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| Temperature in Nursing Home Residents Systematically Tested for SARS-CoV-2 | |
| Rudolph, James L.1,2; Halladay, Christopher W.1; Barber, Malisa1; McConeghy, Kevin W.1; Mor, Vince1,2; Gravenstein, Stefan1,2; Nanda, Aman2 | |
| 2020-07 | |
| 发表期刊 | JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
 |
| ISSN | 1525-8610 |
| EISSN | 1538-9375 |
| 摘要 | Objectives: Many nursing home residents infected with SARS-CoV-2 fail to be identified with standard screening for the associated COVID-19 syndrome. Current nursing home COVID-19 screening guidance includes assessment for fever, defined as a temperature of at least 38.0 degrees C. The objective of this study was to describe the temperature changes before and after universal testing for SARS-CoV-2 in nursing home residents. Design: Cohort study. Setting and Participants: The Veterans Administration (VA) operates 134 Community Living Centers (CLC), similar to nursing homes, that house residents who cannot live independently. VA guidance to CLCs directed daily clinical screening for COVID-19 that included temperature assessment. Measures: All CLC residents (n = 7325) underwent SARS-CoV-2 testing. We report the temperature in the window of 14 days before and after universal SARS-CoV-2 testing among CLC residents. Baseline temperature was calculated for 5 days before the study window. Results: SARS-CoV-2 was identified in 443 (6.0%) residents. The average maximum temperature in SARS-CoV-2epositive residents was 37.66 (0.69) compared with 37.11 (0.36) (P = .001) in SARS-CoV-2 enegative residents. Temperatures in those with SARS-CoV-2 began rising 7 days before testing and remained elevated during the 14-day follow-up. Among SARS-CoV-2epositive residents, only 26.6% (n = 118) met the fever threshold of 38.0 degrees C during the survey period. Most residents (62.5%, n = 277) with confirmed SARS-CoV-2 did experience 2 or more 0.5 degrees C elevations above their baseline values. One cohort of SARS-CoV-2 residents' (20.3%, n = 90) temperatures never deviated >0.5 degrees C from baseline. Conclusions and Implications: A single screening for temperature is unlikely to detect nursing home residents with SARS-CoV-2. Repeated temperature measurement with a patient-derived baseline can increase sensitivity. The current fever threshold as a screening criteria for SARS-CoV-2 infection should be reconsidered. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine. |
| 关键词 | Infection nursing home temperature |
| DOI | 10.1016/j.jamda.2020.06.009 |
| WOS关键词 | INFECTION ; FEVER |
| WOS研究方向 | Geriatrics & Gerontology |
| WOS类目 | Geriatrics & Gerontology |
| 出版者 | ELSEVIER SCIENCE INC |
| 引用统计 | |
| 文献类型 | 期刊论文 |
| 专题 | 新冠肺炎 循证社会科学证据集成 |
| 作者单位 | 1.Providence Vet Adm Med Ctr; 2.Brown Univ |
| 推荐引用方式 GB/T 7714 | Rudolph, James L.,Halladay, Christopher W.,Barber, Malisa,et al. Temperature in Nursing Home Residents Systematically Tested for SARS-CoV-2[J]. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION,2020. |
| APA | Rudolph, James L..,Halladay, Christopher W..,Barber, Malisa.,McConeghy, Kevin W..,Mor, Vince.,...&Nanda, Aman.(2020).Temperature in Nursing Home Residents Systematically Tested for SARS-CoV-2.JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION. |
| MLA | Rudolph, James L.,et al."Temperature in Nursing Home Residents Systematically Tested for SARS-CoV-2".JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION (2020). |
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