Risk Factors Associated with Progression to Severe COVID-19and Mortality among Residents of Long-term Care Facilities in South Korea
10.14192/kjicp.2025.30.2.147
- Author:
Jun PARK
1
;
Hoyeon JANG
;
Yoonkyung CHOI
;
Gilwon KANG
;
Hee-Sung KIM
Author Information
1. Chungbuk Center of Infectious Diseases Control and Prevention, Cheongju, Korea
- Publication Type:Original Article
- From:
Korean Journal of healthcare-associated Infection Control and Prevention
2025;30(2):147-157
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:During the early stages of the COVID-19 pandemic, many residents of longterm care facilities (LTCFs) in various countries were infected with COVID-19, leading to high mortality. This study aimed to identify risk factors associated with severe disease progression and mortality among LTCF residents to mitigate the impact of COVID-19 on this vulnerable population.
Methods:We analyzed risk factors for severe disease and mortality in 224,983 patients with COVID-19 aged 50 years or older, focusing specifically on 4,442 LTCF residents.
Results:Logistic regression analysis showed that, among all patients aged 50 and older, severe progression was associated with LTCF residence (OR: 1.29, 95% CI: 1.15-1.44), older age, male sex, higher Charlson Comorbidity Index (CCI), and having received fewer than three doses of COVID-19 vaccine. Mortality within 30 days was associated with LTCF residence (OR: 2.04, 95% CI: 1.86-2.24), older age, male sex, higher CCI, under-vaccination, and receipt of medical aid. Among LTCF residents, male sex and lack of COVID-19 vaccination (OR: 4.37, 95% CI: 2.77-6.91) were significantly associated with increased risk of severe progression.Mortality among LTCF residents was associated with older age, male sex, absence of vaccination (OR: 6.18, 95% CI: 4.40-8.68), no hospitalization or emergency room visit within 30 days after diagnosis, and an LTCF stay of longer than one year (OR: 1.51, 95% CI: 1.09-2.09). A higher number of medical staff in LTCF was significantly associated with lower mortality (OR:0.71, 95% CI: 0.55-0.91).
Conclusion:LTCF residents shared similar risk factors for severe COVID-19 progression and mortality as the general population. Timely medical intervention for LTCF residents may help reduce severe outcomes and prevent death.
