Preventing the transmission of COVID-19 and other coronaviruses in older adults aged 60 years and above living in long-term care: a rapid review

Syst Rev. 2020 Sep 25;9(1):218. doi: 10.1186/s13643-020-01486-4.


Background: The objective of this review was to examine the current guidelines for infection prevention and control (IPAC) of coronavirus disease-19 (COVID-19) or other coronaviruses in adults 60 years or older living in long-term care facilities (LTCF).

Methods: EMBASE, MEDLINE, Cochrane library, pre-print servers, clinical trial registries, and relevant grey literature sources were searched until July 31, 2020, using database searching and an automated method called Continuous Active Learning® (CAL®). All search results were processed using CAL® to identify the most likely relevant citations that were then screened by a single human reviewer. Full-text screening, data abstraction, and quality appraisal were completed by a single reviewer and verified by a second.

Results: Nine clinical practice guidelines (CPGs) were included. The most common recommendation in the CPGs was establishing surveillance and monitoring systems followed by mandating the use of PPE; physically distancing or cohorting residents; environmental cleaning and disinfection; promoting hand and respiratory hygiene among residents, staff, and visitors; and providing sick leave compensation for staff.

Conclusions: Current evidence suggests robust surveillance and monitoring along with support for IPAC initiatives are key to preventing the spread of COVID-19 in LTCF. However, there are significant gaps in the current recommendations especially with regard to the movement of staff between LTCF and their role as possible transmission vectors.

Systematic review registration: PROSPERO CRD42020181993.

Keywords: COVID-19; Clinical guidelines; Knowledge synthesis; Long-term care; Older adults.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Assisted Living Facilities*
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / prevention & control*
  • Coronavirus Infections / transmission
  • Disinfection
  • Hand Hygiene
  • Humans
  • Infection Control / methods*
  • Long-Term Care
  • Middle Aged
  • Nursing Homes*
  • Pandemics / prevention & control*
  • Personal Protective Equipment
  • Pneumonia, Viral / prevention & control*
  • Pneumonia, Viral / transmission
  • Practice Guidelines as Topic
  • SARS-CoV-2
  • Severe Acute Respiratory Syndrome / prevention & control
  • Severe Acute Respiratory Syndrome / transmission
  • Sick Leave
  • Skilled Nursing Facilities