Italian long-term care facilities during COVID-19 era: a review

Background. Since the start COVID-19 epidemic, 9154 deaths have been registered in Italian Long-Term Care Facilities (LTCF). Half of them were COVID 19-related. Objective. In this review we analyzed the management of COVID-19 outbreak in Italian LTCF, in the most affected regions. Results. In the Italian Institute of Health (ISS) report, 1356 LTCF (41.3%) answered to questionnaires on COVID-19 infection in LTCF. Only 7.4% of deaths was related to Coronavirus (confirmed by swab), while 33,8% of deceased presented flu-like symptoms without confirmation by swab. 77.2% of structures reported the lack of Personal Protective Equipment. The autonomous management policies of the regions cannot be negligible in this assessment, above all Lombardia Region that diverted patients from hospital to extra-structures, like LTCF. Conclusions. The elderlies represent high-risk patients for developing COVID-19 with rapid clinical deterioration. Containment measures should be particularly optimized, especially in anticipation of another possible pandemic recurrence. Surely a comparison among different systems could help to achieve more information in the standardization of procedures. Identifying flaws in this system is necessary to perfect and optimize epidemic management as much as possible.