Effect of vicarious discrimination on race-based stress symptoms among Asian American young adults during the COVID-19 pandemic.

OBJECTIVE: The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. METHOD: We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. RESULTS: Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. CONCLUSION: Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Surveillance for Violent Deaths - National Violent Death Reporting System, 48 States, the District of Columbia, and Puerto Rico, 2020.

Problem/Condition: In 2020, approximately 71,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 48 states, the District of Columbia, and Puerto Rico in 2020. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics. Period Covered: 2020. Description of System: NVDRS collects data regarding violent deaths obtained from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected for violent deaths that occurred in 2020. Data were collected from 48 states (all states with exception of Florida and Hawaii), the District of Columbia, and Puerto Rico. Forty-six states had statewide data, two additional states had data from counties representing a subset of their population (35 California counties, representing 71% of its population, and four Texas counties, representing 39% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each violent death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident. Results: For 2020, NVDRS collected information on 64,388 fatal incidents involving 66,017 deaths that occurred in 48 states (46 states collecting statewide data, 35 California counties, and four Texas counties), and the District of Columbia. In addition, information was collected for 729 fatal incidents involving 790 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately. Of the 66,017 deaths, the majority (58.4%) were suicides, followed by homicides (31.3%), deaths of undetermined intent (8.2%), legal intervention deaths (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm deaths (<1.0%). The term "legal intervention" is a classification incorporated into the International Classification of Diseases, Tenth Revision, and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.Demographic patterns and circumstances varied by manner of death. The suicide rate was higher for males than for females. Across all age groups, the suicide rate was highest among adults aged ≥85 years. In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups. Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide victims, when circumstances were known, suicide was most often preceded by a mental health, intimate partner, or physical health problem or by a recent or impending crisis during the previous or upcoming 2 weeks. The homicide rate was higher for males than for females. Among all homicide victims, the homicide rate was highest among persons aged 20-24 years compared with other age groups. Non-Hispanic Black (Black) males experienced the highest homicide rate of any racial or ethnic group. Among all homicide victims, the most common method of injury was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Homicide most often was precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, was related to intimate partner violence. Nearly all victims of legal intervention deaths were male, and the legal intervention death rate was highest among men aged 35-44 years. The legal intervention death rate was highest among AI/AN males, followed by Black males. A firearm was used in the majority of legal intervention deaths. When a specific type of crime was known to have precipitated a legal intervention death, the type of crime was most frequently assault or homicide. When circumstances were known, the three most frequent circumstances reported for legal intervention deaths were as follows: the victim's death was precipitated by another crime, the victim used a weapon in the incident, and the victim had a substance use problem (other than alcohol use).Other causes of death included unintentional firearm deaths and deaths of undetermined intent. Unintentional firearm deaths were most frequently experienced by males, non-Hispanic White (White) persons, and persons aged 15-24 years. These deaths most frequently occurred while the shooter was playing with a firearm and were precipitated by a person unintentionally pulling the trigger. The rate of deaths of undetermined intent was highest among males, particularly among AI/AN and Black males, and among adults aged 30-54 years. Poisoning was the most common method of injury in deaths of undetermined intent, and opioids were detected in nearly 80% of decedents tested for those substances. Interpretation: This report provides a detailed summary of data from NVDRS on violent deaths that occurred in 2020. The suicide rate was highest among AI/AN and White males, whereas the homicide rate was highest among Black male victims. Intimate partner violence precipitated a large proportion of homicides for females. Mental health problems, intimate partner problems, interpersonal conflicts, and acute life stressors were primary circumstances for multiple types of violent death. Public Health Action: Violence is preventable, and states and communities can use data to guide public health action. NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent violent deaths. For example, the Colorado Violent Death Reporting System (VDRS), Kentucky VDRS, and Oregon VDRS have used their VDRS data to guide suicide prevention efforts and generate reports highlighting where additional focus is needed. In Colorado, VDRS data were used to examine the increased risk for suicide among first and last responders in the state. Kentucky VDRS used local data to highlight how psychological and social effects of the COVID-19 pandemic might increase risk for suicide, particularly among vulnerable populations. Oregon VDRS used their data to develop a publicly available data dashboard displaying firearm mortality trends and rates in support of the state's firearm safety campaign. Similarly, states participating in NVDRS have used their VDRS data to examine homicide in their state. Illinois VDRS, for example, found that state budget cuts were associated with notable increases in homicides among youths in Chicago. With an increase of participating states and jurisdictions, this report marks progress toward providing nationally representative data.

Can dogs serve as stress mediators to decrease salivary cortisol levels in a population of liberal arts college undergraduate students?

The steroid hormone cortisol can be used to measure physiological stress in humans. The hypothalamic-pituitary-adrenal (HPA) axis synthesizes cortisol, and a negative feedback cycle regulates cortisol depending on an individual's stress level and/or circadian rhythm. Chronic stress of college undergraduate students is associated with various adverse health effects, including anxiety and depression. Reports suggest that stress levels have risen dramatically in recent years, particularly among university students dealing with intense academic loads in addition to COVID-19 pandemic-related uncertainty. The increasing rate of mental illness on college campuses necessitates the study of mediators potentially capable of lowering stress, and thus cortisol levels. Research on mediation techniques and coping mechanisms have gained traction to address the concerning levels of stress, including the employment of human-animal interaction sessions on college campuses. In this study, human-canine interaction as a stress mediation strategy for undergraduate students was investigated. We measured salivary cortisol levels in 73 college undergraduate students during a 60-min interaction period with a dog to determine whether human-canine interactions are effective in lowering cortisol levels and potentially reducing chronic stress typical of undergraduate students. Our results indicate that a human-canine interaction for 60 min is an effective method for significantly reducing salivary cortisol and stress levels among undergraduate college students. These findings support the expansion of animal visitation programs on college campuses to help students manage stress.

COVID-19 among University of Otago students living in North Dunedin households in the first half of 2022: was the prevalence underestimated?

Aims: To estimate the prevalence of COVID-19 among occupants of North Dunedin student flats between Flat Orientation Week (Flo-Week, week starting 14 February 2022) and the end of Semester 1 (week starting 30 May 2022);to investigate the potential under-reporting of cases to the University of Otago and under-recording of positive rapid antigen test (RAT) results in My Covid Record;to explore the COVID-related experiences of students during the above period. methods: Randomly selected households in the North Dunedin area were visited at the end of Semester 1 and oral consent was sought for a short interview comprising closed- and open-ended questions. Households were eligible for inclusion if at least one resident was a University of Otago student. Result(s): One hundred and thirty-five (96.4%) of 140 eligible households participated, and in 94.1% of these households at least one resident tested positive for COVID-19 between the start of Flo-Week and the date of the interview (a mean period of 109 days [standard deviation 3.6]). In total, 73.6% of the occupants in the participating households tested positive. Of the cases who were University of Otago students, 60.4% reported their positive status to the University. Of all cases diagnosed via a RAT, 66.9% uploaded their result to My Covid Record. Students reported various academic, financial and mental health stresses associated with the general COVID-19 situation during the study period. Conclusion(s): These findings suggest that the number of COVID-19 cases reported to the University of Otago between Flo-Week and the end of Semester 1 was a substantial underestimate of the true number, as was the number of cases recorded in My Covid Record. The findings also highlight the considerable impact that COVID-19 had on students during Semester 1.Copyright © 2023 New Zealand Medical Association. All rights reserved.

The Role of Social Support in Telehealth Utilization Among Older Adults in the United States During the COVID-19 Pandemic.

Background: Older adults may experience a significant digital divide and need support with using technology to transition to telehealth. This study examines the role of social support for telehealth utilization among older adults during the COVID-19 pandemic. Materials and Methods: We used data from the COVID-19 Sample Person Interview to the National Health and Aging Trends Study. Using logistic regression, we measured the association between telehealth utilization and social support. Results: Nearly one in five respondents used telehealth during the COVID-19 pandemic (weighted %: 20.6 [585/3188]). Currently living with family or friends and receipt of technical support were associated with telehealth utilization. Among residents of an assisted living facility, those who received communications technology support from the facility were more likely to use telehealth. Conclusion: Health care providers and policies should aim to reduce barriers to telehealth among older adults, with efforts such as digital literacy support and training.

Parenting stress and low-income preschool family well-being during COVID-19

The present study examines the associations between COVID-19-related stressors and family functioning 6 months into the COVID-19 pandemic among a sample of low-income caregivers and their preschool-aged children. It is hypothesized that COVID-19-related stressors, family illness, job loss, and difficulties accessing resources will be positively correlated with parenting stress, parent psychological distress, and child behavior problems. 42 caregivers (aged 16-70 yrs), recruited from a Head Start preschool program, completed an online survey about personal or family COVID-19 illness, job loss, resource loss, psychological distress, child behavior problems, and parenting stress. 14% of caregivers reported experiencing COVID-19 symptoms, and 5% reported they had received a COVID-19 diagnosis at the time of study completion. The majority of caregivers, 60%, indicated they had a family member diagnosed with COVID-19. Most caregivers reported they had consistent employment during the COVID-19 pandemic (69%), while 31% reported losing their job. Over a third of caregivers reported "extremely" to difficulties in financial loss, paying rent or bills, and accessing childcare. Results suggest that COVID-19 diagnoses and higher levels of family resource loss are correlated with parenting stress, caregiver psychological distress, and child behavior problems. Only parenting stress was associated with child behavior problems after controlling for COVID-19 diagnoses and resource loss. The present findings also suggest that resource loss may be important to consider in policies designed to aid families with young children. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

MicroRNA Networks in Cognition and Dementia.

The change from viewing noncoding RNA as "junk" in the genome to seeing it as a critical epigenetic regulator in almost every human condition or disease has forced a paradigm shift in biomedical and clinical research. Small and long noncoding RNA transcripts are now routinely evaluated as putative diagnostic or therapeutic agents. A prominent role for noncoding microRNAs in the central nervous system has uncovered promising new clinical candidates for dementia-related disorders, treatments for which currently remain elusive even as the percentage of diagnosed patients increases significantly. Cognitive decline is a core neurodegenerative process in Alzheimer's Disease, Frontotemporal Dementia, Lewy body dementia, vascular dementia, Huntington's Disease, Creutzfeldt-Jakob disease, and a significant portion of Parkinson's Disease patients. This review will discuss the microRNA-associated networks which influence these pathologies, including inflammatory and viral-mediated pathways (such as the novel SARS-CoV-2 virus implicated in COVID-19), and their current status in clinical trials.

Strategies adopted by undergraduate teaching assistants in physiology and biophysics education during the COVID-19 pandemic.

The COVID-19 pandemic affected almost all aspects of our lives, including the education sector and the way of teaching and learning. In March 2020, health authorities in Brazil imposed social isolation and the interruption of on-site activities in schools and universities. In this context, the Federal University of Minas Gerais (UFMG), one of the largest universities in Brazil and Latin America, developed an emergency remote learning (ERL) plan that allowed the return of classes in an online format and supported students to obtain access to equipment and internet network. Within this new perspective, the Undergraduate Teaching Assistant (UTA) program of the Department of Physiology and Biophysics (DFIB) explored strategies to minimize the impact of the absence of face-to-face classes. Using different available tools in online platforms and social media such as Microsoft Teams, YouTube animated video classes, and Instagram, the UTA program assisted >500 undergraduate students and strongly supported professors during ERL. In just over a year, our video classes on YouTube Channel reached ∼40,000 views. Most of the students reported that their questions were fully and quickly solved by the UTA program. Collectively, our results indicate that the strategies implemented by the UTA program helped the undergraduate students and professors to adapt to a remote learning format.

Transitioning to Telehealth for COVID-19 and Beyond: Perspectives of Community Mental Health Clinicians.

In response to COVID-19, mental health clinics transitioned to telehealth to maintain psychotherapy delivery. Community mental health (CMH) settings, which are often under-resourced, likely experienced many barriers. This study examined CMH clinicians' experiences transitioning to telehealth. Data came from a state-funded initiative training CMH clinicians in cognitive behavioral therapy. Participants (N = 197) completed pre-training and post-consultation surveys which included questions about their experiences with telehealth. Most clinicians found telehealth beneficial and effective. Clinicians strongly endorsed wanting telehealth as an option even after in-person services resume. CMH clinicians rated "engaging younger children" as the most significant barrier to telehealth. Despite some telehealth barriers, clinicians generally viewed telehealth favorably and prefer having it as a long-term option. Future work should continue to understand when telehealth may be advantageous and for whom in order to improve the accessibility and quality of behavioral health services.

Prevalence and risk factors associated with SARS-CoV-2 infections among veterinary practitioners and dogs patients, June-August 2020, Lagos, Nigeria.

BACKGROUND: Lagos State is the epicenter of COVID-19 in Nigeria, having the highest number of cases and death. Veterinary practitioners play an important role in public health and risk exposure to SARS-CoV-2, the virus that causes COVID-19 while attending to animal patients and owners. We determined the prevalence of covid-19 among veterinary practitioners and their dog patients in Lagos, and the associated risk factors during the lockdown. METHODS: We administered questionnaires, reviewed clinical records and conducted serological test to determine the COVID-19 status of 112 veterinary practitioners and 154 dog patients and to assess the associated factors in nine veterinary clinics or hospitals between June to August 2020. Data were analyzed using descriptive statistics, bivariate and multivariate analyses at 5% significant level. RESULT: The mean age of participants was 37.5±10.5 and 66 (58.9%) were male. COVID-19 cases among the veterinary practitioners and dogs were 29 (25.9%) and 3 (2%), respectively. Predictors of COVID-19 cases among veterinary practitioners were contact with a SARS-CoV-2 infected dog (AOR: 25.42; CI 4.73-136.66); being a veterinary doctor working during the lockdown (AOR: 6.11; CI 1.56-24.00) and not disinfecting examination table after attending to dogs (AOR: 12.43; CI 1.39-110.99). CONCLUSION: Veterinary practitioners and dogs in Lagos were exposed to SARS-COV-2 virus during the COVID-19 lockdown. Contact with SARS-CoV-2 infected dogs, being a veterinary doctor working during the lockdown and not disinfecting examination tables after clinical examination were predictors of COVID-19 cases among veterinary practitioners in Lagos State. Strict Infection, Prevention and Control measures are recommended in veterinary practice.

Iccpr's global cardiac rehabilitation program survey on covid impacts

In this presentation, I will describe the impacts of COVID-19 on CR delivery around the globe, including effects on providers and patients, and policies regarding safe service resumption. Through a cross-sectional study, a piloted survey was administered to CR programs globally via REDCap from April- June/2020. The 50 members of the ICCPR and personal contacts facilitated program identification. Overall, 1062 (18.3% program response rate) responses were received from 70/111 (63.1% country response rate) countries in the world with existent CR programs. Of these, 367 (49.1%) programs reported they had stopped CR delivery, and 203 (27.1%) stopped temporarily (mean=8.3±2.8weeks);Alternative models were delivered in 322 (39.7%) programs, primarily through low-tech modes (n=226,19.3%). 353 (30.2%) respondents were re-deployed, and 276 (37.3%) felt the need to work due to fear of losing their job, despite the perceived risk of contracting COVID-19 (mean=30.0%±27.4/100). 266 (22.5%) reported anxiety, 241 (20.4%) were concerned about exposing their family, 113 (9.7%) reported increased workload to transition to remote delivery, and 105 (9.0%) were juggling caregiving responsibilities during business hours. Patients were often contacting staff regarding grocery shopping for heart-healthy foods (n=333, 28.4%), how to use technology to interact with the program (n=329,27.9%), having to stop their exercise because they have no place to exercise (n=303, 25.7%), and their risk of death from COVID-19 due to pre-existing cardiovascular disease (n=249, 21.2%). Respondents perceived staff (n=488, 41.3%) and patient (n=453, 38.6%) personal protective equipment, as well as COVID-19 screening (n=414, 35.2%) and testing (n=411, 35.0%) as paramount to in-person service resumption. In conclusion, approximately 4400 programs ceased service delivery. Those that remain open are implementing new technologies to ensure their patients receive CR safely, despite the challenges.

Short-Term Prediction Methodology of COVID-19 Infection in South Korea

The purpose of this study is to predict the short-term trend of the COVID-19 pandemic and give insights into effective response strategies. Based on the basic SIR model, a compartment method for modeling the course of an epidemic, the short-term infection change ratio md, is derived. The number of infected people can be predicted using this ratio. We calculated different md values on a weekly basis. As we tested different combinations of md, the prediction from the combination of md based on a week and md based on 4 weeks was found to be statistically reliable. According to our regression analysis, our approach has an explanatory power of 96%. However, this method could only predict 1 week ahead of current data. Thus, we use LSTM, a deep learning method applied for time series data, to forecast the trend 4 weeks ahead. The forecasted trends show that the number of infected people in South Korea will reach its peak a week after the writing of this work and start to gradually decline after that.

EMOTIONAL AWARENESS IN TIME OF DISRUPTION: THE IMPACT OF TOLERANCE FOR AMBIGUITY, WORRY, PERCEIVED STRESS, HELPFUL COMMUNICATION, AND PAST EXPERIENCE ON STUDENT SATISFACTION

During the Spring 2020 semester, university classes abruptly moved online in the wake of the worldwide Covid-19 pandemic. Unlike courses designed and implemented with an online environment in mind, this transition involved a massive and immediate migration involving faculty and students who had not prepared or registered for online course delivery. Many instructors and students were unfamiliar and/or unskilled for online education. The purpose of this research is to explore the role of tolerance for ambiguity, worry, perceived stress, helpful communication, and past online experience on students’ general satisfaction with the sudden transition to online classes and student satisfaction with individual performance during the transition. Our findings suggest that tolerance for ambiguity, perceived stress, and helpful communication all play a role in understanding general and individual performance satisfaction during a time of disruption. Worry also plays a role in understanding individual performance satisfaction. Identifying influential factors that contribute to student satisfaction during teaching disruptions helps marketing educators better care for and meet the educational needs of students. Ultimately, emotional awareness in the classroom should be a new normal for marketing education. © 2021 Society for Marketing Advances.

Bridging the Telemedicine Gap Among Seniors During the COVID-19 Pandemic.

At the onset of the COVID-19 pandemic, many senior patients in the USC-Keck Family Medicine clinics were limited or lacking in telemedicine participation. Three factors contributed: lack of video-enabled devices, technological literacy, and/or absence of Wi-Fi connectivity. We addressed the first 2 of these factors. Via phone contact, 9 patients agreed to receive donated Android or Apple devices and to trial instruction manuals for use. Donated equipment and instructions were prepared and delivered in accordance with pandemic guidelines. Follow-up calls indicated that 4 participants were able to set up their devices and 3 of whom had connected with their providers. The remaining 5 participants had not set up their devices by the end of the follow-up period, had difficulty with device setup, accessing applications necessary for telemedicine, or had limited access to Wi-Fi. This project highlights some telemedicine barriers that senior patients may overcome with the additional support of care providers.

Digital health technologies for osteopaths and allied healthcare service providers: A scoping review.

Background: Digital health technologies are poised to revolutionise the healthcare industry by improving accessibility to services and patient outcomes. The novel coronavirus disease-19 (COVID-19) pandemic has presented unprecedented challenges for the delivery of allied healthcare and has catalysed rapid adoption of telehealth. As such, allied healthcare consumers and providers stand to benefit from the capabilities of the digital health movement, ultimately justifying a scoping review of current and emerging technologies. Objective: To provide decision makers with up-to-date information on the allied health applications of new and emerging digital health technologies; their evidence of efficacy, scope of use, and limitations. Methods: A scoping review of the literature was conducted, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. To synthesise original research, MEDLINE, CINAHL, and EMBASE databases were searched from 2010 to June 2020 and reference lists were examined for randomised control trials analysing the efficacy of these technologies in allied health applications. Results: A total of 14 articles were included with a focus on common musculoskeletal conditions managed by allied health service providers. Studies were selected for data extraction after abstract and full-text screening by three independent reviewers. The results of this review indicate that telehealth technology effectively monitors and progresses patient care, while mobile health applications provide remote support and enable data collection. Conclusion: Emerging trends suggest that digital technologies serve as promising adjuncts to allied healthcare. Further research is warranted regarding the safety and efficacy of digital health technologies in this context.

International Expert Consensus Statement on Chest Imaging in Pediatric COVID-19 Patient Management: Imaging Findings, Imaging Study Reporting, and Imaging Study Recommendations.

Coronavirus disease 2019 (COVID-19) has quickly spread since it was first detected in December 2019 and has evolved into a global pandemic with over 1.7 million confirmed cases in over 200 countries around the world at the time this document is being prepared. Owing to the novel nature of the virus and the rapidly evolving understanding of the disease, there is a great deal of uncertainty surrounding the diagnosis and management of COVID-19 pneumonia in pediatric patients. Chest imaging plays an important role in the evaluation of pediatric patients with COVID-19; however, there is currently little information available describing imaging manifestations of COVID-19 in pediatric patients and even less information discussing the utilization of imaging studies in pediatric patients. To specifically address these concerns, a group of international experts in pediatric thoracic imaging from five continents convened to create a consensus statement describing the imaging manifestations of COVID-19 in the pediatric population, discussing the potential utility of structured reporting during the COVID-19 pandemic, and generating consensus recommendations for utilization of chest radiographs and CT in the evaluation of pediatric patients with COVID-19. The results were compiled into two structured reporting algorithms (one for chest radiographs and one for chest CT) and eight consensus recommendations for the utilization of chest imaging in pediatric COVID-19 infection. © RSNA, 2020.

COVID-19 Among American Indian and Alaska Native Persons - 23 States, January 31-July 3, 2020.

Although non-Hispanic American Indian and Alaska Native (AI/AN) persons account for 0.7% of the U.S. population,* a recent analysis reported that 1.3% of coronavirus disease 2019 (COVID-19) cases reported to CDC with known race and ethnicity were among AI/AN persons (1). To assess the impact of COVID-19 among the AI/AN population, reports of laboratory-confirmed COVID-19 cases during January 22†-July 3, 2020 were analyzed. The analysis was limited to 23 states§ with >70% complete race/ethnicity information and five or more laboratory-confirmed COVID-19 cases among both AI/AN persons (alone or in combination with other races and ethnicities) and non-Hispanic white (white) persons. Among 424,899 COVID-19 cases reported by these states, 340,059 (80%) had complete race/ethnicity information; among these 340,059 cases, 9,072 (2.7%) occurred among AI/AN persons, and 138,960 (40.9%) among white persons. Among 340,059 cases with complete patient race/ethnicity data, the cumulative incidence among AI/AN persons in these 23 states was 594 per 100,000 AI/AN population (95% confidence interval [CI] = 203-1,740), compared with 169 per 100,000 white population (95% CI = 137-209) (rate ratio [RR] = 3.5; 95% CI = 1.2-10.1). AI/AN persons with COVID-19 were younger (median age = 40 years; interquartile range [IQR] = 26-56 years) than were white persons (median age = 51 years; IQR = 32-67 years). More complete case report data and timely, culturally responsive, and evidence-based public health efforts that leverage the strengths of AI/AN communities are needed to decrease COVID-19 transmission and improve patient outcomes.