COVID-19 vaccination dynamics in the US: coverage velocity and carrying capacity based on socio-demographic vulnerability indices in California's pediatric population.

Introduction: COVID-19 vaccine inequities have been widespread across California, the United States, and globally. As COVID-19 vaccine inequities have not been fully understood in the youth population, it is vital to determine possible factors that drive inequities to enable actionable change that promotes vaccine equity among vulnerable minor populations. Methods: The present study used the social vulnerability index (SVI) and daily vaccination numbers within the age groups of 12-17, 5-11, and under 5 years old across all 58 California counties to model the growth velocity and the anticipated maximum proportion of population vaccinated. Results: Overall, highly vulnerable counties, when compared to low and moderately vulnerable counties, experienced a lower vaccination rate in the 12-17 and 5-11 year-old age groups. For age groups 5-11 and under 5 years old, highly vulnerable counties are expected to achieve a lower overall total proportion of residents vaccinated. In highly vulnerable counties in terms of socioeconomic status and household composition and disability, the 12-17 and 5-11 year-old age groups experienced lower vaccination rates. Additionally, in the 12-17 age group, high vulnerability counties are expected to achieve a higher proportion of residents vaccinated compared to less vulnerable counterparts. Discussion: These findings elucidate shortcomings in vaccine uptake in certain pediatric populations across California and may help guide health policies and future allocation of vaccines, with special emphasis placed on vulnerable populations, especially with respect to socioeconomic status and household composition and disability.

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

IMPORTANCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.

COVID-19 Vaccination Dynamics in the US: Coverage Velocity and Carrying Capacity Based on Socio-demographic Vulnerability Indices in California.

Coronavirus disease 2019 (COVID-19) disparities among vulnerable populations are of paramount concern that extend to vaccine administration. With recent uptick in infection rates, dominance of the delta variant, and authorization of a third booster shot, understanding the population-level vaccine coverage dynamics and underlying sociodemographic factors is critical for achieving equity in public health outcomes. This study aimed to characterize the scope of vaccine inequity in California counties through modeling the trends of vaccination using the Social Vulnerability Index (SVI). Overall SVI, its four themes, and 9228 data points of daily vaccination numbers from December 15, 2020, to May 23, 2021, across all 58 California counties were used to model the growth velocity and anticipated maximum proportion of population vaccinated, defined as having received at least one dose of vaccine. Based on the overall SVI, the vaccination coverage velocity was lower in counties in the high vulnerability category (v = 0.0346, 95% CI 0.0334, 0.0358) compared to moderate (v = 0.0396, 95% CI 0.0385, 0.0408) and low (v = 0.0414, 95% CI 0.0403, 0.0425) vulnerability categories. SVI Theme 3 (minority status and language) yielded the largest disparity in coverage velocity between low and high-vulnerable counties (v = 0.0423 versus v = 0.035, P < 0.001). Based on the current trajectory, while counties in low-vulnerability category of overall SVI are estimated to achieve a higher proportion of vaccinated individuals, our models yielded a higher asymptotic maximum for highly vulnerable counties of Theme 3 (K = 0.544, 95% CI 0.527, 0.561) compared to low-vulnerability counterparts (K = 0.441, 95% CI 0.432, 0.450). The largest disparity in asymptotic proportion vaccinated between the low and high-vulnerability categories was observed in Theme 2 describing the household composition and disability (K = 0.602, 95% CI 0.592, 0.612; versus K = 0.425, 95% CI 0.413, 0.436). Overall, the large initial disparities in vaccination rates by SVI status attenuated over time, particularly based on Theme 3 status which yielded a large decrease in cumulative vaccination rate ratio of low to high-vulnerability categories from 1.42 to 0.95 (P = 0.002). This study provides insight into the problem of COVID-19 vaccine disparity across California which can help promote equity during the current pandemic and guide the allocation of future vaccines such as COVID-19 booster shots.

Chest Computed Tomography Manifestation of Coronavirus Disease 2019 (COVID-19) in Patients With Cardiothoracic Conditions.

The coronavirus disease 2019 (COVID-19) pandemic is a serious public health concern, with an exponentially growing number of patients worldwide. Computed tomography (CT) has been suggested as a highly sensitive modality for the diagnosis of pulmonary involvement in the early stages of COVID-19. The typical features of COVID-19 in chest CT include bilateral, peripheral, and multifocal ground-glass opacities with or without superimposed consolidations. Patients with underlying medical conditions are at higher risks of complications and mortality. The diagnosis of COVID-19 on the basis of the imaging features may be more challenging in patients with preexisting cardiothoracic conditions, such as chronic obstructive pulmonary disease, interstitial lung disease, cardiovascular disease, and malignancies with cardiothoracic involvement. The extensive pulmonary involvement in some of these pathologies may obscure the typical manifestation of COVID-19, whereas other preexisting pathologies may resemble the atypical or rare CT manifestations of this viral pneumonia. Thus, understanding the specific CT manifestations in these special subgroups is essential for a prompt diagnosis.

Coronavirus disease 2019 (COVID-19) imaging reporting and data system (COVID-RADS) and common lexicon: a proposal based on the imaging data of 37 studies.

BACKGROUND: In the vast majority of the laboratory-confirmed coronavirus disease 2019 (COVID-19) patients, computed tomography (CT) examinations yield a typical pattern and the sensitivity of this modality has been reported to be 97% in a large-scale study. Structured reporting systems simplify the interpretation and reporting of imaging examinations, serve as a framework for consistent generation of recommendations, and improve the quality of patient care. PURPOSE: To compose a comprehensive lexicon for description of the imaging findings and propose a grading system and structured reporting format for CT findings in COVID-19. MATERIAL AND METHODS: We updated our published systematic review on imaging findings in COVID-19 to include 37 published studies pertaining to diagnostic features of COVID-19 in chest CT. Using the reported imaging findings of 3647 patients, we summarized the typical chest CT findings, atypical features, and temporal changes of COVID-19 in chest CT. Subsequently, we extracted a list of descriptive terms and mapped it to the terminology that is commonly used in imaging literature. RESULTS: We composed a comprehensive lexicon that can be used for documentation and reporting of typical and atypical CT imaging findings in COVID-19 patients. Using the same data, we propose a grading system with five COVID-RADS categories. Each COVID-RADS grade corresponds to a low, moderate, or high level of suspicion for pulmonary involvement of COVID-19. CONCLUSION: The proposed COVID-RADS and common lexicon would improve the communication of findings to other healthcare providers, thus facilitating the diagnosis and management of COVID-19 patients. KEY POINTS: • Chest CT has high sensitivity in diagnosing the coronavirus disease 2019 (COVID-19). • Structured reporting systems simplify the interpretation and reporting of imaging examinations, serve as a framework for consistent generation of recommendations, and improve the quality of patient care. • The proposed COVID-RADS and common lexicon would improve the communication of findings to other healthcare providers, thus facilitating the diagnosis and management of COVID-19 patients.

Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients.

OBJECTIVE. Available information on CT features of the 2019 novel coronavirus disease (COVID-19) is scattered in different publications, and a cohesive literature review has yet to be compiled. MATERIALS AND METHODS. This article includes a systematic literature search of PubMed, Embase (Elsevier), Google Scholar, and the World Health Organization database. RESULTS. Known features of COVID-19 on initial CT include bilateral multilobar ground-glass opacification (GGO) with a peripheral or posterior distribution, mainly in the lower lobes and less frequently within the right middle lobe. Atypical initial imaging presentation of consolidative opacities superimposed on GGO may be found in a smaller number of cases, mainly in the elderly population. Septal thickening, bronchiectasis, pleural thickening, and subpleural involvement are some of the less common findings, mainly in the later stages of the disease. Pleural effusion, pericardial effusion, lymphadenopathy, cavitation, CT halo sign, and pneumothorax are uncommon but may be seen with disease progression. Follow-up CT in the intermediate stage of disease shows an increase in the number and size of GGOs and progressive transformation of GGO into multifocal consolidative opacities, septal thickening, and development of a crazy paving pattern, with the greatest severity of CT findings visible around day 10 after the symptom onset. Acute respiratory distress syndrome is the most common indication for transferring patients with COVID-19 to the ICU and the major cause of death in this patient population. Imaging patterns corresponding to clinical improvement usually occur after week 2 of the disease and include gradual resolution of consolidative opacities and decrease in the number of lesions and involved lobes. CONCLUSION. This systematic review of current literature on COVID-19 provides insight into the initial and follow-up CT characteristics of the disease.