Magnitude, change over time, demographic characteristics and geographic distribution of excess deaths among nursing home residents during the first wave of COVID-19 in France: a nationwide cohort study

Age Ageing. 2021 Sep 11;50(5):1473-1481. doi: 10.1093/ageing/afab098.


Background: The objectives were to assess the excess deaths among Nursing Home (NH) residents during the first wave of the COVID-19 pandemic, to determine their part in the total excess deaths and whether there was a mortality displacement.

Methods: We studied a cohort of 494,753 adults in 6,515 NHs in France exposed to COVID-19 pandemic (from 1 March to 31 May 2020) and compared with the 2014-2019 cohorts using data from the French National Health Data System. The main outcome was death. Excess deaths and standardized mortality ratios (SMRs) were estimated.

Result: There were 13,505 excess deaths. Mortality increased by 43% (SMR: 1.43). The mortality excess was higher among males than females (SMR: 1.51 and 1.38) and decreased with increasing age (SMRs in females: 1.61 in the 60-74 age group, 1.58 for 75-84, 1.41 for 85-94 and 1.31 for 95 or over; males: SMRs: 1.59 for 60-74, 1.69 for 75-84, 1.47 for 85-94 and 1.41 for 95 or over). No mortality displacement effect was observed up until 30 August 2020. By extrapolating to all NH residents nationally (N = 570,003), we estimated that they accounted for 51% of the general population excess deaths (N = 15,114 out of 29,563).

Conclusion: NH residents accounted for half of the total excess deaths in France during the first wave of the COVID-19 pandemic. The excess death rate was higher among males than females and among younger than older residents.

Keywords: COVID-19; excess deaths; nursing home; older adults.

MeSH terms

  • COVID-19*
  • Cohort Studies
  • Demography
  • Female
  • France / epidemiology
  • Humans
  • Male
  • Nursing Homes
  • Pandemics*
  • SARS-CoV-2