Long-term Care & Seniors
Immunity in LTCF residents at risk of COVID-19 disease and death: immune biomarkers, immune function, and frailty associated with clinical outcomes in COVID-19 pandemic waves 1 and 2
Lisa Barrett, Dalhousie University and Nova Scotia Health Authority
This study aims to understand what makes older people more at risk for severe or fatal COVID-19 symptoms, and how effective vaccines are in stopping the spread of COVID-19 in long-term care facilities. The study participants are residents of several long-term care facilities in Nova Scotia.
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COVID-19 Infection and Immunity in Residents of Long-term care Facilities
Andrew Costa and Dawn Bowdish, McMaster University
This study examines how well vaccines work in the older population living in long-term care residences and which factors at the facilities may be directly linked to outbreaks.
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Identification of underlying factors influencing the immune response to SARS-CoV-2 among workers and residents in long-term care homes: a multi-province study
Amy Hsu and Marc-André Langlois, Bruyère Research Institute
Researchers are studying the immune response of 800 residents, 2,000 staff and 500 caregivers in certain long-term care facilities in Ontario and British Columbia over the course of a year, and monitoring their vaccine response.
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Integrating longitudinal epidemiologic, virologic and immunologic analyses to understand COVID-19 immunity and infection outcomes in long term care
Marc Romney, Providence Health Care / University of British Columbia
The study examines how the immune systems of older residents and staff in long-term care facilities in British Columbia respond to COVID-19 vaccination. Researchers will also assess the viral, immunological and social factors that have contributed to COVID-19 outbreaks in long-term care facilities to better understand why the disease has been fatal to so many residents.
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IPAC+ evaluating intervention impact using serological and cellular assays as correlates of SARS-CoV-2 exposure among long-term care homes (LTCH) staff, residents, and transmission networks
Sharon Straus, Unity Health Toronto
This study aims to understand the different aspects of immunity for long-term care residents and workers as well as their response to vaccines.
Research summary Results Study website View study on
DISCoVER (Determining Infection Severity of CoV-2 in Elderly Residents): Type I interferon responses and their bio-psychosocial determinants to guide management of SARS-CoV-2 infection in the long-term care facility elderly
Donald Vinh, Research Institute of the McGill University Health Centre (RI-MUHC)
Researchers are looking at immune system, cardiovascular and mental health factors in a group of long-term care facility residents to determine what makes certain elderly people more prone than others to developing severe COVID-19.
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The PREVENT-COVID in Seniors Study: PRospEctiVe EvaluatioN of immuniTy after COVID-19 vaccines in Seniors
Agatha Jassem and Manish Sadarangani, University of British Columbia
This study aims to characterize and compare both short- and long-term immune responses to different COVID-19 vaccines, including among older adults and seniors. Researchers are comparing antibody quantities and function after various vaccine doses. The study is also exploring how a person’s prior human coronavirus infection may influence their response to COVID-19 vaccines.
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Early warning and rapid public health response to prevent COVID-19 outbreaks in long-term care facilities (LTCF) by monitoring SARS-CoV-2 RNA in LTCF site-specific sewage samples and assessment of antibodies response in this population
Xiaoli (Lilly) Pang and Chris Sikora, University of Alberta
This study is examining how the immune systems of residents and staff in long-term care facilities in Alberta react to COVID-19 infection and to vaccines. Monitoring will be done via blood samples and sewage wastewater.
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Vaccine effectiveness against SARS-CoV-2 variants of concern in long-term care populations: a multi-province study
Amy T. Hsu, Bruyère Research Institute
This project builds on another CITF-funded study that encompasses the largest prospective cohort of workers, residents and caregivers of residents in long-term care homes across Canada. The team is studying the humoral immunity (immunity associated with circulating antibodies) against emerging variants in people in LTC and the association between humoral response and sociodemographic factors.
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Safety and Efficacy of Preventative COVID Vaccines (STOPCoV)
Sharon Walmsley, University Health Network
STOPCoV is comparing how people aged 70 and over respond to COVID-19 vaccines compared to younger people aged 30 to 50. They are looking at demographics, underlying illness, medication taken, and other factors. Once people are eligible for a third dose, the team will continue to follow participants to determine antibody responses to that third dose.
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Canadian Longitudinal Study on Aging (CLSA): Platform for studying the epidemiology of the COVID-19 pandemic in aging populations (CLSA COVID-19 Study)
Parminder Raina, McMaster University
Building on the Canadian Longitudinal Study on Aging (CLSA), a national research platform with more than 50,000 individuals, the CLSA COVID-19 Antibody Study aims to collect and analyze blood samples from more than 19,000 CLSA participants in 10 provinces in order to estimate how widespread SARS-CoV-2 is among older adults by province, age, and sex.
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Vaccine effectiveness against SARS-CoV-2 variants of concern in long-term care populations: a multi-province study
Viruses can mutate and change over time, which results in new versions or variants that behave differently from the strain they originated from. Data indicate that some variants of COVID-19, commonly referred to as Variants of Concern (VOC), can spread more easily and faster, and may cause more severe outcomes in people who are infected. The presence of VOCs in a vulnerable population such as individuals living and working in long-term care (LTC) homes, may make it harder to slow the spread of COVID-19 and control outbreaks.
In this project, called Vaccine effectiveness against SARS-CoV-2 variants of concern in long-term care populations: a multi-province study, we are studying the humoral immunity—that is, immunity associated with circulating antibodies— against emerging VOCs in vaccinated LTC workers, residents, and family members and caregivers of LTC residents. Building on an existing study we began in 2020, which follows 6,000 LTC workers and residents in several Canadian provinces, we are adding an additional 2,000 participants to this study. Our research is also looking at the association between humoral response and sociodemographic factors such as household status and level of education, pre-existing health conditions, and healthcare outcomes including hospitalization and emergency room visits.
This project is the largest prospective cohort following workers, residents and caregivers of residents in LTC homes across Canada to investigate their immunity against VOCs. Our large sample size supports more complex analysis (including regression and prediction modelling) and sub-analysis (by disease groups). The findings will provide decision-makers with guidance regarding vaccine effectiveness in this high-risk and highly vulnerable population.
Results: Vaccine effectiveness against SARS-CoV-2 variants of concern in long-term care populations: a multi-province study
The PREVENT-COVID in Seniors Study: PRospEctiVe EvaluatioN of immuniTy after COVID-19 vaccines in Seniors
The urgent need for COVID-19 vaccines resulted in rapid vaccine development and distribution. Evidence suggests that the vaccines are effective against infection, but many questions remain about whether certain antibodies and T cells play a role in how effective the vaccines are. It’s also possible that there are innate immune mechanisms in humans which are responsible for early protection after vaccination. The fact that there may be multiple ways to develop protection against the SARS-CoV-2 virus poses a challenge to identifying an immunologic correlate of protection—that is, the level of antibodies needed to protect against infection—on which to base future vaccine development.
This study, called the PREVENT-COVID Study, has as an objective to characterize and compare both short- and long-term immune responses to the different COVID-19 vaccines. This research builds on existing collaborations for COVID-19 studies with partners that include the BC Centre for Disease Control Public Health Laboratory and regional Health Authorities. The study participants include older adults and seniors, and researchers are comparing their antibody quantities and function after each vaccine dose. Researchers are also determining the quality of T cell responses after various doses of COVID-19 vaccines. The study is also exploring how a person’s prior human coronavirus infection may influence their response to COVID-19 vaccines.
The results of the study will provide data which can guide future vaccine design, and aid strategies for optimal deployment of COVID-19 vaccines immediately and in the future. These data will be of value to public health practitioners and vaccine developers in Canada and around the world.
Results: The PREVENT-COVID in Seniors Study: PRospEctiVe EvaluatioN of immuniTy after COVID-19 vaccines in Seniors
Manish Sadarangani
Manish Sadarangani, MD, DPhil
Associate Professor, Department of Pediatrics, University of British Columbia
Clinical title and affiliated institution
Physician, Division of Infectious Diseases, Department of Pediatrics, BC Children’s Hospital
Administrative title and affiliated institution
Director, Vaccine Evaluation Center, BC Children’s Hospital Research Institute
Key words
COVID-19
Children
Antibodies
Transmission
Prevalence
Adolescents and young adults
Research interests
Research links clinical trials with basic microbiology, immunology and epidemiology to address clinically relevant problems related to immunization and vaccine-preventable diseases.
Specific research interests include bacterial vaccines, understanding vaccine-induced immunity, maternal immunization, antibiotic resistance and CNS infections.
Lisa Barrett
Assistant Professor, Departments of Medicine, Microbiology and Immunology and Pathology, Dalhousie University, Halifax, NS
Clinician Scientist and Physician of Infectious Diseases, Division of Infectious Diseases, Nova Scotia Health, Halifax, NS
Contact info
lisa.barrett@nshealth.ca
https://www.dal.ca/sites/sail.html
Key words
Immunology
Vaccinology
Aging
Immune senescence
SARS-CoV-2
COVID-19
Chronic viral infection
Hepatitis C
HIV
CMV
Research interests
Dr. Barrett’s Senescence, Aging, Infection and Immunity (SAIL) laboratory’s COVID research program studies immune responses in SARS-CoV-2 infection, with and without therapeutic intervention; immunity to SARS-CoV-2 and response to vaccination in elderly long-term care facility residents; and cellular immune responses to COVID-19 vaccines.
SAIL also studies chronic and persistent viral infections (HIV, CMV, HCV) including the role of chronic viral infection in chronologic and immunologic aging; interactions between innate and adaptive immunity in chronic viral infection; the modulation of the immune response to generate therapeutic and prophylactic vaccines in persistent viral infections; and the implementation of HCV elimination strategies with strong focuses on stakeholder engagement, increased testing to identify all infected individuals, harm reduction strategies, and expanding access to care through engagement of high-risk populations and educational intervention to increase treatment providers.
Immunity in LTCF residents at risk of COVID-19 disease and death: immune biomarkers, immune function, and frailty associated with clinical outcomes in COVID-19 pandemic waves 1 and 2
The elderly have a higher risk of severe COVID-19, particularly those living in long-term care residences. Why some elderly, but not all, have poor outcomes is not yet understood. Questions arise as to whether frailty may play a role and if frail people develop an immune response to fight the disease. There is also the question of whether other viral infections may affect the severity of COVID-19. Our study aims to understand what makes elderly people more at risk for severe or fatal COVID-19 symptoms, and how effective vaccines are in stopping the spread of COVID-19 in long-term care facilities.
The study participants are residents of several long-term care facilities in Nova Scotia. We are measuring their immune response by looking at multiple blood samples both before and after several vaccine doses. We are comparing the response across several groups: in residents who were never infected with COVID-19, residents who were highly exposed but not infected, residents who had moderate cases and those who had severe cases. We are also looking at how effective vaccines are in the frail elderly population by studying their immune response over time to determine whether vaccines protect people in this group from reinfection or at least from severe cases of the disease.
Our research will provide a greater understanding of elderly people’s immune response. Learning which factors can protect the elderly in long-term care facilities will also contribute to effective COVID-19 prevention, treatment, and vaccination strategies for this vulnerable group.
Results: Immunity in LTCF residents at risk of COVID-19 disease and death: immune biomarkers, immune function, and frailty associated with clinical outcomes in COVID-19 pandemic waves 1 and 2
Andrew Costa
Andrew Costa
Associate Professor and Schlegel Chair in Clinical Epidemiology & Aging, McMaster University
Contact info
acosta@mcmaster.ca
Key words
Long-term care, Nursing homes, Epidemiology
Research interests
– Use of health information (‘big data’) to target, develop, and evaluate models of care in home and community care, emergency departments, hospitals, and long-term care (https://bdg.mcmaster.ca/)
– Digital tools for health care, including caregivers (https://www.yourcareplus.ca)
– Data platforms
– Integrated care
Publications
– Costa AP, Manis D, Jones A, Stall N, Brown KA, et al. Risk factors for outbreaks of SARS-CoV-2 infection at retirement homes in Ontario, Canada: A population-level cohort study. (pre-print). CMAJ. In press.
– Stall NM, Zipursky JS, Rangrej J, Jones A, Costa AP, Hillmer MP, Brown K. Assessment of Psychotropic Drug Prescribing Among Nursing Home Residents in Ontario, Canada, During the COVID-19 Pandemic. JAMA Intern Med. doi:10.1001/jamainternmed.2021.0224
– Pitre T, Jones A, Su J, Helmeczi W, Xu G, Lee C, Shamsuddin A, Mir A, MacGregor S, Duong M, Ho T, Beauchamp MK, Costa AP, Kruisselbrink R; COREG Investigators. Inflammatory biomarkers as independent prognosticators of 28-day mortality for COVID-19 patients admitted to general medicine or ICU wards: a retrospective cohort study. Intern Emerg Med. 2021 Jan 26:1–10. doi: 10.1007/s11739-021-02637-8.
– Brown KA, Jones A, Daneman N, Chan AK, Schwartz KL, Garber GE, Costa AP, Stall NM. Association Between Nursing Home Crowding and COVID-19 Infection and Mortality in Ontario, Canada. JAMA Intern Med. 2021 Feb 1;181(2):229-236. doi: 10.1001/jamainternmed.2020.6466. PMID: 33165560; PMCID: PMC7653540.
– Jones A, Watts AG, Khan SU, Forsyth J, Brown KA, Costa AP, Bogoch II, Stall NM. Impact of a Public Policy Restricting Staff Mobility Between Nursing Homes in Ontario, Canada During the COVID-19 Pandemic. J Am Med Dir Assoc. 2021 Mar;22(3):494-497. doi: 10.1016/j.jamda.2021.01.068. Epub 2021 Jan 26. PMID: 33516671.
– Stall NM, Jones A, Brown KA, Rochon PA, Costa AP*. For-profit long-term care homes and the risk of COVID-19 outbreaks and resident deaths. CMAJ. 2020. August 17, 2020 192 (33) E946-E955 / Stall NM, Jones A, Brown KA, Rochon PA, Costa AP*. Risque d’eclosions de COVID-19 et de deces de residents dans les foyers de soins de longue duree a but lucrative. CMAJ. 2020 Nov 30;192(48):E1662-E1672.
Dawn Bowdish
Dawn Bowdish
Professor, McMaster University
Canada Research Chair in Aging & Immunity, McMaster University
Contact info
bowdish@mcmaster.ca
Key words
Long-term care, Frailty, Vaccination, Immunology, Antibodies, Cellular immunity
Research interests
– Immunosenescence
– Respiratory infections
– Microbiome
– Innate immunity
– Inflammation
Publications
– Characteristics of anti-SARS-CoV-2 antibodies in recovered COVID-19 subjects. Authors: Angela Huynh, Donald M. Arnold, James W. Smith, Jane C. Moore, Ali Zhang, Zain Chagla, Bart J. Harvey, Hannah D. Stacey, Jann C. Ang, RumiClare, Nikola Ivetic, Vasudhevan T. Chetty, Dawn M.E. Bowdish, Matthew S. Miller, John G. Kelton, Ishac Nazy. Accepted for publication in Viruses
COVID-19 infection and immunity in residents of long-term care facilities
Long-term care facilities have seen the greatest percentage of COVID-19 deaths in Canada. Protecting the elderly and helping them stay safe is a top priority and vaccinations are an essential component to moving beyond the crisis. Understanding how well vaccines work in the elderly population living in long-term care residences and which factors at the facilities may be directly linked to outbreaks may help guide future planning to protect this vulnerable population.
Our study involves more than 2,000 residents, staff and visitors of a select group of long-term care residences in Ontario, who are being followed over the course of about two years to include analyses post-fourth COVID-19 vaccine dose. Through blood tests to measure antibodies, we are determining how well vaccination works in the residents of these long-term care homes and whether their previous exposure to the virus or their immune system response can protect them against a future infection or make them vulnerable to it.
We are also determining which factors contributed to previous outbreaks in the homes and whether these homes are likely to have future outbreaks. Our research also involves mapping this information with Ontario provincial data to better understand the spread of the virus and immunity response across the province.
We are working directly with provincial policy makers and COVID-19 decision-makers at public health authorities, universities, and hospital centres, so our research recommendations will influence health policy in a timely way and can be implemented where they will have the most impact.
Results: Covid-19 infection and immunity in residents of long-term care facilities
Amy Hsu
Investigator, Bruyère Research Institute
Assistant Professor, Department of Family Medicine, University of Ottawa
Contact info
AHsu@Bruyere.org
Key words
Long-term care
nursing homes
older adults
health services research
prediction modelling
Research interests
Long-term care
palliative care
dementia
health economics
health services research
Marc-André Langlois
Canada Research Chair in Molecular Virology and Intrinsic Immunity
Professor, Faculty of Medicine
Department of Biochemistry, Microbiology and Immunology
University of Ottawa
Key words
SARS-CoV-2
Humoral immunity
Vaccine-induced immunity
Research interests
Molecular virology
Innate immunity
SARS-CoV-2
Influenza
HIV
Retroviruses
Identification of underlying factors influencing the immune response to SARS-CoV-2 among workers and residents in long-term care homes: a multi-province study
Among the various population groups in Canada, residents of long-term care facilities have been the most severely affected by COVID-19 in terms of illness and death. In some areas, as many as 70 per cent of the deaths due to COVID-19 have occurred in long-term care facilities. Investigating various aspects of immunity and people’s response to vaccines will provide greater protection to this vulnerable group and help develop protocols to better protect them in the future.
Monitoring vaccine effectiveness and safety is crucial within groups such as the elderly and healthcare workers who can easily be re-exposed to the virus. We are studying the immune response of 800 residents, 2,000 staff, and 500 caregivers in long-term care facilities across Ontario and British Columbia, over the course of 12-18 months. This allows us to monitor their vaccine response post vaccination, including post 3rd and 4th booster shots, as well as post bivalent vaccine administration. Our study is following COVID-naïve participants as well as participants with previous history of COVID-19, to track breakthrough infections in the long-term care sector. We are linking the individual’s immune response information to their health data to look at their long-term outcomes following an infection, and the level and duration of protection from vaccination. We are tracking adverse events and serious illness over time, including closely analyzing the specific type of antibody which protects against new infections, including neutralizing antibodies against variants of concern (VOC).
Xiaoli (Lilly) Pang
Professor, Department of Laboratory Medicine and Pathology, Investigator, Li Ka Shing Institute of Virology, University of Alberta
Molecular Virologist, Alberta Precision Laboratories
Program Leader, Alberta Precision Laboratories
Principal investigator, Li Ka Shing Institute of Virology – University of Alberta
Contact info
Xiao-li.Pang@albertapresicionlabs.ca
Key words
Virology
gastroenteric viruses
norovirus
rotavirus
environmental virology
diagnostics
infectious diseases
SARS-CoV-2
Research interests
Human viral gastroenteritis: etiology and diagnosis of enteric viruses (norovirus, rotavirus, sapovirus, astrovirus, and enteric adenovirus)
Epochal evolution of norovirus associated with epidemic gastroenteritis and its relationship with host susceptibility and herd immunity
Environmental virology and microbiology
Diagnosis of human viruses (CMV, EBV, BKV) infection in solid-organ transplantation recipient
Wastewater-based epidemiology on SARS-CoV-2 surveillance in wastewater
Chris Sikora
Associate Clinical Professor, Division of Preventive Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
Medical Officer of Health, Alberta Health Services, Edmonton Zone
Contact info
chris.sikora@ahs.ca
Key words
public health
prevention
health systems
immunization
Research interests
Public health
health systems
immunization
communicable disease
respiratory disease
Long-term care residents: Studying immune response to COVID-19 and developing an early warning system for outbreaks
Our study is examining how the immune systems of residents and staff in long-term care facilities in Alberta react to COVID-19 infection and to vaccines. Using blood samples, we are comparing the response of people who have previously been infected with COVID-19 to those who were not infected. Our study will provide important information about the impact of vaccines in this population group.
We are also monitoring sewage wastewater near long-term care facilities in Edmonton for the presence of SARS-CoV-2 RNA to develop an early warning system to detect and monitor outbreaks. Studies conducted elsewhere in the world have identified the COVID-19 virus in human wastewater before people nearby show signs of illness. Detecting the virus this way provides an early sign that the virus is circulating. The goal will be to combine an early warning system with a quick public health response including rapid testing of residents and staff to stop outbreaks and prevent further spread of the disease within the facility.
Ultimately, our research study aims to decrease the illness burden of COVID-19 outbreaks in this vulnerable population.
Results: Long-term care residents: Studying immune response to COVID-19 and developing an early warning system for outbreaks
Parminder Raina
Professor, Department of Health Research Methods, Evidence, and Impact, McMaster University
Lead Principal Investigator, Canadian Longitudinal Study on Aging
Scientific Director, McMaster Institute for Research on Aging
Scientific Director, Labarge Centre for Mobility in Aging
Raymond and Margaret Labarge Chair in Optimal Aging and Knowledge Application for Optimal Aging
Canada Research Chair in GeroScience
Key words
Canadian Longitudinal Study on Aging (CLSA)
Étude longitudinale canadienne sur le vieillissement (ELCV)
Epidemiology
Population health
COVID-19
Geroscience
Research interests
Epidemiology of aging
Geroscience
Epidemiologic modeling
Systematic review methodology
Injury
Knowledge transfer
Canadian Longitudinal Study on Aging (CLSA): Platform for studying the epidemiology of the COVID-19 pandemic in aging populations (CLSA COVID-19 Study)
The CLSA COVID-19 Antibody Study is collecting and analyzing blood samples from more than 19,000 CLSA participants in 10 provinces to estimate how widespread SARS-CoV-2 is among older adults by province, age, and sex. This national seroprevalence study will create a better understanding of SARS-CoV-2 infection in Canada among older adults, the subgroup of the population shown to be at greatest risk.
As well as providing blood samples, participants complete a questionnaire that collects information on symptoms, risks factors, psychosocial and economic impacts of COVID-19, healthcare use, and vaccinations. The blood sample analysis will show how widespread SARS-CoV-2 infection is among men and women over age 50, while the questionnaire will tell us about the lives of these individuals since the onset of the pandemic.
Together, this information will give us a more complete understanding of the transmission dynamics and the risk factors associated with SARS-CoV-2 infection in Canada’s aging adults.
Marc Romney
Marc Romney, MD, FRCPC, DTM&H
Clinical Professor, University of British Columbia
Head, Medical Microbiology and Virology, St. Paul’s Hospital/Providence Health Care
Contact info
mromney@providencehealth.bc.ca
Publications
https://pubmed.ncbi.nlm.nih.gov/?term=romney+mg
Determining the impact of COVID-19 vaccines on long-term care residents
Residents of long-term care facilities are at increased risk for serious outcomes from COVID-19, and vaccination programs are a vital step in protecting this vulnerable population. Understanding how effective vaccines are for the elderly, how quickly their immune responses develop, and how long immunity lasts is crucial to inform the best use of vaccinations.
Our study is looking at how the immune systems of elderly residents and staff in long-term care facilities in British Columbia respond to COVID-19 vaccination. Our researchers will also assess the viral, immunological, and social factors that have contributed to COVID-19 outbreaks in long-term care facilities to better understand why the disease has been fatal to so many residents.
We have collected blood samples from residents and staff at a number of long-term care facilities, before they were vaccinated whenever possible, then taking more blood samples periodically after vaccination. We will analyze their vaccine-induced immunity over time using innovative laboratory tests to understand how much protection is provided and how it changes over time. We are also taking into account which vaccine participants received, and when they got their subsequent doses , to determine vaccine effectiveness at different dosing intervals.
Our study also involves looking at blood samples collected from a long-term care residence that experienced an outbreak early in the pandemic to understand why it was so much worse for some residents than for others.
What we learn in this study will help provide the evidence needed to develop the best possible protection for people who live and work in long-term care facilities, and hopefully save lives.
RESULTS: DETERMINING THE IMPACT OF COVID-19 VACCINES ON LONG-TERM CARE RESIDENTS
mRNA vaccines administered with an extended interval between doses elicit strong SARS-CoV-2 antibody responses after two doses
Sharon Straus
Sharon E. Straus
Professor, Department of Medicine, University of Toronto
Physician-in-Chief, St. Michael’s Hospital-Unity Health Toronto
Director, Knowledge Translation Program, St. Michael’s
Contact info
Sharon.straus@utoronto.ca
Key words
Geriatric medicine
implementation science and practice
mentorship
Research interests
Advancing the science and practice of evidence implementation to improve patient care and wellbeing and strengthen the health system
Advancing methods for engaging patients and other knowledge users in research
Publications
https://wellness-hub.ca
IPAC+ evaluating intervention impact using serological and cellular assays as correlates of SARS-CoV-2 exposure among long-term care homes (LTCH) staff, residents, and transmission networks
Residents of long-term care facilities are particularly vulnerable to COVID-19 because of factors such as advanced age, weaker immune systems, or other health conditions. Staff in these facilities are also at a greater risk for contracting COVID-19 than the community at large. Understanding different aspects of immunity for long-term care residents and workers as well as their response to vaccines will help provide important information to protect against serious outbreaks in the future.
Our study is looking at people in 72 long-term care facilities in Southwestern Ontario and the Ottawa-Champlain region. Through saliva and blood samples, we are determining how many participants have already had COVID-19, whether they showed symptoms or not, and the impact of the vaccine on immune response. We are looking at factors related to the residence as a whole, as well as the individual, to determine what immune-response levels are associated with a previous infection or prevention of that infection. We are also looking at participants’ immune system response after receiving a COVID-19 vaccine.
Our research also extends to the essential care partners of residents, and the household members of the long-term care workers to understand how a person’s “bubble” may affect their risk of infection. We are also looking at wastewater testing near certain long-term care homes and in high-risk communities to see if it can help identify outbreaks sooner.
Working with 40 partners nationally, we are also developing an intervention plan with tools such as town halls, vaccine infographics and support services that will enhance staff wellness and encourage infection prevention best practices and vaccine implementation, including addressing vaccine acceptance. We have also tailored this intervention to offer support to 15 emergency shelter sites, as many of the challenges faced by long-term care facilities are also shared by other congregate settings, such as shelters.
RESULTS: IPAC+ EVALUATING INTERVENTION IMPACT USING SEROLOGICAL AND CELLULAR ASSAYS AS CORRELATES OF SARS-COV-2 EXPOSURE AMONG LONG-TERM CARE HOMES (LTCH) STAFF, RESIDENTS, AND TRANSMISSION NETWORKS
Donald Vinh
Clinician-Scientist, Research Institute-McGill University Health Centre
Associate Professor, McGill University Health Centre
Contact info
donald.vinh@mcgill.ca
Key words
COVID
Interferon
auto-antibodies
severity
elderly
angiotensin
ACE2
Isolation
Loneliness
Stress
CoV2 complications
Coagulation
psychosocial determinants
Research interests
Genetics of infectious diseases
Human susceptibility to infectious diseases
Primary immunodeficiency
Inborn errors of immunity
DISCoVER (Determining Infection Severity of CoV-2 in Elderly Residents): Type I interferon responses and their bio-psychosocial determinants to guide management of SARS-CoV-2 infection in the long-term care facility elderly
Across Canada, and particularly in Quebec, the majority of deaths from COVID-19 have been residents of long-term care facilities, but it’s still not understood why some residents in a given facility become very sick and die of COVID-19 while other people in the same facility have mild cases or show no symptoms at all. Our study is taking a comprehensive approach to understanding this better by looking at immune system, cardiovascular and mental health factors in a group of elderly people to determine what makes certain people more prone than others to developing severe COVID-19.
Our study participants live in both public and private long-term care residences in Quebec. We are taking multiple blood samples over time to compare the immune response in people ranging from those who had no COVID-19 infection to those who had severe infection. We are also studying how vaccination affects the severity of the illness.
Psychosocial stress factors such as loneliness or poor sleep may influence immune function, so we are also studying how these may be related to increased severity of COVID-19. Our study is also looking at heart problems which have been linked to COVID-19, namely high blood pressure and blood clotting problems, to establish indicators that could predict more serious cases of COVID-19 and guide treatments to prevent complications from the disease.
Through our research we aim to identify those elderly people at greater risk of developing medical complications from COVID-19, which will help guide better infection control measures and prioritize medical care to increase their chances of better outcomes.
Results: DISCoVER (Determining Infection Severity of CoV-2 in Elderly Residents): Type I interferon responses and their bio-psychosocial determinants to guide management of SARS-CoV-2 infection in the long-term care facility elderly
Sharon Walmsley
Sharon Walmsley
Professor of Medicine, University of Toronto
Infectious Diseases Consultant, University Health Network
Director Immunodeficiency Clinic, University Health Network
Senior Scientist, Toronto General Hospital Research Institute
Contact info
Sharon.walmsley@uhn.ca
Key words
COVID
Vaccine
Elderly
Immunity
Dried blood spots
Research interests
HIV
Women’s health
Infections in elderly
Safety and Efficacy of Preventative COVID Vaccines (STOPCoV)
COVID-19 vaccines were rapidly approved for use and considered an extremely important step towards ending the pandemic. However, since most participants in the vaccine clinical trials were Caucasian with an average age of 50 and little underlying illness, more information is needed about how well the vaccines work in older persons, and in more diverse populations. Our study, STOPCoV, is following more than 1,300 people living in Ontario. Within this group, we are comparing how people aged 70 and over respond to COVID-19 vaccines compared to younger people aged 30 to 50.
Our study, called Safety and Efficacy of Preventative COVID Vaccines (STOPCoV), requires participants to complete on-line questionnaires about their demographics, any underlying illness, medications they take, and any prior COVID-19 diagnosis, and they keep a seven-day diary of symptoms and reactions after each COVID-19 vaccine dose. We are also measuring the levels of antibodies or proteins in older individuals to see how well they respond to the vaccine and to follow the levels over time.
Since more Canadians of all ages will likely become eligible for a “booster” dose, we are planning another phase of our study to determine antibody response to a third vaccine dose. For those participants who receive a third dose, we are measuring their antibody levels for an additional year, as well as asking them to keep another seven-day diary to record any side effects after the third dose.
We are also looking at the impact of race, gender, and underlying illnesses such as diabetes, high blood pressure, heart, liver or kidney disease on vaccine safety and effectiveness. Our research results will be shared with public health officials.
