Impact of nonalcoholic fatty liver disease on clinical outcomes in patients with COVID-19 among persons living with HIV: A multicenter research network study.

BACKGROUND: People living with human immunodeficiency virus (PLWH) are at an increased risk of nonalcoholic fatty liver disease (NAFLD) but how these patients react to COVID-19 infection is unclear. We examined the clinical characteristics and outcomes of patients with and without nonalcoholic fatty liver disease (NAFLD) among people living with human immunodeficiency virus (PLWH) diagnosed with COVID-19. METHODS: A multicenter, retrospective cohort study was conducted using TriNetX. Participants diagnosed with COVID-19 between January 20, 2020, and October 31, 2021, in PLWH were identified and divided into cohorts based on preexisting NAFLD. The primary outcome was all-cause mortality, and secondary outcomes were hospitalization, severe disease, critical care, need for mechanical ventilation, and acute kidney injury(AKI). Propensity score matching (PSM) mitigated the imbalance among group covariates. Risk ratios (RR) with 95 % confidence intervals (CI) were calculated. RESULTS: Of the 5012 PLWH identified with confirmed COVID-19 during the study period, 563 had a diagnosis of NAFLD. After PSM, both groups were well-matched with 561 patients. The primary outcome did not differ between the cohorts at 30-days, even after a fully adjusted analysis, and the risk of all-cause mortality did not differ at 60 and 90 days. NAFLD had a significantly higher risk for hospitalization rates (RR 1.32; 95 % CI, 1.06-1.63) and AKI (RR 2.55; 95 % CI 1.42-4.57) than the non-NAFLD group at 30 days. No other differences were detected in other secondary outcome measures. CONCLUSIONS: Preexisting NAFLD is associated with an increased risk for hospitalization and AKI among PLWH infected with COVID-19. The potential role of NAFLD in developing severe COVID-19 among PLWH remains to be elucidated in future studies. Still, this study indicates the need for careful monitoring of this at-risk population.

COVID-19 Vaccination Intention and Factors Associated with Hesitance and Resistance in the Deep South: Montgomery, Alabama.

Using COVID-19-related survey data collected from residents in the city of Montgomery, Alabama, this study assessed the prevalence of COVID-19 vaccine acceptance, hesitance, and resistance, and identified factors associated with COVID-19 vaccine hesitance and resistance. To analyze the survey data (n = 1000), a consolidation approach (machine learning modeling and multinomial logistic regression modeling) was used to identify predictors of COVID-19 vaccine hesitancy and resistance. The prevalence of vaccine acceptance, hesitancy, and resistance was 62%, 23%, and 15%, respectively. Female gender and a higher level of trust that friends and family will provide accurate information about the COVID-19 vaccine were positively associated with vaccine hesitancy. Female gender and higher trust that social media will provide accurate information about COVID-19 were positively associated with vaccine resistance. Factors positively associated with COVID-19 vaccine hesitance and resistance in the study's geographical area are worrisome, especially given the high burden of chronic diseases and health disparities that exist in both Montgomery and the Deep South. More research is needed to elucidate COVID-19 vaccination attitudes and reasons for non-acceptance of the COVID-19 vaccine. Efforts to improve acceptance should remain a priority in this respective geographical area and across the general population.

Associations between Bonus and Lottery COVID-19 Vaccine Incentive Policies and Increases in COVID-19 Vaccination Rates: A Social Epidemiologic Analysis.

The objectives of this longitudinal study were to analyze the impact of COVID-19 vaccine incentive policies (e.g., bonuses and lottery entries) on county-level COVID-19 vaccination rates, and to examine the interactive effects between COVID-19 vaccine incentive policies and socioeconomic factors on COVID-19 vaccination rates. Using publicly available data, county-level COVID-19 vaccination rates and socioeconomic data between January 2021 and July 2021 were extracted and analyzed across counties in the United States (US)-an analysis of 19,992 observations over time. Pooled ordinary least squares (OLS) analysis was employed to longitudinally examine associations with COVID-19 vaccination rates, and four random-effects models were developed to analyze interaction effects. Bonus incentive policies were effective in counties with a high per capita income, high levels of education, and a high percentage of racial minorities, but not in counties with high unemployment. Lottery incentive policies were effective in counties with a high percentage of racial minorities, but not in counties with high per capita income, high levels of education, and high unemployment. County-level socioeconomic factors should be considered ahead of implementing incentive policies, versus a blanket approach, to avoid the unintentional misuse of economic resources for futile COVID-19 vaccination outcomes.

An Epidemiologic Analysis of Associations between County-Level Per Capita Income, Unemployment Rate, and COVID-19 Vaccination Rates in the United States.

The purpose of this longitudinal study was to examine associations between per capita income, unemployment rates, and COVID-19 vaccination rates at the county-level across the United States (U.S.), as well as to identify the interaction effects between county-level per capita income, unemployment rates, and racial/ethnic composition on COVID-19 vaccination rates. All counties in the U.S. that reported COVID-19 vaccination rates from January 2021 to July 2021 were included in this longitudinal study (n = 2857). Pooled ordinary least squares (OLS) with fixed-effects were employed to longitudinally examine economic impacts on racial/ethnic disparities on county-level COVID-19 vaccination rates. County-level per capita income and county-level unemployment rates were both positively associated with county-level COVID-19 vaccination rates across the U.S. However, the associations were divergent in the context of race/ethnicity. Public health efforts to bolster COVID-19 vaccination rates are encouraged to consider economic factors that are associated with decreases in COVID-19 vaccination rates.

Factors Associated with Symptoms of Depression and Psychological Distress during the COVID-19 Pandemic.

The objective of this study was to examine factors associated with symptoms of depression and psychological distress during the COVID-19 pandemic in China. Convenience sampling and snowball sampling were used to recruit a sample of adults in China (n = 2130) from 14 February 2020 to 3 March 2020 to complete an online survey. Linear regression was used to examine the predictors of symptoms of depression and psychological distress. Living in a non-urban area and the number of confirmed cases in their city of residence were positively associated with symptoms of depression. Female gender, not being married, practicing social distancing, the amount of time spent daily on social media searching for and reading information on COVID-19, the number of confirmed cases of COVID-19 in their city of residence, and having confirmed or suspected cases of COVID-19 in personal networks were positively associated with psychological distress. Social distancing is a widely used public health approach for population-wide virus-containment of COVID-19. However, reductions in population-wide psychological well-being are inadvertent consequences of social distancing. There is an emerging need to negate factors that increase adverse mental health vulnerabilities during the COVID-19 pandemic.

A Cross-Sectional Analysis of Tobacco Use and Concurrent Alcohol and Substance Use Among Patients Living with HIV/HCV Co-infection: Findings from a Large Urban Tertiary Center.

This study aimed to assess the prevalence of and factors associated with tobacco use among patients living with HIV/HCV co-infection. Patient reported outcomes (PROs) were analyzed of patients living with HIV/HCV co-infection (n = 313) who presented for clinical evaluation and treatment of HCV between 2013 and 2017 at a university-affiliated HIV/HCV Co-infection Clinic. The prevalence of tobacco use in patients living with HIV/HCV co-infection was 48%. Compared to non-smokers, a higher proportion of tobacco smokers had substance use disorders and concurrent alcohol and substance use. In the multivariate analysis, concurrent alcohol and substance use was positively associated with tobacco use. The findings suggest clinical interventions are urgently needed to reduce tobacco use among patients living with HIV/HCV co-infection-a doubly-vulnerable immunocompromised population. Otherwise, failed efforts to dedicate resources and targeted behavioral interventions for this respective population will inhibit survival-especially considering the recent and evolving COVID-19 pandemic.