ABSTRACT
Background Preventive measures are crucial for improving the survival and quality of life of patients and reducing healthcare costs. The COVID-19 pandemic has induced various social changes, including to socioeconomic status, behavior, and income. We evaluated changes in income following COVID-19 as well as the effects on individual engagement in preventive activities.Methods Data from the 2021 Community Health Survey were used to select individuals aged 30–65 years who were involved in economic activities. We used logistic regression models to evaluate associations between changes in household income following COVID-19 and engagement in preventive activities.Results Of the 89,992 study participants, 36,193 (36.3%) experienced a decrease in household income due to COVID-19. Compared to individuals who had stable or increased income due to COVID-19, those whose income declined had a lower likelihood of participating in preventive activities, including vaccination(OR: 0.824, 95% CI: 0.794–0.856), medical checkups(OR: 0.625, 95% CI: 0.596–0.656), and cancer screening(OR: 0.815, 95% CI: 0.782–0.849). These differences were particularly significant in men and younger individuals, without chronic diseases and who were less satisfied with medical infrastructure.Conclusion Individuals who experienced a decreased in income due to COVID-19 encountered challenges in participating in prevention programs, leading to health inequality. For individuals with low rates of preventive activity, it is crucial to implement measures that encourage screening, such as providing incentives for individuals.
Subject(s)
COVID-19 , Chronic Disease , NeoplasmsABSTRACT
Background: Because of the racial and regional inequalities regarding COVID-19, more research is required to deconstruct how the pandemic impacted different populations. This study explores differences in COVID-19 in-hospital mortality rates by patient and hospital factors. Hospital factors are differences in mortality by rurality level, region, and census division. Methods: The latest 2020 United States NIS data was used to obtain a population-based estimate for patients with COVID-19. We conducted a cross-sectional retrospective data analysis on the NIS dataset. Sampling weights were used for all statistical analyses to represent nationwide in-hospital mortality of patients with COVID-19. We investigated how patients with COVID-19 and other characteristics, like region or race, are associated with in-hospital death using the multivariate survey logistic regression analysis. Additionally, we ran the models using census divisions to determine more specific regional mortality variance. Results: Of 1,002,655 patients, 88.9% did not have an in-hospital death (n=178,369), and 11.1% died in-hospital (n=22,162). Among them, we used the weighted logistic regression results examining predictors of in-hospital death. Patients older than 70 were 10 times more likely to have an in-hospital death than patients younger than 40 (p<.001). Male patients were 37% more likely to have an in-hospital death than female patients (p<.001). Hispanic patients were 25% more likely to have in-hospital deaths than white patients (p<.001). In the sub-analysis, Hispanic patients in the 50-60, 60-70, and 70 age groups were 32%, 34%, and 24%, respectively, more likely to die in-hospital than white patients (p<.001). Conclusion: Health disparities in the COVID-19 pandemic occurred across races and regions and must be addressed to prevent future deaths. Age and comorbidities like diabetes have a well-established link to increased disease severity, and we have linked both to higher mortality risk. Low-income patients had a significantly increased risk of in-hospital death starting at over 40 years old. In sum, Hispanic patients were at increased odds of mortality because of age and economics. Policy concerns should be raised to illuminate populations uniquely burdened by the COVID-19 pandemic to direct more significant research and funding to alleviate inequalities and mitigate future suffering.
Subject(s)
COVID-19 , Diabetes Mellitus , DeathABSTRACT
Background We evaluated clinical effectiveness of regdanvimab (CT-P59), a SARS-CoV-2 neutralizing monoclonal antibody, in reducing disease progression and clinical recovery time in patients with mild-to-moderate COVID-19, primarily alpha variant. Methods This was phase 3 of a phase 2/3 parallel-group, double-blind, randomized clinical trial. Outpatients with mild-to-moderate COVID-19, were randomized to single dose regdanvimab 40 mg/kg (n = 656) or placebo (n = 659), alongside standard-of-care. Primary endpoint: COVID-19 disease progression (clinical symptoms requiring hospitalization or oxygen therapy, or mortality) up to day 28 among “high risk” patients. Key secondary endpoints: disease progression (all randomized patients) and time to recovery (high-risk and all randomized patients). Results Of 1315 patients randomized to regdanvimab or placebo, 880 were high risk (regdanvimab, n = 446;placebo, n = 434);the majority (regdanvimab, n = 371;placebo n = 381) were infected with alpha variant. The proportion with disease progression was lower (14/446 [3.1%;95% CI, 1.9–5.2] vs. 48/434 [11.1%;95% CI, 8.4–14.4];P < 0.001) and time to recovery was shorter (median, 9.27 days [95% CI, 8.27–11.05] vs. not reached [95% CI, 12.35–not calculable];P < 0.001) with regdanvimab than placebo. Consistent improvements were seen in all randomized and non–high-risk patients who received regdanvimab. Viral load reductions were more rapid with regdanvimab. Infusion-related reactions occurred in 11/1302 patients (4/652 [0.6%] regdanvimab, 7/650 [1.1%] placebo). Treatment-emergent serious adverse events were reported in 5/1302 patients (4 [0.6%] regdanvimab, 1 [0.2%] placebo). Conclusions Regdanvimab was an effective treatment for patients with mild-to-moderate COVID-19, significantly reducing disease progression and clinical recovery time without notable safety concerns prior to the emergence of the omicron variant. Trial registration ClinicalTrials.gov identifier, NCT04602000;EudraCT number, 2020-003369-20