10.1056/NEJMoa2008457

Wang L, He W, Yu X, Hu D, Bao M, Liu H, et al. Coronavirus disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020;80(6):639-45. doi: 10.1016/j.jinf.2020.03.019. DOI: https://doi.org/10.1016/j.jinf.2020.03.019

Sacco G, Foucault G, Briere O, Annweiler C. COVID-19 in seniors: findings and lessons from mass screening in a nursing home. Maturitas. 2020;141:46-52. doi:10.1016/j.maturitas.2020.06.023. DOI: https://doi.org/10.1016/j.maturitas.2020.06.023

Rebêlo FL, Lisboa JMS, Oliveira WCR, Santos RS. Prevalência e impacto da COVID-19 em pessoas idosas institucionalizadas: uma revisão bibliográfica. Biomotriz. 2021;15(1):183-93. doi: 10.33053/biomotriz.v15i1.461. DOI: https://doi.org/10.33053/biomotriz.v15i1.461

Chen N, Zhou M, Qu J, Han Y, Qiu Y, Wang J, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/S0140-6736(20)30211-7. DOI: https://doi.org/10.1016/S0140-6736(20)30211-7

Huang C, Wang Y, Li X, Ren L, Zhao J, Zhang L, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. DOI: https://doi.org/10.1016/S0140-6736(20)30183-5

Guan WJ, Ni Z, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N England J Med. 2020;382(18):1708-20. doi: 10.1056/NEJMoa2002032. DOI: https://doi.org/10.1056/NEJMoa2002032

Jaillon S, Berthenet K, Garlanda C. Sexual dimorphism in innate immunity. Clin Rev Allergy Immunol. 2019;56(3):308-21. doi: 10.1007/s12016-017-8648-x. DOI: https://doi.org/10.1007/s12016-017-8648-x

Lima DLF, Dias AA, Rabelo RS, Cruz ID, Costa SC, Nigri FM, et al. COVID-19 no estado do Ceará, Brasil: comportamentos e crenças na chegada da pandemia. Ciênc Saúde Colet. 2020;25(5):2020-07192020. doi: 10.1590/1413-81232020255.07192020. DOI: https://doi.org/10.1590/1413-81232020255.07192020

Long QX, Tang XJ, Shi QL, Li Q, Deng HJ, Yuan J, et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nature Med. 2020;26(8):1200-4. doi:10.1038/s41591-020-0965-6. DOI: https://doi.org/10.1038/s41591-020-0965-6

Mehta HB, Li S, Goodwin JS. Risk factors associated with SARS-CoV-2 infections, hospitalization, and mortality among US nursing home residents. JAMA Netw Open. 2021;4(3):e216315. doi: 10.1001/jamanetworkopen.2021.6315. DOI: https://doi.org/10.1001/jamanetworkopen.2021.6315

Souza LPS, Souza AG. Enfermagem brasileira na linha de frente contra o novo Coronavírus: quem cuidará de quem cuida? J Nurs Health. 2029;10(4). doi: 10.15210/jonah.v10i4.18444. DOI: https://doi.org/10.15210/jonah.v10i4.18444

Ejaz H, Alsrhani A, Zafar A, Javed H, Junaid K, Abdalla AE, et al. COVID-19 and comorbidities: Deleterious impact on infected patients. J Infect Public Health. 2020;13(12):1833-9. doi: 10.1016/j.jiph.2020.07.014. DOI: https://doi.org/10.1016/j.jiph.2020.07.014

Freitas ARR, Beckedorff OA, Cavalcanti LPG, Siqueira AM, Castro DB, Costa CF, et al. The emergence of novel SARS-CoV-2 variant P.1 in Amazonas (Brazil) was temporally associated with a change in the age and sex profile of COVID-19 mortality: a population-based ecological study. Lancet Reg Health Am. 2021;1:100021. doi: 10.1016/j.lana.2021.100021. DOI: https://doi.org/10.1016/j.lana.2021.100021

Pratt NL, Ellett LM, Andrade AQ, Blanc VT, Barratt J, Roughhead EE. Prevalence of multiple risk factors for poor outcomes associated with COVID-19 among an elderly Australian population. Aust J Gen Pract. 2021;50(1-2):84-9. doi: 10.3316/informit.761212792972035. DOI: https://doi.org/10.31128/AJGP-07-20-5546

Carnahan JL, Lieb KM, Albert L, Wagle K, Kaeh E, Unroe K. COVID-19 disease trajectories among nursing home residents. J Am Geriatr

Soc. 2021;69(9):2412-8. doi:10.1111/jgs.17308. DOI: https://doi.org/10.1111/jgs.17308

Santos JLS, Santana FP, Serafim CS, Freitas LR, Oliveira WLS, Melo MVS, et al. Enfrentamento à COVID-19: importância da educação permanente em serviços de saúde. Rev Eletrônica Acervo Enferm. 2021;13:e8669. doi: 10.25248/reaenf.e8669.2021. DOI: https://doi.org/10.25248/reaenf.e8669.2021

Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of malnutrition in older adults: a multinational perspective using the Mini Nutritional Assessment. J Am Geriatr Soc. 2010;58(9):1734-8. doi: 10.1111/j.1532-5415.2010.03016.x. DOI: https://doi.org/10.1111/j.1532-5415.2010.03016.x

Li T, Zhang Y, Gong C, Wang J, Liu B, Shi L, et al. Prevalence of malnutrition and analysis of related factors in elderly patients with

COVID-19 in Wuhan, China. Eur J Clin Nutr. 2020;74(6):871-5. doi: 10.1038/s41430-020-0642-3. DOI: https://doi.org/10.1038/s41430-020-0642-3

Kurtz A, Grant K, Marano R, Arrieta A, Grant Jr K, Feaster W, et al. Long-term effects of malnutrition on severity of COVID-19. Sci Rep. 2021;11(1):14974. doi: 10.1038/s41598-021-94138-z. DOI: https://doi.org/10.1038/s41598-021-94138-z

Cardoso TCA, Rotondano Filho AF, Arruda JT. Correlation between pandemics: smoking and COVID-19. Res Soc Dev. 2021;10(10):e222101018442. doi: 10.33448/rsd-v10i10.18442. DOI: https://doi.org/10.33448/rsd-v10i10.18442

Downloads

Published

2025-11-03

How to Cite

Cavalcante, M. L. S. N., Alcântara, R. K. L. de, Sousa, J. V. T. de, Mendonça, G. U. G., Almeida, P. C., & Carvalho, R. E. F. L. de. (2025). COVID-19 in institutionalized elderly people: clinical repercussions and risk factors for death. Revista De Enfermagem Da UFSM, 15, e21. https://doi.org/10.5902/2179769291167

Issue

Vol. 15 (2025): Artigos do volume 15

Section

Artigos Originais

License

Copyright (c) 2025 Revista de Enfermagem da UFSM

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Most read articles by the same author(s)