Background: At the beginning of the pandemic in Spain, concern was raised about the need to hospitalize the elderly living in nursing homes affected by coronavirus disease 2019 (COVID-19). A multidisciplinary hospital team was formed in Valladolid (Spain) to medicalize these facilities. Methods: 835 elderly residents (70% women and 30% men) of six nursing homes were analyzed. We performed a universal screening by real time-polymerase chain reaction (RT-PCR) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and a retrospective analysis of the outcomes (incidence, severity, hospital admissions and mortality) at 14, 21 and 28 days after diagnosis. Treatments administered to patients were also analyzed. Results: Of the 578residents with positive RT-PCR,177 (31%)showed moderate or severe symptoms,71 (12%) required hospitalizationand103 (18%) died in the 28 days after diagnosis. In the group with negative RT-PCR, the mortality rate was 16%. Patients received more corticosteroids in nursing homes and more lopinavir-ritonavir in the Hospital. Among critically ill patients, no difference in the mortality rate was found between those hospitalized (80%) and those who remained in the nursing home (81%). Conclusions: The screening showed that 72% of the elderly had SARS-CoV-2 infection. The mortality rate was similar in the initially positive and negative RT-PCR groups, suggesting that many residents subsequently developed the infection. In our experience, when adequate health care is provided, with sufficiently trained health workers, the life expectancy of elderly people with COVID-19 is not affected by staying in nursing homes, even in severe cases.
