{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T12:59:44Z","timestamp":1762174784618,"version":"build-2065373602"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["K01HP39479","T1MHP39062","U1QHP28728"],"award-info":[{"award-number":["K01HP39479","T1MHP39062","U1QHP28728"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1TR002388"],"award-info":[{"award-number":["TL1TR002388"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K23AG049106"],"award-info":[{"award-number":["K23AG049106"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Few studies present clinical management approaches and outcomes of coronavirus disease 2019 (COVID\u201019) outbreaks in skilled nursing facilities (SNFs). We describe outcomes of a clinical management pathway for a large COVID\u201019 outbreak in an urban SNF with predominantly racial minority (&gt;90% black), medically complex, older residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single\u2010center, retrospective, and observational cohort study (March 1, 2020\u2013May 31, 2020).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and Participants<\/jats:title>\n                    <jats:p>All subacute and long\u2010term care residents at an urban SNF between March 1, 2020 and May 31, 2020 (Chicago, IL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A multicomponent management pathway was developed to manage a large COVID\u201019 outbreak in an SNF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Chart review was used to extract demographics, comorbidities, symptoms, lab results, and clinical outcomes over 12\u2009weeks, which were summarized and compared between residents with and without COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A multicomponent clinical management pathway was used to care for residents with COVID\u201019, which included frequent scheduled clinical and laboratory evaluation, use of intravenous fluids, supplemental oxygen, antibiotics when indicated, and goals\u2010of\u2010care discussions. Of the 204 residents, 172 (84.3%) tested positive for SARS\u2010CoV\u20102 during the 3\u2010month period, with 50.5% symptomatic, 9.3% presymptomatic, and 24.5% asymptomatic, with a 30\u2010day mortality rate of 15.7%. Predominant symptoms were low\u2010grade fever &gt;99\u2009\u00b0F, anorexia, delirium, and fatigue. While in the facility, approximately one\u2010quarter of residents experienced hypernatremia [Na\u2009&gt;\u2009145\u2009mEq\/L] (24.5%), acute kidney injury [Cr\u2009&gt;\u20090.03\u2009mg\/dL or 1.5\u00d7 baseline] (29.7%), or leukopenia [WBC\u2009&lt;\u20094.8 1000\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ] (39.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We present the first available clinical strategy guiding the medical management of a COVID\u201019 syndrome in an urban SNF, caring for largely black residents, which may lead to improved mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17126","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T10:06:41Z","timestamp":1616148401000},"page":"1155-1165","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Management and outcomes of a\n                    <scp>COVID<\/scp>\n                    \u201019 outbreak in a nursing home with predominantly Black residents"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9450-0537","authenticated-orcid":false,"given":"Kimberly J.","family":"Beiting","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Huisingh\u2010Scheetz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Graupner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Martinchek","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"},{"name":"Department of Physician Assistant Studies School of Health and Rehabilitation Sciences, MGH Institute of Health Professions  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacie","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren J.","family":"Gleason","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics and Palliative Medicine University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6915e3"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.139292"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16472"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2008457"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2005412"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16513"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6913e1"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16787"},{"key":"e_1_2_13_10_1","unstructured":"The New York Times. 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