# Nationwide cross-sectional study results on long-term care and SARS-CoV-2 infection among older adults in Germany during the COVID-19 pandemic

## TL;DR

This study examines how factors like vaccination and social interactions affect SARS-CoV-2 infection risk in older adults in Germany.

## Contribution

The study identifies key risk factors for SARS-CoV-2 infection in older adults, emphasizing vaccination and in-person interactions.

## Key findings

- Not having double vaccination was strongly associated with SARS-CoV-2 infection.
- In-person visits and not living alone increased infection risk.
- Home care and social activities were not linked to higher infection risk.

## Abstract

This study investigates determinants of self-reported SARS-CoV-2 infection, addressing a gap in understanding how social and care-related factors are associated with infection risk among older people. We analyzed the baseline wave of “Gesundheit 65+”, a German nationwide population-registry survey. This wave was performed between June 2021 and April 2022, with a sample of 3450 participants aged 65 to 100 living in private households. SARS-CoV-2 infection prevalence was 3.5% (95% confidence interval, CI 2.6–4.5), slightly higher among those aged 85+, and higher among those receiving home care, and not having double vaccination. We identified with multivariable logistic regression that not having double vaccination (odds ratio, OR = 9.72; CI 4.81–19.61), receiving in-person visits (OR = 2.96; CI 1.12–7.80), and not living alone (OR = 1.96; CI 1.02–3.76) were independently associated with SARS-CoV-2 infection, but receiving formal or informal care at home, and participating in work and social activities were not. Our results emphasize the importance of vaccination and caution during in-person interactions. Despite receiving formal or informal care at home implying close personal contact, we did not detect increased infection risk in those receiving care at home.

The online version contains supplementary material available at 10.1038/s41598-026-37108-7.