Coronavirus disease 2019 in French residential care facilities: a nationwide study

Belmin, Joël; Georges, Scarlett; Franke, Florian; Daniau, Come; Cochet, Amandine; Durand, Cécile; Noury, Ursula; Gomes do Espirito Santo, Maria Eugênia; Fonteneau, Laure; Pariel, Sylvie; Lafuente-Lafuente, Carmelo; Danis, Kostas

Objectives The Coronavirus 2019 (COVID-19) pandemic caused a considerable mortality in long-term care facilities (LTCFs), including residential care setting and nursing homes. This study aimed to estimate COVID-19 incidence and mortality in residential care facilities and to compare them with those recorded in nursing homes. Design Nationwide observational study conducted by French health authorities. Settings and participants Since March 1, 2020, all LTCFs in France reported all COVID-19 cases and COVID-19-related deaths among their residents. Methods Possible cases were those with COVID-19 related symptoms without laboratory confirmation and confirmed cases those with a RT-PCR test or serology positive for SARS-CoV-2. We included facilities with at least one confirmed case of COVID-19 and estimated the cumulative incidence of COVID-19 cases and mortality due to COVID-19 reported until June 30th, 2020, using the maximum bed capacity as a denominator. Results Of the 2,288 residential care facilities, 310 (14%) and of the 7,688 nursing homes, 3,110 (40%) reported COVID-19 cases among residents (p<0.001). The cumulative incidence of COVID-19 was significantly lower in residential care facilities as compared with nursing homes (1.10 vs 9.97 per 100 beds, p<0.001. Mortality due to COVID-19 was also lower in residential care facilities compared with nursing homes (0.07 vs 1.29 per 100 beds, p<0.001). Case fatality was lower in residential care facilities (6.49% vs 12.93%, p<0.001). Conclusion and implications: French residential care facilities experienced a much lower burden from COVID-19 than nursing homes. Our findings may inform the implementation of better infection control practices in these settings.