In a new study, 59% of nursing facility residents with symptomatic COVID-19 had high rates of dehydration. The authors concluded that this condition was related to higher and more persistent fever, a known risk factor for dehydration in this setting, as well as difficulty maintaining oral hydration following acute declines in alertness and strength.

Dehydration was also associated with a higher risk of falls and death. A 37% higher risk of dehydration was seen in residents with moderate-to-severe cognition impairment or delirium associated with COVID, compared with residents who had neither condition.

While the study was small, involving only one facility, the findings support those of other recent studies. Furthermore, the results indicate that nursing facilities should be prepared to consider administering IV fluids to residents with symptomatic COVID.

This study also backs research suggesting that older adults with infection of any kind may be better managed in nursing facilities than in the hospital. As the authors said, “[These] results are consistent with a recent study in which protocolized medical care of COVID-19 in the nursing home setting was associated with better outcomes.”

They noted that care pathways for infection and dehydration are available as part of such programs as Interventions to Reduce Acute Care Transfers (INTERACT), which is widely used in long-term and post-acute care. “Given the continued risk of COVID-19 in skilled nursing facilities, it is imperative to identify interventions consistent with goals of care that may lead to better outcomes,” they observed.

Click here to read about the study.