{"doi":"10.1111/jgs.17760","title":"<scp>P</scp> <scp>ost‐acute</scp> sequelae of <scp>SARS‐CoV</scp> ‐2 infection in nursing homes: Do not forget the most vulnerable","abstract":"In the early days of the current pandemic, many expected that COVID-19 would behave like most other respiratory viral illnesses—causing an acute illness that would resolve after, at most, a couple of weeks. However, there is a now a rapidly emerging literature on long COVID or a post-acute sequelae of SARS-CoV-2 infection (PASC)1 syndrome in which patients may experience significant limitations in physical, cognitive, and mental health for several weeks to months after the initial COVID-19 diagnosis. It is unclear whether these sequelae are directly related to damage caused by SARS-CoV-2 itself, a post-viral syndrome, deconditioning from prolonged hospital stays or post-intensive care syndrome. Also unknown about PASC are its incidence, prevalence, trajectory, and risk factors. Presently, there is growing concern that there will be a subsequent public health crisis if this syndrome is not recognized or adequately treated.2 While it is well known that residents of skilled nursing facilities have endured a disproportionate impact from COVID-19 with high case fatality rates, little is known about PASC in this specific patient population. Like PASC patients in the community,3 survivors of COVID-19 residing in nursing homes may have new supplemental oxygen requirements and significant debilitation from acute COVID-19, resulting in high rehabilitation needs and need for additional caregiver support for activities of daily living (ADLs). It is also uncertain whether COVID-19 has synergistic adverse effects on preexisting medical conditions, such as chronic obstructive pulmonary disease, given the severe lung damage that it can cause in some patients. Furthermore, current data characterizing PASC syndrome profiles are dominated by symptoms of neurological dysfunction and persistent fatigue. Whether PASC may alter the disease course of patients with mild cognitive impairment, Alzheimer's disease and related dementia, or other types of dementia remains unknown. Prolonged social confinement imposed by clinical isolation requirements may affect cognitive faculties. Social confinement also significantly impacts a nursing home resident's overall quality of life. Prior work has indicated that in community-dwelling older adults, the COVID-19 pandemic has had a global effect on worsened physical functioning and fall outcomes, notably in those with reduced activity levels and social isolation.4 These observations will likely be more apparent in nursing home residents. In addition, little is known about how immunization might modulate the development and progression of PASC, particularly in nursing home residents—given the likely differential immune response to vaccination in impaired older adults. Though COVID-19 vaccination rates among nursing home residents are relatively high in many regions, breakthrough infections occur, especially among frail older adults.5 It has been theorized that this persistent increased risk may be from repeated exposures through increased interactions with the healthcare system. Current national vaccination rates among nursing home staff are 60%,6 though they are substantially higher in locations that have vaccination mandates (e.g., 92% in New York State7).While primary immunization against COVID-19 has demonstrated some promise against the risk of developing PASC,5 these results may not be generalizable to patients residing in nursing homes. In addition, the effect of booster doses, authorized in the Fall of 2021, remains to be fully understood. We applaud the National Institute of Health's RECOVER (Researching COVID to Enhance Recovery) Initiative to study PASC.8 However, previous PASC research is limited in that it has focused primarily on community-dwelling patients. These patients are able to enroll selectively into studies and self-report symptoms either over a web-based survey or over the phone. Patients in these studies tend to be younger (<60 years old), English-speaking, or have been able to form patient","journal":"Journal of the American Geriatrics Society","year":2022,"id":272524,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9607,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":939076,"name":"Mana Rao","orcid":"0000-0002-2516-2079","position":1,"is_corresponding":false},{"id":939077,"name":"Kenneth S. Boockvar","orcid":"0000-0003-1165-5558","position":2,"is_corresponding":false},{"id":496234,"name":"Himali Weerahandi","orcid":"0000-0001-9614-345X","position":0,"is_corresponding":true}],"reference_count":14,"raw_metadata":null,"created_at":"2026-07-19T00:27:47.926496Z","pmid":"35323991","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}