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We report a single-step, room-temperature, 5-10 minute SARS-CoV-2 saliva self-monitoring method that overcomes the limitations of existing approaches through the use of fluorophore-releasing Designer DNA Nanostructures (DDNs) that bind with the multivalent pattern of spike proteins on the exterior intact virions and an inexpensive smartphone-linked, pocket-size fluorimeter, called a "V-Pod” for its resemblance to an Apple AirPod™ headphone case. We characterize the V-Pod fluorimeter performance and the DDN-based assay to demonstrate a clinically relevant detection limit of 104 virus particles/mL for pseudo-typed WT SARS-CoV-2 and 105 virus particles/mL for real pathogenic variants, including Delta, Omicron, and D614g. © 2023 SPIE.
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Medical waste has been excessively generated in various medical facilities due to COVID-19, and its treatment has become an important concern. Previously, an optimized medical waste sterilization and shredding system was developed for hospital scale but due to increased demand, it is necessary to scale such a system for different facilities. Therefore, in this paper, a sensitivity analysis for the design variables of the shredding system has been conducted and a surrogate model is developed for stress estimation. The surrogate model was generated using LHS (Latin hypercube sampling), which can represent the overall information of the design domain with a limited number of samples. The surrogate model was then used to increase the number of samples for sensitivity analysis which helped in reducing the computational time for finite element analysis. The sensitive variables for the shredder system were then estimated using sensitivity analysis. Consequently, an efficient design framework for various capacities of medical waste shredder was suggested using sensitivity analysis and a data-driven surrogate model.
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Background: Loss of upper extremity function after tetraplegia results in significant disability. Emerging evidence from pilot studies suggests that functional electrical stimulation (FES) therapy may enhance recovery of upper extremity function after tetraplegia. The aim of this trial was to determine the effectiveness of FES therapy delivered by the Myndmove stimulator in people with tetraplegia. Methods: A multi-center, single-blind, parallel-group, two-arm, randomized controlled trial was conducted comparing FES to conventional therapy in adults (≥18 years) with C4-C7 traumatic incomplete tetraplegia between 4 and 96 months post-injury, and with a baseline spinal cord injury independence measure III -self-care (SCIM III-SC) score of ≤10. Participants were enrolled at four SCI-specialized neurorehabilitation centers in the U.S. and Canada. Participants were stratified by center and randomized in a 1:1 ratio to receive either 40 sessions of FES or conventional therapy targeting upper extremities over a 14-week period. Blinded assessors measured SCIM III, Toronto Rehabilitation Institute Hand Function Test, and Graded Redefined Assessment of Strength, Sensibility, and Prehension at baseline, after 20th session, after 40th session or 14 weeks after 1st session, and at 24 weeks after 1st session. The primary outcome measure was change in SCIM III-SC from baseline to end of the treatment. Based on the primary outcome measure, a sample size of 60 was calculated. Seventeen participants' progress in the study was interrupted due to the COVID-19 lockdown. The protocol was modified for these participants to allow them to complete the study. Results: Between June 2019 to August 2021, 51 participants were randomized to FES (n = 27) and conventional therapy (n = 24). Both groups gained a mean of 2 points in SCIM-SC scores at the end of treatment, which was a clinically meaningful change. However, there was no statistically significant difference between the groups on any outcomes. Conclusion: Forty sessions of FES therapy delivered by the MyndMove stimulator are as effective as conventional therapy in producing meaningful functional improvements that persist after therapy is completed. Limitations of this study include the impact of COVID-19 limiting the ability to recruit the target sample size and per-protocol execution of the study in one-third of the participants. Registration: This trial is registered at www.ClinicalTrials.gov, NCT03439319.
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BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has influenced hospital infection control practices. AIM: To evaluate the impact of the COVID-19 pandemic on healthcare-associated infections (HAIs) in intensive care units (ICUs). METHODS: A retrospective analysis using data from the Korean National Healthcare-Associated Infections Surveillance System was conducted. Comparisons between incidence rates and micro-organism distributions of bloodstream infection (BSI), central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) before and during the COVID-19 pandemic were performed according to hospital size. FINDINGS: The incidence rate of BSI significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period (1.38 vs 1.23 per 10,000 patient-days, relative change -11.5%; P < 0.001). The incidence rate of VAP (1.03 vs 0.81 per 1000 device-days, relative change -21.4%; P < 0.001) significantly decreased during the COVID-19 pandemic compared to the pre-COVID-19 period, whereas rates of CLABSI (2.30 vs 2.23 per 1000 device-days; P = 0.19) and CAUTI (1.26 vs 1.26 per 1000 device-days; P = 0.99) were similar between the two periods. The rates of BSI and CLABSI significantly increased during the COVID-19 pandemic compared to the pre-COVID-19 period in large-sized hospitals, whereas these rates significantly decreased in small-to-medium-sized hospitals. The rates of CAUTI and VAP significantly decreased in small-sized hospitals. There were no significant changing trends in the rates of multidrug-resistant pathogens isolated from patients with HAI between the two periods. CONCLUSION: The incidence rates of BSI and VAP in ICUs decreased during the COVID-19 pandemic compared to the pre-COVID-19 period. This decrease was mainly seen in small-to-medium-sized hospitals.
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Background: Immunocompromised patients with COVID-19 tend to shed viable virus for a prolonged period. Therefore, for moderately or severely immunocompromised patients with COVID-19, CDC recommends an isolation period of at least 20 days and ending isolation in conjunction with serial testing and consultation with an infectious disease specialist. However, data on viral kinetics and risk factors for prolonged viral shedding in these patients are limited. Method(s): From February 1, 2022 to April 1, 2022, we collected weekly saliva samples from immunocompromised patients with COVID-19 admitted to a tertiary hospital in Seoul, South Korea. Genomic and subgenomic RNAs were measured, and virus culture was performed. Result(s): A total of 41 patients were enrolled;29 (70%) were receiving chemotherapy against hematologic malignancies and the remaining 12 (30%) had undergone solid organ transplantation. Of the 41 patients, 14 (34%) had received 3 doses or more of COVID-19 vaccines. Real-time RT-PCR revealed that 7 (17%) were infected with Omicron BA.1, and 33 (80%) with Omicron BA.2. The median duration of viable virus shedding was 4 weeks (IQR 3-6). Patients undergoing B-cell depleting therapy shed viable virus for longer than the comparator (p=0.01). Multivariable analysis showed that 3-dose or more vaccination (HR 0.33, 95% CI 0.12 - 0.93, p = 0.04) and B-cell depleting therapy (HR 12.50, 95% CI 2.44 - 100.00, p = 0.003) independently affected viable virus shedding of SARS-CoV-2. Conclusion(s): Immunocompromised patients with COVID-19 shed viable virus for median 4 weeks. B-cell depleting therapy increases the risk of prolonged viable viral shedding, while completion of a primary vaccine series reduces this risk. Overall distribution of samples according to genomic viral copy number and culture positivity. Red dot indicates positive culture results, whereas blue dot indicated negative culture results. (Figure Presented).
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Contact tracing is an effective strategy to slow down the COVID-19 pandemic. However, the use of digital footprints as supportive evidences in the contact tracing process rises the privacy problems since private information must be shared to the contact tracing providers. This paper proposed a novel privacypreserving contact tracing procedure based on zero-knowledgerange-proof and blockchain platform, which helps users to prove whether they in contact with the confirmed patient without disclosing the exact location they have visited. The blockchain is used to guarantee anonymity through the use of address as an identity, and provide strong non-repudiation from transactions. Finally, we provide a proof-of-concept implementation of our proposal using Hyperledger Fabric and smartphone application. The evaluation showed that the proposed system can work as intended with minimal processing delay.
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The dockless e-scooter sharing service is rapidly spreading, replacing existing transportation, and improving last-mile accessibility. User segmentation with travel regularity and segment-level behavior analysis, which are already conducted in public transit, also benefits e-scooter sharing service to enhance service quality and increase usage. In this work, we group e-scooter users according to their travel regularity and identify each group's usage characteristics. Through the dockless e-scooter usage data, as operated in six cities in South Korea, travel regularity measured by users' repetitive departure time and destination is discovered and spatiotemporal usage patterns are identified. We divide e-scooter users into three groups by type of travel regularity: irregular user, spatially regular user, and regular user. Regular users more frequently use e-scooters, travel shorter distances, and walk longer distances to find an e-scooter than other groups. It is also revealed that the use in morning peak hours only occurs in the regular user group. By decomposing the temporal patterns of spatially regular and regular users, we discover that spatially regular users are composed of daytime, evening peak, and nighttime users. In contrast, regular users are composed of morning peak, evening peak, and lockdown (restriction in response to COVID-19 pandemic) peak users. This research suggests user segmentation based on travel regularity in e-scooter sharing services, enabling multiple strategies to be drawn to retain users with high regularity and convert users with low regularity to regular users.
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For the extended duration of the coronavirus disease 2019 (COVID-19) pandemic, reports emerged that mother-to-child transmission rates were low. However, the pandemic protocols including strict isolation, testing for severe acute respiratory syndrome coronavirus 2, and negative pressure isolation remained in Korea. Recently, the guideline for the management of neonates born to mothers with COVID-19 have been revised based on guidelines in other countries. Here, we introduce this newly developed guideline and review the foreign guidelines that were used for reference.Copyright © 2022 The Korean Society of Pediatric Infectious Diseases.
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Objective: In this study, we sought to gain insight into the challenges Latina immigrant mothers in rural Midwest communities encountered during the pandemic, strategies they employed to avoid infection of the virus, and impacts of the pandemic on family health and well-being. Background: In rural Midwestern communities, the pandemic disproportionately affected immigrants, many of whom are Latino and worked in meatpacking and food processing plants. Latina mothers are commonly viewed as caretakers of the family. This prescribed role placed mothers at the center of safeguarding their families' health during the pandemic. Method: In this descriptive study, we conducted individual interviews with 124 Latina immigrant mothers across six rural Midwestern communities who participated in one of two previous studies in the communities. Thematic analyses was used to identify themes that aligned with three areas of interest: challenges experienced, strategies employed to avoid virus infection, and impacts of the pandemic on family health and well-being. Results: Mothers enacted behaviors (e.g., sanitation practices, wore masks, stayed home) to lessen negative impacts of the pandemic on family health and well-being. Factors beyond their control (e.g., public policies, work policies and practices) placed families at greater risk for poor health and well-being. Eleven themes were identified that aligned with the three areas of interest. Conclusion: Findings build upon and extend prior research that reexposed unjust employment conditions, inadequate health-care systems, and an anti-immigrant context during the pandemic that perpetuated health disparities among Latino immigrants and other minoritized populations. Implications: Ethnographic and longitudinal studies that give voice to populations underrepresented in COVID-19 research and at high risk for poor health are warranted to inform policies and practices to protect health during public health crises. © 2023 The Authors. Family Relations published by Wiley Periodicals LLC on behalf of National Council on Family Relations.
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Purpose: This study was to identify nurses' intentions for COVID-19 vaccination in 2022. Methods: A questionnaire survey was conducted among 222 nurses in Korea. The collected data were analyzed using the independent t-test, one-way analysis of variance, the Wilcoxon rank sum test, Pearson's correlation coefficients, and multiple regression analysis. Results: The score for intention to be vaccinated against COVID-19 in 2022 was 2.70 points on a 5-point scale, significantly lower than in 2020 (3.02 points on a 5-point scale). The average score for knowledge related to COVID-19 was 7.22 out of 10 points. Positive correlations were found between the intention for COVID-19 vaccination in 2022 and preventive health behavior, as well as between nurses' intentions for COVID-19 vaccination in 2022 and 2020. The factors affecting nurses' intentions for COVID-19 vaccination in 2022 were preventive health behavior (β=.11, p=.045) and nurses' intentions for COVID-19 vaccination in 2020 (β=.65, p<.001). This model showed a significant explanatory power of approximately 45% (F=36.88, p<.001) for the COVID-19 vaccination intention in 2022. Conclusion: This result points to the importance of managing nurses' preventive health behaviors to promote COVID-19 vaccination uptake. Nurses' vaccination intentions are an important issue for the safety of both nurses and patients. A safe vaccination environment and national policy should be prepared to reduce nurses' hesitations about COVID-19 vaccination. © 2023 Korean Academy of Fundamentals of Nursing.
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An accurate, convenient, and rapid diagnostic platform, which can be applied in facility-limited or point-of-care (POC) settings, is essential to help prevent the spread of infectious diseases and enable the most effective treatment to be selected. In this study, we describe the development of a new isothermal molecular diagnostic system named multipurpose advanced split T7 promoter-based transcription amplification (MASTER) for the rapid and ultrasensitive detection of various pathogens containing single-stranded RNA and double-stranded DNA. MASTER produces a large number of RNA amplicons in the presence of target pathogens, which generate fluorescence or colorimetric signals based on light-up RNA aptamers or lateral flow assays. Implementing MASTER at 37 °C for<1 h achieved the detection of a single copy per reaction without cross-reactivity. Moreover, the testing of 40 clinical samples revealed that MASTER exhibited excellent accuracy with 100% sensitivity and specificity for SARS-CoV-2 diagnosis. Furthermore, a one-pot MASTER system capable of accelerating practical applications was demonstrated, indicating that the MASTER system is a promising platform for the effective surveillance of various pathogens. © 2023 Elsevier B.V.
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The coronavirus disease 19 (COVID-19) pandemic had a profound impact on blood services operations in Korea. Blood collection was affected due to decrease in donor availability caused by avoidance of public places, social distancing policies, and cancellation of blood drives. The negative impact on blood collection was more pronounced with the COVID-19 pandemic than with other outbreaks experienced previously such as the influenza (H1N1) outbreak or the Middle East respiratory virus (MERS) pandemic. To cope with the blood shortage, campaigns to appeal for blood donation, raise public awareness on the importance of blood donation and gain donor's confidence in safe blood donation were implemented using mass communication media such as TV and radio broadcasting as well as postings on various social media platforms. Upon Korean Red Cross Blood Services's (KRCBS) request, the Ministry of Health and Welfare (MoHW) approved the relaxation of the geographical restrictions regarding indigenous malaria thus enabling collection of more than 23,000 units of whole blood. To mitigate even a theoretical risk of transfusion-transmission of SARS-CoV-2 via blood donation from pre-symptomatic COVID-19 donors, the KRCBS received the data on COVID-19 identified cases from the Korean Disease Control and Prevention Agency (KDCA) from the early get-go of the pandemic for cross referencing to donors for further recipient investigation and recall of blood products not transfused. Communication with donors, staff members, national health authorities, hospital customers and other stakeholders was and remains of utmost importance to respond to this unprecedented situation which is still ongoing.Copyright © Annals of Blood. All rights reserved.
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As the number of people infected with COVID-19 in Korea is increasing, several measures have been implemented to gradually restrict outdoor activities and indoor gatherings while promoting a non-face-to-face social culture. In this study, we performed a gender-based multi-group analysis using a technology acceptance model (TAM) as an external variable for COVID-19 risk perception to verify the model's predictive ability to increase participation behavior toward digital fitness services. We analyzed the data of 433 Koreans using an online survey consisting of 23 items. A structural equation model was used to verify the perceived ease of use (PEOU), perceived usefulness (PU), intention to use and exercise participation behavior of the TAM with COVID-19 risk perception as an external variable. First, our results showed that COVID-19 risk perception had a statistically higher significant and positive effect on PEOU (beta = 0.170, t = 3.296, p < 0.001) than on PU (beta = 0.130, t = 2.848, p = 0.004) of digital fitness services. Second, the PEOU of the digital fitness service was found to have a statistically higher significant positive effect on PU (beta = 0.512, t = 9.728, p < 0.001) than on intention to use (beta = 0.130, t = -2.774, p = 0.006). Third, the PU of digital fitness services was found to have a statistically significant positive effect on the intention to use (beta = 0.684, t = 12.909, p < 0.001). Fourth, the intention to use the digital fitness service was found to have a statistically significant positive effect on exercise participation behavior (beta = 0.796, t = 16.248, p < 0.001). Lastly, we observed a significant difference between men and women in COVID-19 risk perception and PEOU among the six paths established. Digital environments that encourage participation in exercises could promote health during a pandemic. This study highlighted the need to consider digital environments that encourage exercise participation in creating physical exercise contents as there was no significant difference in the intention to use digital fitness services between men and women.Copyright © 2023 The Author(s).
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Coronavirus disease (COVID-19) has significantly affected daily lives since its declaration as a Pandemic in March 2020 by the WHO. Studies in Korea to interpret the relationship between COVID-19 and transportation show that there has been a decrease in public transportation use, and a significant decrease when a widespread infection occurs. In addition, COVID-19 has affected the commercial environment, particularly the number of people using commercial districts where the use of retail outlets decreased significantly. This study analyses the disease-vectors (spread factors) of COVID-19 in terms of transportation demand, the revitalisation of commercial districts, living populations, and socioeconomic indicators. It attempts to identify different infection factors for each district in Seoul using a causal analysis methodology PLS-SEM (Partial Least-Squares Structural Equation Modelling) such that COVID-19 can be managed continuously with the aim to provide a foundation for pre-emptive actions by adjusting or controlling specific influencing factors pertaining to infectious diseases. © 2023 ICE Publishing: All rights reserved.
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The rise of virtual education and increase in distance, partly owing to the spread of COVID-19 pandemic, has made it more difficult for teachers to determine each student's learning status. In this situation, knowledge tracing (KT), which tracks a student's mastery of specific knowledge concepts, is receiving increasing attention. KT utilizes a sequence of studentexercise interactive activities to predict the mastery of concepts corresponding to a target problem, recommending appropriate learning resources to students and optimizing learning sequences for adaptive learning. With the development of deep learning, various studies have been proposed, such as sequential models using recurrent neural networks, attention models influenced by transformers, and graph-based models that depict the relationships between knowledge concepts. However, they all have common limitations in that they cannot utilize the learning activities of students other than the target student and can only use a limited form of exercise information. In this study, we have applied the concept of rating prediction to the studentexercise knowledge tracing problem and solved the limitations of the existing models. Our proposed Inductive Graph-based Knowledge Tracing (IGKT) designed to integrate structural information and various unrestricted types of additional information into the model through subgraph sampling, has been found superior over the existing models across two different datasets in predicting student performances. © 2023 IEEE.
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Background Against the problem of declining physical activity among youth after COVID-19, this study has developed a design-led intervention that promotes physical activity using a smartphone service for families with children in upper grades of elementary school. The objective of this research is to evaluate the effectiveness of design elements constituting the intervention program via testing the service against a family with children in upper grades of elementary school. Methods Through forming a multidisciplinary team between the Department of Design and the Department of Children and Families, the study developed a strategy to instigate a constructive behavioral change to help family members become more physically active at home. The strategy used information, empowerment, and motivation as a driver of stimuli. A 13-day home user test was conducted to examine its effectiveness and to identify its limitations for future enhancements. Results Through the home user test, it was achievable to confirm an increase in actual physical activity as well as beneficial improvements in the perception of regulating physiological activity into habits. It was observed that motivation was internalized through family-level behavior intervention, parental role modeling through feed-forward information, reinforcing the importance of physical activity in children and adolescents, and experiencing a sense of accomplishment and self-efficacy from achieving their daily goals. Conclusions Based on theoretical considerations for motivation and the maintenance of changed behavior, a service that combines various intervention elements, is presented in this paper. This resulted in an understanding of the theoretical background and anticipated impacts on the future development of such smartphone-based services for tackling social issues such as sedentary behavior. Through this study, both children and their parents would be better equipped to make positive contributions to building a healthy community. © 2023, Archives of Design Research. All rights reserved.
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SARS-CoV-2 infection (COVID) is associated with high morbidity and mortality in solid organ transplants and vaccine efficacy is suboptimal. Tixagevimab and cilgavimab (T/C) are neutralizing antibodies used in the U.S. under emergency use authorization for COVID pre-exposure prophylaxis. However, T/C were developed when the Alpha and Omega variants were dominant. The purpose of this study is to look at real-world efficacy of T/C during the Omicron phase of the pandemic in heart transplants (HT). This was a retrospective study of adult HT recipients at a single center comparing those who received at least 3 doses of a COVID vaccine plus T/C versus those who only received the vaccine series (control) without prior infections. The primary outcome was development of COVID infection. Secondary outcomes included time from last vaccine to start of Omicron phase of pandemic, time from last vaccine to infection, and time from HT to infection. The Omicron phase was defined from 1/2022 to 2/2022. Chi-square and t-tests were used to assess for differences. Of the 244 patients identified, 44 received vaccination + T/C and 200 had vaccines only (Table 1). In the T/C group, patients were younger and more female (Table 1). In the control and T/C groups, 23% and 9.1% of patients, respectively, had documented COVID infections during the Omicron phase (p=0.039, Table 2). Months from last vaccine to start of Omicron phase, months from last vaccine to infection, and time from date of transplant to infection were similar between the two groups. Characteristics of the T/C patients who had breakthrough infections are shown in Table 3, none of whom required hospitalization or died. Patients who received vaccination + T/C had a significantly lower incidence of COVID infection compared to those who received vaccination alone in the Omicron era. T/C appeared to be protective in both recent and remote HT recipients, underscoring the utility of administering protective monoclonal antibodies in this population. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. 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.)
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Nowadays, telepresence systems based on the Extended Reality (XR) system are actively developed and used for remote collaboration due to COVID-19. Still, several issues, such as limited traversable space in Virtual Reality (VR) and require all participants to wear head-mounted display (HMD), stop these systems from being used in our daily life. On the other hand, telepresence robots have been used in various fields before the pandemic. However, these robots also have a limitation in that the current form is incapable of delivering non-verbal expressions, which is essential for social interaction. Therefore, we present a Holobot, a telepresence robot based on the XR system. A remote user connects to the Holobot through VR HMDs, and the Holobot augments a virtual avatar that projectsusers' facial and gesture expressions.We developed a prototype and conducted a simple field test in the exhibition to receive feedback. VR participants enjoyed exploring remote spaces and interacting with each other through Holobot. Furthermore, remote space participants mentioned that a 1:1 scale avatar helped to build co-presence with the VR user. Based on these insights, we think Holobot could provide design guideline for future telepresence robot. For further approach, we plan to improve our prototype and conduct user test for structured evaluation of our system. © 2023 IEEE Computer Society. All rights reserved.
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COVID-19 is caused by SARS COV-2, which first emerged in China and spread widely worldwide. Chest X-ray(CXR) is the first-line tool for COVID-19, and it allows initial assessment and follow-up, giving a great insight into the disease course. A high-resolution computed tomography (HRCT) has become essential for the diagnosis of postCOVID related interstitial lung disease (ILD). Our aim was to determine the COVID-19 disease severity using the CXR scoring system and then evaluate whether the severity of admission CXR could predict the presence of post-COVID related ILD. Data were analysed retrospectively for all adult patients presenting to our hospital between August 2020 and December 2021. 44 patients were found with post-COVID related ILD on HRCT which was performed as a result of persistent abnormalities on 6-12 week follow up CXR. We used severity scoring systems which were classified as mild, moderate, and severe depending on the number of lung segments involved. Severity scoring was performed by an experienced radiologist. Each CXR classification was then compared to HRCT findings. A total of 44 patients with COVID-19, 31 men and 13 women were included. The mean age was 67.7 (range 45-93). The following disease patterns were reported on HRCT: ground-glass opacities, traction bronchiectasis, reticulation, fibrosis, consolidation, organizing pneumonia, and honeycombing. When HRCTs were correlated, 18 admission CXRs were classified as mild, 23 as moderate and 3 as severe. This suggests that the severity of admission CXR does not predict the subsequent emergence of post-covid related ILD. We would recommend looking at other possible predictors such as the need for ventilatory support, comorbidities, and intensive care admissions.
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Background Frailty is associated with mortality in older adults hospitalized with COVID-19, yet few studies have quantified healthcare utilization and spending following COVID-19 hospitalization. Objective To evaluate whether survival and follow-up healthcare utilization and expenditures varied as a function of claims-based frailty status for older adults hospitalized with COVID-19. Design Retrospective cohort study Participants 136 patients aged 65 and older enrolled in an Accountable Care Organization (ACO) risk contract at an academic medical center and hospitalized for COVID-19 between March 11, 2020 - June 3, 2020 Measurements We linked a COVID-19 Registry with administrative claims data to quantify a frailty index and its relationship to mortality, healthcare utilization, and expenditures over 6 months following hospital discharge. Kaplan Meier curves and Cox Proportional Hazards models were used to evaluate survival by frailty. Kruskal-Wallis tests were used to compare utilization. A generalized linear model with a gamma distribution was used to evaluate differences in monthly Medicare expenditures. Results Much of the cohort was classified as moderate to severely frail (65.4%), 24.3% mildly frail, and 10.3% robust or pre-frail. Overall, 27.2% (n=37) of the cohort died (n=26 during hospitalization, n=11 after discharge) and survival did not significantly differ by frailty. Among survivors, inpatient hospitalizations during the 6-month follow-up period varied significantly by frailty (p=0.02). Mean cost over follow-up was $856.37 for the mild and $4914.16 for the moderate to severe frailty group, and monthly expenditures increased with higher frailty classification (p <.001). Conclusions In this cohort, claims-based frailty was not significantly associated with survival but was associated with follow-up hospitalizations and Medicare expenditures. Electronic Supplementary Material Supplementary material is available for this article at 10.14283/jfa.2023.15 and is accessible for authorized users.