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Mateos-Nozal J, Rodríguez-Domínguez M, San Román J, Candel FJ, Villarrubia N, Pérez-Panizo N, Segura E, Cuñarro JM, Ramírez-Arellano MVM, Rodríguez-Ramos R, Pariente-Rodríguez R, Villar LM, Ramos P, Cantón R, Cruz-Jentoft AJ, Galán JC. Factors Associated with SARS-CoV-2 Infection in Fully Vaccinated Nursing Home Residents and Workers. Viruses 2024; 16:186. [PMID: 38399962 PMCID: PMC10891794 DOI: 10.3390/v16020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Persons living or working in nursing homes faced a higher risk of SARS-CoV-2 infections during the pandemic, resulting in heightened morbidity and mortality among older adults despite robust vaccination efforts. This prospective study evaluated the humoral and cellular immunity in fully vaccinated residents and workers from two nursing homes in Madrid, Spain, from 2020 to 2021. Measurements of IgG levels were conducted in August 2020 (pre-vaccination) and June and September 2021 (post-vaccination), alongside assessments of neutralizing antibodies and cellular responses in September 2021 among the most vulnerable individuals. Follow-up extended until February 2022 to identify risk factors for SARS-CoV-2 infection or mortality, involving 267 residents (mean age 87.6 years, 81.3% women) and 302 workers (mean age 50.7 years, 82.1% women). Residents exhibited a significantly higher likelihood of experiencing COVID-19 before June 2021 compared with nursing staff (OR [95% CI], 7.2 [3.0 to 17.2], p < 0.01). Participants with a history of previous COVID-19 infection showed more significant increases in IgG levels in August 2020, June 2021 and September 2021, alongside an increased proportion of neutralizing antibodies in the most vulnerable individuals. However, IgG decay remained the same between June and September 2021 based on the previous COVID-19 status. During the Omicron variant wave, residents and staff showed a similar rate of SARS-CoV-2 infection. Notably, preceding clinical or immunological factors before receiving three vaccination doses did not demonstrate associations with COVID-19 infection or overall mortality in our participant cohort.
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Affiliation(s)
- Jesús Mateos-Nozal
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (N.P.-P.); (M.V.M.R.-A.); (A.J.C.-J.)
| | - Mario Rodríguez-Domínguez
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (M.R.-D.); (R.C.); (J.C.G.)
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Francisco Javier Candel
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - Noelia Villarrubia
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | - Nuria Pérez-Panizo
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (N.P.-P.); (M.V.M.R.-A.); (A.J.C.-J.)
| | - Esther Segura
- Residencia de Mayores Manoteras, 28050 Madrid, Spain;
| | | | | | - Rafael Rodríguez-Ramos
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | - Roberto Pariente-Rodríguez
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | - Luisa M. Villar
- Servicio de Inmunología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain (R.R.-R.); (R.P.-R.); (L.M.V.)
| | | | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (M.R.-D.); (R.C.); (J.C.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alfonso J. Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (N.P.-P.); (M.V.M.R.-A.); (A.J.C.-J.)
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain; (M.R.-D.); (R.C.); (J.C.G.)
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Mateos-Nozal J, Bermejo Boixareu C, Pérez-Panizo N, Hormigo Sánchez AI, Martínez Peromingo FJ. [Situation and activity of the liaison geriatrics units with nursing homes in the Community of Madrid]. Rev Esp Geriatr Gerontol 2023; 58:27-30. [PMID: 36446658 PMCID: PMC9701085 DOI: 10.1016/j.regg.2022.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/06/2022] [Accepted: 11/03/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In June 2020, after the first wave of the COVID-19 pandemic, Hospital-Based Liaison Geriatrics units and Primary Care nursing care units were created in the Community of Madrid to improve health care for residents in a coordinated manner. OBJECTIVE To analyze the situation and the activity of the Hospital-Based Liaison Geriatrics units. MATERIAL AND METHODS A cross-sectional study was conducted using an electronic survey prepared and sent to the liaison geriatricians in March 2022, including the following sections: available resources, areas of health care, reasons for consultation, care interventions, research and teaching activity, profiles of residents attended and coordination with other health professionals at that time. A descriptive analysis of the data was performed. RESULTS 100% of the existing Liaison Geriatrics units responded, describing essential differences in human resources, hours of care and volume of patients attended. Regarding the care activity of these units, they highlighted the telematic consultation, and the face-to-face assessment during hospitalization and in the emergency department. The main reasons for assessment were decision-making, acute pathology and geriatric syndromes; and the in-hospital drug management or orthoprosthetic aids among the interventions. CONCLUSIONS Despite the heterogeneity in the resources of the different Liaison Geriatric units, there is a similarity in their care activity and the use of telemedicine. It is common to request an assessment for decision-making, acute pathology or geriatric syndromes and interventions for managing in-hospital drugs and tests, orthoprosthetic aids and coordination with other specialists. Liaison Geriatrics units must continue leading quality health care coordinated with nursing homes, as well as continuity of care for residents.
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Affiliation(s)
- Jesús Mateos-Nozal
- Unidad de Geriatría de Atención a Residencias, Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, España.
| | | | - Nuria Pérez-Panizo
- Unidad de Geriatría de Atención a Residencias, Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, España
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Sanchez T, Mavragani A, Álamo E, Pérez-Panizo N, Mousa A, Dacal E, Lin L, Vladimirov A, Cuadrado D, Mateos-Nozal J, Galán JC, Romero-Hernandez B, Cantón R, Luengo-Oroz M, Rodriguez-Dominguez M. A Smartphone-Based Platform Assisted by Artificial Intelligence for Reading and Reporting Rapid Diagnostic Tests: Evaluation Study in SARS-CoV-2 Lateral Flow Immunoassays. JMIR Public Health Surveill 2022; 8:e38533. [PMID: 36265136 PMCID: PMC9840096 DOI: 10.2196/38533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/16/2022] [Accepted: 10/13/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Rapid diagnostic tests (RDTs) are being widely used to manage COVID-19 pandemic. However, many results remain unreported or unconfirmed, altering a correct epidemiological surveillance. OBJECTIVE Our aim was to evaluate an artificial intelligence-based smartphone app, connected to a cloud web platform, to automatically and objectively read RDT results and assess its impact on COVID-19 pandemic management. METHODS Overall, 252 human sera were used to inoculate a total of 1165 RDTs for training and validation purposes. We then conducted two field studies to assess the performance on real-world scenarios by testing 172 antibody RDTs at two nursing homes and 96 antigen RDTs at one hospital emergency department. RESULTS Field studies demonstrated high levels of sensitivity (100%) and specificity (94.4%, CI 92.8%-96.1%) for reading IgG band of COVID-19 antibody RDTs compared to visual readings from health workers. Sensitivity of detecting IgM test bands was 100%, and specificity was 95.8% (CI 94.3%-97.3%). All COVID-19 antigen RDTs were correctly read by the app. CONCLUSIONS The proposed reading system is automatic, reducing variability and uncertainty associated with RDTs interpretation and can be used to read different RDT brands. The web platform serves as a real-time epidemiological tracking tool and facilitates reporting of positive RDTs to relevant health authorities.
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Affiliation(s)
| | | | | | - Nuria Pérez-Panizo
- Servicio de Geriatría, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | | | - Lin Lin
- Spotlab, Madrid, Spain.,Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | | | | | - Jesús Mateos-Nozal
- Servicio de Geriatría, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Beatriz Romero-Hernandez
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Mario Rodriguez-Dominguez
- Servicio de Microbiología, Hospital Universitario Ramon y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,CIBER en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Mateos-Nozal J, Pérez-Panizo N, Zárate-Sáez CM, Vaquero-Pinto MN, Roldán-Plaza C, Mejía Ramírez-Arellano MV, Sánchez García E, Garza-Martínez AJ, Cruz-Jentoft AJ. Proactive Geriatric Comanagement of Nursing Home Patients by a New Hospital-Based Liaison Geriatric Unit: A New Model for the Future. J Am Med Dir Assoc 2021; 23:308-310. [PMID: 34958745 PMCID: PMC8709437 DOI: 10.1016/j.jamda.2021.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
During the SARS-CoV-2 pandemic, hospital-based liaison geriatric units (LGUs) were created in Spanish hospitals with the aim to improve health care coordination between nursing homes (NHs) and hospitals. Our university hospital created a comprehensive, proactive LGU serving 31 public and private NHs of different sizes and characteristics to offer support to more than 2500 residents. In the first 3 months of 2021, this LGU performed 1252 assessments (81% as outpatients, 12% at the emergency department, and 7% during hospitalization), avoiding an estimated 49 hospital transfers and 29 hospitalizations. Other activities included giving NHs support and advice during COVID-19 outbreaks, comanagement of selected residents with other hospital-based specialists (implementing telemedicine), and implementation of a protocol that allowed using drugs only approved for hospital use in selected NHs. This model of LGU has been shown to be feasible, to improve residents' health care, and avoid hospital referrals. Long-term care needs to be re-imagined, and hospital geriatric departments need to prove that they are able to offer expertise to support NH health care professionals.
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Affiliation(s)
- Jesús Mateos-Nozal
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.
| | - Nuria Pérez-Panizo
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
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