Imperial College London


Faculty of MedicineSchool of Public Health

Chair in Epidemiology and Public Health Medicine



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Miss Jennifer Wells +44 (0)20 7594 3328




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BibTex format

author = {Graham, NSN and Junghans, C and Downes, R and Sendall, C and Lai, H and McKirdy, A and Elliott, P and Howard, R and Wingfield, D and Priestman, M and Ciechonska, M and Cameron, L and Storch, M and Crone, M and Freemont, P and Randell, P and McLaren, R and Lang, N and Ladhani, S and Sanderson, F and Sharp, DJ},
doi = {10.1101/2020.05.19.20105460},
publisher = {Cold Spring Harbor Laboratory},
title = {SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes},
url = {},
year = {2020}

RIS format (EndNote, RefMan)

AB - <jats:p>Objectives:To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents. Design:An outbreak investigation.Setting:4 nursing homes affected by COVID-19 outbreaks in central London. Participants: 394 residents and 70 staff in nursing homes.Interventions:Two point-prevalence surveys one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing.Main outcome measures:All-cause mortality, and mortality attributed to COVID-19 on death certificates. Prevalence of SARS-CoV-2 infection and symptoms in residents and staff. Results:Overall, 26% (95% confidence interval 22 to 31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70 to 336). Systematic testing identified 40% (95% CI 35 to 46) of residents, of whom 43% (95% CI 34 to 52) were asymptomatic and 18% (95% CI 11 to 24) had atypical symptoms, as well as 4% (95% CI -1 to 9) of asymptomatic staff who tested positive for SARS-CoV-2.Conclusions:The SARS-CoV-2 outbreak was associated with a very high mortality rate in residents of nursing homes. Systematic testing of all residents and a representative sample of staff identified high rates of SARS-CoV-2 positivity across the four nursing homes, highlighting a potential for regular screening to prevent future outbreaks.</jats:p>
AU - Graham,NSN
AU - Junghans,C
AU - Downes,R
AU - Sendall,C
AU - Lai,H
AU - McKirdy,A
AU - Elliott,P
AU - Howard,R
AU - Wingfield,D
AU - Priestman,M
AU - Ciechonska,M
AU - Cameron,L
AU - Storch,M
AU - Crone,M
AU - Freemont,P
AU - Randell,P
AU - McLaren,R
AU - Lang,N
AU - Ladhani,S
AU - Sanderson,F
AU - Sharp,DJ
DO - 10.1101/2020.05.19.20105460
PB - Cold Spring Harbor Laboratory
PY - 2020///
TI - SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes
UR -
ER -