{"id":23768,"date":"2023-04-26T04:16:00","date_gmt":"2023-04-25T20:16:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23768"},"modified":"2023-04-26T07:17:57","modified_gmt":"2023-04-25T23:17:57","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%96%b0%e5%86%a0%e7%97%85%e6%af%92%e6%84%9f%e6%9f%93%e7%9b%91%e6%b5%8b%e4%b8%8e%e5%ae%89%e5%85%bb%e9%99%a2%e6%82%a3%e8%80%85%e9%a2%84%e5%90%8e","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23768","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u65b0\u51a0\u75c5\u6bd2\u611f\u67d3\u76d1\u6d4b\u4e0e\u5b89\u517b\u9662\u60a3\u8005\u9884\u540e"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Covid-19 Surveillance Testing and Resident Outcomes in Nursing Homes<\/h1>\n\n\n\n

Brian E. McGarry, Ashvin D. Gandhi, Michael L. Barnett<\/h3>\n\n\n\n

N Engl J Med 2023; 388:1101-1110
DOI: 10.1056\/NEJMoa2210063<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h2>\n\n\n\n

Despite widespread adoption of surveillance testing for coronavirus disease 2019 (Covid-19) among staff members in skilled nursing facilities, evidence is limited regarding its relationship with outcomes among facility residents.<\/p>\n\n\n\n

METHODS<\/h2>\n\n\n\n

Using data obtained from 2020 to 2022, we performed a retrospective cohort study of testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among staff members in 13,424 skilled nursing facilities during three pandemic periods: before vaccine approval, before the B.1.1.529 (omicron) variant wave, and during the omicron wave. We assessed staff testing volumes during weeks without Covid-19 cases relative to other skilled nursing facilities in the same county, along with Covid-19 cases and deaths among residents during potential outbreaks (defined as the occurrence of a case after 2 weeks with no cases). We reported adjusted differences in outcomes between high-testing facilities (90th percentile of test volume) and low-testing facilities (10th percentile). The two primary outcomes were the weekly cumulative number of Covid-19 cases and related deaths among residents during potential outbreaks.<\/p>\n\n\n\n

RESULTS<\/h2>\n\n\n\n

During the overall study period, 519.7 cases of Covid-19 per 100 potential outbreaks were reported among residents of high-testing facilities as compared with 591.2 cases among residents of low-testing facilities (adjusted difference, \u221271.5; 95% confidence interval [CI], \u221291.3 to \u221251.6). During the same period, 42.7 deaths per 100 potential outbreaks occurred in high-testing facilities as compared with 49.8 deaths in low-testing facilities (adjusted difference, \u22127.1; 95% CI, \u221211.0 to \u22123.2). Before vaccine availability, high- and low-testing facilities had 759.9 cases and 1060.2 cases, respectively, per 100 potential outbreaks (adjusted difference, \u2212300.3; 95% CI, \u2212377.1 to \u2212223.5), along with 125.2 and 166.8 deaths (adjusted difference, \u221241.6; 95% CI, \u221257.8 to \u221225.5). Before the omicron wave, the numbers of cases and deaths were similar in high- and low-testing facilities; during the omicron wave, high-testing facilities had fewer cases among residents, but deaths were similar in the two groups.<\/p>\n\n\n\n

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CONCLUSIONS<\/h2>\n\n\n\n

Greater surveillance testing of staff members at skilled nursing facilities was associated with clinically meaningful reductions in Covid-19 cases and deaths among residents, particularly before vaccine availability.<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Covid-19 Surveillance Testing and Resi […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23768"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23768"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23768\/revisions"}],"predecessor-version":[{"id":23769,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23768\/revisions\/23769"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23768"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23768"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23768"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}