AIM and Patient Safety

Patient safety has constituted a huge public health concern for a long period of time. The focus of safety in the healthcare context is around reducing preventable harms, such as medical errors and treatment-related injuries. COVID-19 pandemic, if anything, has act as a wake-up call for health experts to address latent safety problems. Advancements in the field of artificial intelligence have highlighted the use of intelligent systems as a proven means of improving patient safety and enhancing quality of care. This chapter explores trends in quality and safety research, the use of machine learning and natural language processing in the context of improving patient safety and outcomes, the use of patient safety databases as a source of data for machine learning, and the future of artificial intelligence in quality and safety. © Springer Nature Switzerland AG 2022.

Angiopoietin-Like4 Is a Novel Marker of COVID-19 Severity.

Vascular dysfunction and capillary leak are common in critically ill COVID-19 patients, but identification of endothelial pathways involved in COVID-19 pathogenesis has been limited. Angiopoietin-like 4 (ANGPTL4) is a protein secreted in response to hypoxic and nutrient-poor conditions that has a variety of biological effects including vascular injury and capillary leak. OBJECTIVES: To assess the role of ANGPTL4 in COVID-19-related outcomes. DESIGN SETTING AND PARTICIPANTS: Two hundred twenty-five COVID-19 ICU patients were enrolled from April 2020 to May 2021 in a prospective, multicenter cohort study from three different medical centers, University of Washington, University of Southern California and New York University. MAIN OUTCOMES AND MEASURES: Plasma ANGPTL4 was measured on days 1, 7, and 14 after ICU admission. We used previously published tissue proteomic data and lung single nucleus RNA (snRNA) sequencing data from specimens collected from COVID-19 patients to determine the tissues and cells that produce ANGPTL4. RESULTS: Higher plasma ANGPTL4 concentrations were significantly associated with worse hospital mortality (adjusted odds ratio per log2 increase, 1.53; 95% CI, 1.17-2.00; p = 0.002). Higher ANGPTL4 concentrations were also associated with higher proportions of venous thromboembolism and acute respiratory distress syndrome. Longitudinal ANGPTL4 concentrations were significantly different during the first 2 weeks of hospitalization in patients who subsequently died compared with survivors (p for interaction = 8.1 × 10-5). Proteomics analysis demonstrated abundance of ANGPTL4 in lung tissue compared with other organs in COVID-19. ANGPTL4 single-nuclear RNA gene expression was significantly increased in pulmonary alveolar type 2 epithelial cells and fibroblasts in COVID-19 lung tissue compared with controls. CONCLUSIONS AND RELEVANCE: ANGPTL4 is expressed in pulmonary epithelial cells and fibroblasts and is associated with clinical prognosis in critically ill COVID-19 patients.

Perceived Hospital Stress, Severe Acute Respiratory Syndrome Coronavirus 2 Activity, and Care Process Temporal Variance During the COVID-19 Pandemic.

OBJECTIVES: The COVID-19 pandemic threatened standard hospital operations. We sought to understand how this stress was perceived and manifested within individual hospitals and in relation to local viral activity. DESIGN: Prospective weekly hospital stress survey, November 2020-June 2022. SETTING: Society of Critical Care Medicine's Discovery Severe Acute Respiratory Infection-Preparedness multicenter cohort study. SUBJECTS: Thirteen hospitals across seven U.S. health systems. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed 839 hospital-weeks of data over 85 pandemic weeks and five viral surges. Perceived overall hospital, ICU, and emergency department (ED) stress due to severe acute respiratory infection patients during the pandemic were reported by a mean of 43% ( sd , 36%), 32% (30%), and 14% (22%) of hospitals per week, respectively, and perceived care deviations in a mean of 36% (33%). Overall hospital stress was highly correlated with ICU stress (ρ = 0.82; p < 0.0001) but only moderately correlated with ED stress (ρ = 0.52; p < 0.0001). A county increase in 10 severe acute respiratory syndrome coronavirus 2 cases per 100,000 residents was associated with an increase in the odds of overall hospital, ICU, and ED stress by 9% (95% CI, 5-12%), 7% (3-10%), and 4% (2-6%), respectively. During the Delta variant surge, overall hospital stress persisted for a median of 11.5 weeks (interquartile range, 9-14 wk) after local case peak. ICU stress had a similar pattern of resolution (median 11 wk [6-14 wk] after local case peak; p = 0.59) while the resolution of ED stress (median 6 wk [5-6 wk] after local case peak; p = 0.003) was earlier. There was a similar but attenuated pattern during the Omicron BA.1 subvariant surge. CONCLUSIONS: During the COVID-19 pandemic, perceived care deviations were common and potentially avoidable patient harm was rare. Perceived hospital stress persisted for weeks after surges peaked.

Prevalence of Depression in an Urban, Predominantly Black ESKD Population During the COVID-19 Pandemic

Background: The COVID-19 pandemic has had far-reaching implications in terms of physical and mental health ramifications, and minority communities have been disproportionately impacted;particularly, prevalence of depression increased. Throughout the pandemic, ESKD patients have continued thrice-weekly in-center hemodialysis sessions or home therapies. We explored whether there was an increase in depression prevalence after the start of the pandemic in our urban predominantly Black ESKD population. Method(s): We used data from social worker-administered PHQ-2 questionnaire depression screenings (required by Centers for Medicare & Medicaid Services) in eligible patients treated at four Emory University affiliated in-center dialysis units and three home dialysis units from 2018-2019 (pre-pandemic) to 2020-2021 (pandemic). Excluded from this study were patients with no assessments or incomplete assessments. Data were analyzed using chi-square tests comparing the prevalence of depression in pre-pandemic versus pandemic period. Result(s): In 2021, 91.5% of our patients were Black. There were 2433 in-center patient depression scores and 586 home dialysis patient depression scores. Excluded from the study were 1045 patients in the in-center and 214 patients in the home population. Of the 2433 patient scores analyzed in the in-center group, 1289 were pre-pandemic and 1144 were in the pandemic period. 155 (12%) in-center patient scores in the prepandemic period were classified as depressed while 128 (11.2%) in-center patient scores during the pandemic were classified as depressed (two-sided p-value 0.5272). Of the 586 home dialysis patient scores, 325 were pre-pandemic and 261 in the pandemic period. 71 (21.8%) patient scores in the pre-pandemic period had a positive depression screening while 29 (11.1%) patient scores during the pandemic period had depression (two-sided p-value 0.0006). Conclusion(s): We did not observe an increase in depression prevalence during the COVID-19 pandemic in in-center dialysis patients, and surprisingly observed a statistically significant decrease in depression among our home dialysis patients. The decrease in depression in our home dialysis patients during the pandemic may reflect being at home is a protective mechanism, and this observation should be further investigated.

COVID-19 Infection in Dialysis Patients: Efficacy of Vaccination

Background: End stage kidney disease (ESKD) patients are particularly susceptible to poor outcomes from Covid-19 infection (C19). Vaccination has been the cornerstone of mortality prevention. We examine the efficacy of C19 vaccine in ESKD patients. Method(s): All patients dialyzed at Emory dialysis centers from December 1, 2020 until February 2022 represent the study population. Date of completed vaccines series was recorded. Confirmed C19 cases were also registered. Time from vaccination to C19 and from C19 to death was recorded. Mortality risk was compared between vaccinated and unvaccinated patients. Patients that received vaccination after an episode of C19 were excluded from the analysis (n=89). Result(s): 935 patients received maintenance dialysis during the study period. 68% completed 2 doses of C19 vaccine. 46% of vaccinated patients received a booster dose after 294 days (IQR: 251-273) of completing the primary vaccination series. Non-vaccinated patients were younger (55 vs 60y/o), with shorter dialysis vintage (1.0 vs 2.8 years). The proportion of home and in-center dialysis was similar among vaccinated and unvaccinated patients. The prevalence of diabetes, CHF, PVD, COPD, atrial fibrillation, and previous transplants was also similar. 71 vaccinated patients died during follow up (11%) after 196 days (IQR 122-290), compared to 70 in the non-vaccinated group (24%) after 86 days (IQR 39-166), p<0.001. Adjusting for age, dialysis vintage, diabetes and CHF, ESKD vaccinated patients had a 78% reduction in mortality risk (A). 73 vaccinated patients (11%) acquired C19 after 250 days (IQR 150-288) compared to 48 unvaccinated patients (16%) who acquired C19 after 64 days (IQR 30-215), p<0.001. The mortality odds ratio after C19 infection was 3.9 [CI: 1.3-11.9] for unvaccinated patients 30 days post infection, 4.7 [CI: 1.7-14.2] at 60 days and 4.1 [CI: 1.6-11.5] at 90 days (B). Conclusion(s): Vaccination against C-19 infection resulted in a 78% reduction of mortality risk in patients receiving dialysis. Non-vaccinated patients diagnosed with C19 had higher mortality rates than vaccinated patients (OR 4.1 at 90 days post infection).

Effect of COVID-19 Vaccination Drive on COVID-19 Outcomes in Urban Dialysis Centers

Vaccination is a critical strategy to prevent COVID-19. We describe the effects of a vaccine drive implemented in Emory Dialysis centers on COVID-19 vaccine uptake, infection rates and outcomes. Emory Dialysis, serving an urban population, conducted a COVID-19 vaccination drive (i.e. vaccine education and onsite vaccine administration) across its 4 dialysis centers (~750 patients) from March—April 2021. Monthly COVID-infection and vaccination rates were tracked from March 2020—September 2021. We assessed the effect of the drive on the COVID-19 vaccine uptake, infection rates and outcomes including hospitalizations and 30-day mortality. Patients were included if they were diagnosed with COVID-19, 14 days after the vaccination drive (to reflect fully vaccinated status). Patients were stratified by vaccination status and descriptive statistics were performed. From March 2020–April 2021, monthly COVID-19 infection rates were 0.41—4.97% and vaccination rates were 0–6%. From May–September 2021 (post-vaccination drive), the monthly COVID-19 infection rates ranged from 0–2.50% and vaccination rates were 67.4–76.1%. In the post-vaccination period, 34 patients were diagnosed with COVID-19;26 were fully vaccinated and 8 were unvaccinated. Among the 34 patients, the median age was 57 years [interquartile range (IQR) 47–73], 29% were female and 79.4% were Black. Compared to unvaccinated group, the vaccinated group was older (62 years [IQR 50-73] vs. 50 years [IQR 41-60], p=0.06), and had a higher prevalence of cardiovascular disease (46.2% vs. 25.0%, p=0.62);otherwise, patient characteristics were similar between the groups. Twelve patients (48.1%) in the vaccinated group vs. 6 patients (75.0%) in the unvaccinated group were hospitalized for COVID-infection (p=0.26). Three patients (11.5%) in the vaccinated group vs. 2 patients (25%) in the unvaccinated group (p=0.35) died within 30-days of COVID-19 diagnosis. Providing vaccinations at dialysis centers may improve COVID-19 vaccine uptake and outcomes. Studies evaluating the long-term effects of vaccination programs in dialysis centers are needed.

An Electronic Data Capture Tool for Data Collection During Public Health Emergencies: Development and Usability Study.

BACKGROUND: The Discovery Critical Care Research Network Program for Resilience and Emergency Preparedness (Discovery PREP) partnered with a third-party technology vendor to design and implement an electronic data capture tool that addressed multisite data collection challenges during public health emergencies (PHE) in the United States. The basis of the work was to design an electronic data capture tool and to prospectively gather data on usability from bedside clinicians during national health system stress queries and influenza observational studies. OBJECTIVE: The aim of this paper is to describe the lessons learned in the design and implementation of a novel electronic data capture tool with the goal of significantly increasing the nation's capability to manage real-time data collection and analysis during PHE. METHODS: A multiyear and multiphase design approach was taken to create an electronic data capture tool, which was used to pilot rapid data capture during a simulated PHE. Following the pilot, the study team retrospectively assessed the feasibility of automating the data captured by the electronic data capture tool directly from the electronic health record. In addition to user feedback during semistructured interviews, the System Usability Scale (SUS) questionnaire was used as a basis to evaluate the usability and performance of the electronic data capture tool. RESULTS: Participants included Discovery PREP physicians, their local administrators, and data collectors from tertiary-level academic medical centers at 5 different institutions. User feedback indicated that the designed system had an intuitive user interface and could be used to automate study communication tasks making for more efficient management of multisite studies. SUS questionnaire results classified the system as highly usable (SUS score 82.5/100). Automation of 17 (61%) of the 28 variables in the influenza observational study was deemed feasible during the exploration of automated versus manual data abstraction. The creation and use of the Project Meridian electronic data capture tool identified 6 key design requirements for multisite data collection, including the need for the following: (1) scalability irrespective of the type of participant; (2) a common data set across sites; (3) automated back end administrative capability (eg, reminders and a self-service status board); (4) multimedia communication pathways (eg, email and SMS text messaging); (5) interoperability and integration with local site information technology infrastructure; and (6) natural language processing to extract nondiscrete data elements. CONCLUSIONS: The use of the electronic data capture tool in multiple multisite Discovery PREP clinical studies proved the feasibility of using the novel, cloud-based platform in practice. The lessons learned from this effort can be used to inform the improvement of ongoing global multisite data collection efforts during the COVID-19 pandemic and transform current manual data abstraction approaches into reliable, real time, and automated information exchange. Future research is needed to expand the ability to perform automated multisite data extraction during a PHE and beyond.

Improving ABCDEF Bundle Compliance and Clinical Outcomes in the ICU: Randomized Control Trial to Assess the Impact of Performance Measurement, Feedback, and Data Literacy Training

OBJECTIVES: Describe the effects of data literacy training and continuous performance reports on ICU staff compliance with the 6-element ICU quality bundle approach known as the ABCDEF (A–F) bundle and patient outcomes. DESIGN: Stepped-wedge cluster randomized trial conducted during an institutional A–F bundle implementation program. SETTING: Single-center study conducted in eight adult ICUs. PATIENTS: Adult patients admitted for at least 24 hours, not undergoing active withdrawal of life support or palliative care. INTERVENTIONS: Four ICUs in the intervention group received bundle-related staff education, data literacy training, and weekly bundle performance reports during the 12-month study period. The four ICUs in the nonintervention group received none of these interventions. Bundle compliance and patient outcomes were tracked, including ICU and hospital mortality, transfer and discharge, discharge disposition, mechanical ventilation, and ICU delirium. MEASUREMENT AND RESULTS: In the intervention group, staff education alone increased bundle compliance from 9% to 16% (p < 0.0001);data literacy training further increased compliance from 16% to 21% (p = 0.03). This improvement was sustained throughout the study period including the onset of the COVID-19 pandemic and was greater than improvement in the nonintervention group (p < 0.001). Full A–F bundle compliance was associated with a lower likelihood of next-day ICU and hospital mortality, discharge to a facility other than home, and was associated with a higher likelihood of next-day extubation in patients. Next-day ICU and hospital discharge likelihood decreased, and delirium frequency was not affected. CONCLUSIONS: This is the first study demonstrating that the combination of staff education, data literacy training, and access to performance data improves A–F bundle compliance, sustains performance, and improves ICU patient outcomes (ICU and hospital mortality, mechanical ventilation duration, and home discharge rates). In contrast to previous studies, increased bundle compliance did not hasten ICU or hospital discharges or reduce delirium frequency in patients.

Severe acute respiratory infection-preparedness (Sari-Prep): A multicenter prospective study

OBJECTIVES: We designed a prospective cohort study to systematically study patients with severe acute respiratory infection (SARI) and improve hospital preparedness (SARI-PREP). The goal of this project is to evaluate the natural history, prognostic biomarkers, and characteristics, including hospital stress, associated with SARI clinical outcomes and severity. METHODS: In collaboration with the Society of Critical Care Medicine Discovery Research Network and the National Emerging Special Pathogen Training and Education Center (NETEC), SARIPREP is an ongoing, prospective, observational, multi-center cohort study of hospitalized patients with respiratory viral infections. We collected patient demographics, signs, symptoms, and medications;microbiology, imaging, and other diagnostics;mechanical ventilation, hospital procedures, and other interventions;and clinical outcomes. Hospital leadership completed a weekly hospital stress survey. Respiratory, blood, and urine biospecimens were collected from patients on days 0, 3, 7-14 after study enrollment and at hospital discharge. MEASUREMENTS AND MAIN RESULTS: SARI-PREP enrollment began on April 4, 2020 and currently includes 674 patients. Here we report results from the first 400 patients: 216 are from the University of Washington Hospitals, Seattle WA, 142 from New York University, New York NY and 42 from University of Southern California, Los Angeles, CA. Almost all tested positive for SARS-CoV-2 infection (n=397), whereas 3 patients tested positive for an alternative viral pathogen. The mean (±SD) age of the patients was 57±16 years;72% were men, 62% were White, 14% were Asian, 12% were Black, and 31% were Hispanic. Most of the patients were admitted to the intensive care unit (96%). The median (interquartile range) hospital length of stay was 22 (9-46) days. Rates of invasive mechanical ventilation (72%) and renal replacement therapy (19%) were common and the rate of hospital mortality was 35%. CONCLUSIONS: Initial SARI-PREP analysis indicates enrollment of a diverse population of hospitalized patients primarily with SARSCoV-2 infection. The demographics and clinical outcomes of our cohort mirror other large critically ill cohorts of COVID-19 patients. Results of a concomitant, weekly, hospital stress assessment are reported separately.

Critical Care Response During the COVID-19 Pandemic.

Hospitals and health care systems with active critical care organizations (CCOs) that unified ICU units before the onset of the COVID-19 Pandemic were better positioned to adapt to the demands of the pandemic, due to their established standardization of care and integration of critical care within the larger structure of the hospital or health care system. CCOs should continue to make changes, based on the real experience of COVID-19 that would lead to improved care during the ongoing pandemic, and beyond.

HOSPITAL STRESS AND CARE PROCESS TEMPORAL VARIANCE DURING THE COVID-19 PANDEMIC IN THE U.S

The survey assessed hospital stress ordinally and also assessed ED and ICU stress and deviations from standard operating procedures. During one December 2020 week, hospital stress, ICU stress, and care deviations were all present at 100% of reporting sites. B Introduction: b Hospitals experienced substantial stress during the COVID-19 pandemic - threats to standard operations - but it is not well known how this stress manifested at individual hospitals. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Project Restart';Safe resumption of elective orthopaedic surgery following the Covid-19 pandemic

Introduction: The Covid-19 pandemic resulted in nearly 2 million patients being put on waiting lists for elective procedures in the UK. We aim to describe how the COVID-19 Algorithm for Resuming Elective Surgery (CARES) was used to allocate patients to elective theatre lists while factoring in patient safety, risk to healthcare workers and, protection of resources. Methodology: A multidisciplinary team was employed with the task of using CARES to allocate theatre slots to 1169 patients on the waiting list. CARES was used in conjunction with an evidence-based scale for procedural urgency (Levels 1-4) to stratify patients and list them for surgery at one of three 'COVID-light' sites i.e. 1. With HDU/ITU access, specialist staff, and equipment, 2. An NHS short-stay surgical unit, 3. A private surgical unit. Incidence of post-operative Covid-19 infection was assessed by looking at positive Covid-19 RT-PCR or CT Chest with characteristic findings performed within 2 weeks of the surgery. Results: 118 cases were deemed to be Priority 1/2, 222 were Level 3, and 808 were Level 4. In 6 weeks, 355 surgeries were performed, with Urgent and Level 1/2 cases performed soonest (mean 18 days, p<0.001). 33 high-risk/complex/paediatric patients had surgery at Site 1 and the rest at Sites 2 and 3. No patients contracted COVID-19 within 2 weeks of surgery. Conclusion: CARES' holistic approach enabled equitable and safe resumption of arthroplasty during the pandemic, by stratification and creation of COVID-light sites. It could be applied internationally and across sub-specialties.

Temporary changes in hemodialysis parameters in patients affected by COVID-19 infection: A visual guide

Background: ESKD patients on dialysis have been significantly affected by the COVID pandemic. By now, a substantial number of patients have survived the disease. We display graphically the temporary changes in dialysis parameters of patients that have survived COVID-19 infection. Methods: All patients receiving hemodialysis at Emory dialysis centers diagnosed with COVID-19 infection between 3/1/20 to 1/31/21 who survived for at least 3 months were identified. The date of COVID-19 diagnosis was used to time-reference dialysis parameters including duration of hemodialysis, weight, ultrafiltration, mean arterial pressure pre-dialysis, hemoglobin, albumin, calcium, phosphorus, potassium, serum bicarbonate, absolute lymphocyte count and Kt/V. The temporary behavior of these parameters is presented graphically. Data manipulation, analysis and graphical display was performed using R-software and tidyverse package. Results: 96 patients were identified. 82% were African-American with a median age of 64y/o. 52% were male and 60% were diabetics, The median time on dialysis was 2.5 years. All studied parameters showed a significant deviation from baseline measurements obtained in the 60 days prior to the diagnosis of COVID-19. The parameter with the least amount of change was Kt/V. In the subsequent 2 months after diagnosis, all of the parameters studied returned to baseline except for Potassium, that remained below premorbid levels 2 months after the COVID-19 diagnosis. These changes are presented in Figure 1. Conclusions: COVID-19 infection has a significant impact on hemodialysis parameters as presented in figure 1. The temporary variation of the most common parameters associated with COVID-19 infection presented in this study can be used as reference for patients, dieticians, and nephrologists caring for ESKD affected by COVID-19. (Figure Presented) .

Prevalence of vitamin D deficiency in a predominantly African-American hemodialysis patient population

Background: Vitamin D insufficiency and deficiency are common abnormalities and high risk groups include kidney disease patients and African-Americans. Recommendations on the evaluation of vitamin D levels in CKD and ESKD are ambiguous due to a lack of studies examining epidemiology and treatment. The COVID-19 pandemic has disproportionately affected minorities and has highlighted the need for evidence as studies have examined vitamin D deficiency as a risk factor for COVID-19 complications. We present a case series examining the prevalence of vitamin D deficiency in a predominantly African-American hemodialysis patient population. Methods: Retrospective chart review of all in-center hemodialysis patients at Emory Dialysis in Atlanta, GA. Data extracted from Sep to Nov 2020. We excluded any patients on home therapies. Serum 25(OH)vitamin D concentration total was analyzed. We defined vitamin D insufficiency as 20-29.9 ng/mL and vitamin D deficiency as a level<20 ng/ml. Results: Patients receiving in-center hemodialysis(n=615). Average length of time on dialysis was 5 years and average age was 59.4 years. Patients were 52.5% male(n=323). 91.5%(n=563) of patients were African-American. Mean calcium level for all patients was 8.73 mg/dL and PTH level of 554 pg/mL. Mean vitamin D in all patients was 26.32 ng/mL. 98%(n=603) of patients had a vitamin D level available. All patients with vitamin D level<30 ng/mL=412(68.3%) and all patients with vitamin D level<20 ng/ mL=244(40.5%). African-American patients with a vitamin D level was 552. African-American patients with vitamin D level<30 ng/mL=382 (69.2%) and African-American patients with vitamin D level<20 ng/ml=229(41.5%). Mean vitamin D in African-American patients 25.7 ng/mL and non-African-American patients 32.7 ng/mL, p=0.01. Conclusions: In comparison to others such as the DIVINE trial, we present a larger and more diverse cohort. In our study, African-Americans had a statistically significant lower vitamin D level. A case for replacing 25(OH) vitamin D even in ESKD patients is based on the action of vitamin D beyond mineral metabolism, especially with regard to autocrine regulation of immune function. Future directions include examining effects of treatment on PTH and study of vitamin D deficient patients' risks for adverse events like COVID-19 infection.

Firm partisan positioning, polarization, and risk communication: Examining voluntary disclosures on COVID-19.

Research Summary: The COVID-19 pandemic will rank among the greatest challenges many executives will have faced and not only due to the operational challenges it posed. Upon entering the U.S. context, the disease was immediately politically polarized, with clear partisan splits forming in risk perceptions of the disease unrelated to science. We exploit this context to examine whether firms' partisan positioning affects whether and how they communicate risk to their investors on a polarized public policy issue. To do so, we examine the covariation between firms' disclosure of COVID-19 risks and the partisanship of their political giving. Our analysis of earnings call and campaign contribution data for the S&P 500 reveals a positive association between a firm's contributions to Democrats and its disclosure of COVID-19 risks. Managerial Summary: From its onset in the United States, attitudes toward and discourse around the COVID-19 pandemic was heavily politicized and perceptions of the disease's risks were seen as more serious by Democratic-identifying individuals than Republican identifiers. In this study, we examine whether this pattern also holds for U.S. publicly traded firms, who can also stake out a political position through their corporate political action committee campaign contributions. In analyses of earnings call transcripts from the first quarter of 2020, we show that the more Republican-leaning (Democrat-leaning) a firm's campaign contributions are, the less (more) likely it was to voluntarily disclose risks related to COVID-19. We argue that these findings hold implications for parties interested in interpreting firm's risk disclosures on politically polarized issues.