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1.
BMC Public Health ; 22(1):2351, 2022.
Article in English | MEDLINE | ID: covidwho-2162352

ABSTRACT

BACKGROUND: The rapid authorization and widespread rollout of COVID-19 vaccines in the United States demonstrated a need for additional data on vaccine side effects, both to provide insight into the range and severity of side effects that might be expected in medically-diverse populations as well as to inform decision-making and combat vaccine hesitancy going forward. Here we report the results of a survey of 4825 individuals from southcentral Kentucky who received two doses of either the Pfizer-BioNTech (BNT162b2) or Moderna (mRNA-1273) vaccine between December 14, 2020 and May 1, 2021. As new versions of the vaccine are rolled-out, local initiatives such as this may offer a means to combat vaccine hesitancy in reference to COVID-19, but are also important as we face new viral threats that will necessitate a rapid vaccine rollout, and to combat a growing public distrust of vaccines in general.

2.
Nature Medicine ; 08:08, 2022.
Article in English | MEDLINE | ID: covidwho-2160251

ABSTRACT

Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are debilitating, clinically heterogeneous and of unknown molecular etiology. A transcriptome-wide investigation was performed in 165 acutely infected hospitalized individuals who were followed clinically into the post-acute period. Distinct gene expression signatures of post-acute sequelae were already present in whole blood during acute infection, with innate and adaptive immune cells implicated in different symptoms. Two clusters of sequelae exhibited divergent plasma-cell-associated gene expression patterns. In one cluster, sequelae associated with higher expression of immunoglobulin-related genes in an anti-spike antibody titer-dependent manner. In the other, sequelae associated independently of these titers with lower expression of immunoglobulin-related genes, indicating lower non-specific antibody production in individuals with these sequelae. This relationship between lower total immunoglobulins and sequelae was validated in an external cohort. Altogether, multiple etiologies of post-acute sequelae were already detectable during SARS-CoV-2 infection, directly linking these sequelae with the acute host response to the virus and providing early insights into their development.

3.
Hepatology ; 76(Supplement 1):S882, 2022.
Article in English | EMBASE | ID: covidwho-2157780

ABSTRACT

Background: Fatty liver is a well-recognized health risk and epidemic. It is associated with obesity, diabetes mellitus, and metabolic syndrome. Transient elastography is a quick and simple, non-invasive tool, validated across a range of liver diseases for the assessment for fibrosis and steatosis. Using Fibroscan, liver fibrosis is assessed by liver stiffness measured (LSM) in kilopascals (kPa) and steatosis is estimated using controlled attenuation parameter (CAP). In 2017 we initiated and reported on a screening program for fatty liver and liver fibrosis using FibroScan in a primary care facility in Southern California. Aim(s): To report on the 5-year disposition of the patients who had participated in the 2017 screening program and the outcome of their management in a primary care setting in the context of COVID-19 pandemic. Method(s): Between March, 2017 and June, 2017 958 individuals attending a primary care clinic, who had no known history of liver disease agreed to be screened and had an evaluable Fibroscan. Pts were followed and managed per standard of care in the primary care setting including annual check-ups, FibroScan assessments and referral to specialists as indicated. Result(s): Of the 958 pts, 79 were lost to follow-up, 14 pts declined follow-up, and 749 are in the process of being contacted for the 5-year follow-up check. The subjects of this analysis are 116 pts who returned for follow-up. 73.2% were females;mean age was 56.1 +/-11.6years and 88.8% Hispanic. There was no significant change in Hemoglobin A1c, ALT, and AST values. However, over the 5-year period, there was an increase of more than 25% in the number of pts diagnosed with two or more metabolic syndrome risk factors including hypertension, diabetes, hyperlipidemia, and/or fatty liver. Refer to table 1 for the 5-year change in FibroScan measurements and BMI. Conclusion(s): In a pre-dominantly Hispanic community patient population with no known history of liver disease attending a primary care clinic, over 70% had significant fat infiltration of the liver;23% had significant liver fibrosis at baseline. Only 55% of pts continued to follow regularly with primary care. Over 5years with at minimum annual follow-up visit, 1) there was no change in the fat infiltration, 2) there was increase in liver stiffness measure, 3) there was significant worsening in the metabolic syndrome presentation and risk factors. Further analysis is underway to determine the impact of the COVID-19 pandemic in leading to worsening BMI, LSM, and metabolic syndrome, especially with the 2-year quarantine, isolation, TeleHealth visits. Educational programs are urgently needed to increase the awareness of patients, community, the Primary Care practices on the epidemic of fatty liver and its consequences.

4.
SKIN: Journal of Cutaneous Medicine ; 6(6):497-501, 2022.
Article in English | Scopus | ID: covidwho-2146206

ABSTRACT

Although dermatomyositis (DM) patients have been included in studies evaluating for COVID-19 risk and severity in large cohorts of chronic immune mediated disease patients, there have been few studies looking specifically at cohorts of DM patients. We performed a single-center, retrospective cohort study of DM patients seen at the Cleveland Clinic who were diagnosed with COVID-19 via PCR test between March 2020 – July 2021. To assess for risk factors for severe COVID-19 disease course in the DM patient population, we utilized several characteristics known to impact COVID-19 disease course including age, BMI, and medications at time of diagnosis. We additionally included characteristics unique to the DM patient population including DM subtype and autoantibody status. Our results showed that risk factors for COVID-19 hospitalization in our DM cohort include age, BMI, and systemic medication use at time of COVID-19 infection. Despite our small sample size, our study is one of the first to elucidate characteristics important for COVID-19 disease course in DM specifically, rather than having it grouped alongside other disease processes. Awareness of this risk is important for clinicians caring for DM patients in order to optimize their care and protect them from a severe COVID-19 disease course. © 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine.

6.
Journal of Applied Polymer Science ; 2022.
Article in English | Scopus | ID: covidwho-2127569

ABSTRACT

During the global spread of COVID-19, high demand and limited availability of melt-blown filtration material led to a manufacturing backlog of N95 Filtering Facepiece Respirators (FFRs). This shortfall prompted the search for alternative filter materials that could be quickly mass produced while meeting N95 FFR filtration and breathability performance standards. Here, an unsupported, nonwoven layer of uncharged polystyrene (PS) microfibers was produced via electrospinning that achieves N95 performance standards based on physical parameters (e.g., filter thickness) alone. PS microfibers 3–6 μm in diameter and deposited in an ~5 mm thick filter layer are favorable for use in FFRs, achieving high filtration efficiencies (≥97.5%) and low pressure drops (≤15 mm H2O). The PS microfiber filter demonstrates durability upon disinfection with hydroxyl radicals (•OH), maintaining high filtration efficiencies and low pressure drops over six rounds of disinfection. Additionally, the PS microfibers exhibit antibacterial activity (1-log removal of E. coli) and can be modified readily through integration of silver nanoparticles (AgNPs) during electrospinning to enhance their activity (≥3-log removal at 25 wt% AgNP integration). Because of their tunable performance, potential reusability with disinfection, and antimicrobial properties, these electrospun PS microfibers may represent a suitable, alternative filter material for use in N95 FFRs. © 2022 The Authors. Journal of Applied Polymer Science published by Wiley Periodicals LLC.

7.
Journal of the Academy of Consultation-Liaison Psychiatry ; 63:S28-S28, 2022.
Article in English | Web of Science | ID: covidwho-2105192
10.
Postgraduate Medicine ; 134(Supplement 2):61-63, 2022.
Article in English | EMBASE | ID: covidwho-2087442

ABSTRACT

Learning Objectives (1) Upon completion, participants will be able to list the types of over-the-counter medicines that survey participants reported having in their homes for self care. (2) Upon completion, participants will be able to describe why survey participants viewed over-the-counter availability of acetaminophen as important to them. (3) Upon completion, participants will be able to list 3 reasons survey participants agreed were important for acetaminophen to be available OTC. Purpose The COVID-19 pandemic triggered dramatic changes in daily life in the United States (US) and globally. The pandemic also exacerbated existing inequitable access to health care and accelerated changes in the delivery of health care, influencing individuals to take more responsibility for their own care (selfcare). Review of published literature confirms changes in healthcare access, delivery and seeking brought on by the pandemic.1,2 However, a gap exists regarding patients' perceptions of the value of over-the-counter (OTC) medicines for appropriate selfcare at home. In this context, the current study aimed to understand patients' attitudes about OTC pain relievers, particularly acetaminophen, and its role in the at-home health care toolkit. Methods APCO Insight, a stakeholder research consultancy that has particular expertise in conducting qualitative and quantitative research in the health sector, identified and refined key concepts to develop a consumer-focused questionnaire in partnership with medical experts (e.g. medical doctors) and academically credentialed survey methodologists. The main survey focused on 4 distinct sets of questions to capture the current public health context and view of OTCs: demographics, health history/access, views toward OTC medicines, and the value and impact of current acetaminophen options. APCO partnered with YouGov, an internationally-recognized data collection platform and analytics group, to conduct a 400-person pilot study of the questionnaire to ensure target populations understood the survey language and questions had meaningful differentiation. Pilot study results and open-end responses from participants about the survey quality and ease of use for both Spanish and English speakers were reviewed to improve quality. APCO and YouGov then conducted a 20-minute, nationally representative online survey in both English and Spanish from January 26 to 9 February 2022 among 2,499 US adults, including oversamples for key subpopulations. The survey monitored national demographics by gender, age, race, and geography: 48% of participants were male, 51% female, 51% under 50-years-old, 49% older than 50 and 23% older than 65. The majority were white (64%), with 12% self-identifying as Black/African American, 15% as Hispanic/Latino and 10% as part of another group;48% lived in suburban areas, 28% in urban, and 24% in rural areas. The data were examined descriptively. Oversampling was implemented for two key subpopulations (African Americans and low-income households) to ensure large enough sample sizes for statistical analysis. Survey results were weighted to be representative of the US adult population. The margin of error for the survey is }2% overall;though the margin of error is higher when opinion is more divided. Results 51% reported using OTC medicines, 60% prescription medicines and 68% daily vitamins/nutritional supplements during the previous week. OTC medicines that >=50% reported having in their homes included pain relievers (85%), cold/cough (75%), allergy relief (61%), antibiotic ointment (58%) and antacids (56%). Among those with a pain reliever in their home, acetaminophen (76%) and ibuprofen (77%) were reported most commonly. Ibuprofen and acetaminophen were most often preferred for common ailments, except cold/flu. Acetaminophen was most preferred for fever, seen as satisfactory in treating multiple common conditions and used occasionally (73% reported use >=few times over previous 6 months). During the previous 6 months, 3 of 4 participants experienced aches and pains (85%), he dache (79%), and back pain (73%);>=3 of 10 also had cold/flu (49%), pain from injury (43%), arthritis pain (41%), or fever (31%). Ibuprofen was preferred to acetaminophen for treating aches and pains (50% and 40%, respectively), back pain (40% and 32%, respectively), and arthritis pain (24% and 20%, respectively). Acetaminophen was preferred to ibuprofen to treat fever (46% and 34%, respectively). Multiple ingredient cold treatments were most preferred for cold/flu (66%). Acetaminophen is seen as important to have OTC;has preferred existing dosing options;is viewed as efficacious, accessible, and safe;helps people manage pain to engage in regular activities;and satisfactorily relieves common ailments. Similar percentages of respondents preferred regular strength (650 mg) and extra strength (1000 mg) acetaminophen (43% and 42%, respectively). Among 81% who reported ability to get acetaminophen as an OTC medicine was very (53%) or somewhat (28%) important, efficacy (46%) and accessibility (38%) were the most common open-ended reasons. A majority strongly or somewhat agreed that acetaminophen was important to be available OTC because it was accessible without a prescription (88%), affordable (83%), effective (76%), tolerable (77%), nonaddictive (75%), and safer than other pain relief options (60%). Regarding how acetaminophen helped with their regular activities, 52% reported that acetaminophen aided them in getting a full night's sleep through pain relief. Approximately 40% said acetaminophen helped them with daily living tasks like showering and dressing (40%), spending quality time with loved ones (40%) and typical movement activities (48%). 41% reported relying on acetaminophen for pain relief so that they were able to participate in activities that required extra effort (e.g. swimming, hiking). For headaches (66%), aches and pains (63%), and fever (61%) over 6 in 10 participants were satisfied with acetaminophen;< 5% were unsatisfied. Conclusion This nationally representative survey of adults in the US showed strong reported use of various self-care options. Half of participants reported using OTC medicines. Pain relievers were the most commonly reported OTC medicines in participants' homes and acetaminophen and ibuprofen were the analgesics most commonly used to manage aches and pains, back pain, arthritis pain, and fever. Nearly 3 of 4 participants (73%) reported using acetaminophen at least a few times over the previous 6 months. When asked to focus on acetaminophen, survey participants cited efficaciousness, availability, and affordability of acetaminophen as top reasons for it to be available as an OTC medicine. Moreover, participants confirmed that OTC acetaminophen enabled them to be active in a variety of activities of daily living. Survey results suggest that the accessibility and effectiveness of OTC acetaminophen allows individuals to appropriately self-manage their health and quality of life.

11.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P23, 2022.
Article in English | EMBASE | ID: covidwho-2064484

ABSTRACT

Introduction: Since the onset of the COVID-19 pandemic, telemedicine has become an increasingly utilized resource in all fields of medicine, allowing greater access to and efficiency of medical care. This study seeks to quantify the average reduction in cost to patients and carbon footprint attributable to telemedicine for endocrine cancer care. Method(s): This retrospective cohort study includes telemedicine visits for in-state patients from April 1, 2020, to June 20, 2021, at the endocrine oncology clinic of a single National Cancer Institute-designated comprehensive cancer center. The primary outcome is cost savings of endocrine cancer care with use of telemedicine. This includes 2 components: (1) direct costs of travel (round-trip distance of car travel) and (2) loss of productivity due to the clinic visit (loss of income from travel and in-office visit time). The secondary outcome is reduction of carbon footprint (kg CO2 emissions) with use of telemedicine. Result(s): There were 3171 telemedicine visits for 2921 patients conducted within the designated time frame. Telemedicine was associated with total savings of 494,895 round-trip travel miles for patients (9734 hours total drive time). An additional 3613 hours were saved in accounting for time to park, enter the building, and wait. Telemedicine resulted in an average savings of $145/visit for patients under 65 years old and $111/visit for patients greater than 65 years old. Additionally, telemedicine reduced the carbon footprint by an average of 46.18 kg CO2 emissions per visit. Conclusion(s): As the costs of medical care continue to rise, further implementation of telemedicine may result in significant savings for patients. This study found that telemedicine is associated with reduction in financial burden caused by both travel and time costs. Additionally, implementation of telemedicine may significantly reduce the carbon footprint of endocrine cancer care. These data need to be interpreted in the context of clinical efficacy of the telemedicine visit, which will require additional study of clinical impact, patient satisfaction, and oncological outcomes.

12.
Otolaryngology - Head and Neck Surgery ; 167(1 Supplement):P287, 2022.
Article in English | EMBASE | ID: covidwho-2064409

ABSTRACT

Introduction: To limit the spread of COVID-19 and keep faculty and applicants safe, many otolaryngology subspecialties conducted their fellowship interviews via a virtual format, including within the field of rhinology. Given the novel virtual format of interviews during the 2021 rhinology interview cycle, our study looked to determine how virtual interviews compared with in-person interviews from the perspective of rhinology fellowship directors. Method(s): A web-based anonymous survey was developed consisting of 15 questions. Electronic letters were sent to all fellowship directors participating in the 2021 rhinology match requesting their participation. Fourteen of the 15 questions from our survey were based on a 5-point Likert-type scale, with 1 representing strong disagree and 5 representing strongly agree;there was 1 one open-ended question. Result(s): Overall, 70% of rhinology fellowship directors responded. Fellowship directors were divided on whether they were satisfied with the virtual interview but overall felt the process was convenient (74%). Most (74%) reported that virtual interviews did not allow them to sufficiently display their program. In addition, 70% felt that the virtual interview process did not allow them to establish rapport with applicants and also to determine who would be the best fit for their program (70%). Most also reported placing more emphasis on applicants' curriculum vitae and letters of recommendation. Overall, 65% said they would not plan to offer virtual interviews in the future despite similar or better match results. Conclusion(s): While virtual interviews result in notable cost reductions and increased convenience to programs and applicants, fellowship directors were mixed in their level of satisfaction with the overall process. This was primarily related to the perceived inability to accurately reflect their program remotely and also an increased difficulty evaluating applicants via a virtual format. These limitations led to most fellowship directors not planning to offer virtual interviews in the future despite similar match results to when conducting traditional interviews.

13.
10th IEEE International Conference on Healthcare Informatics, ICHI 2022 ; : 664-668, 2022.
Article in English | Scopus | ID: covidwho-2063259

ABSTRACT

Previous studies have documented an association of D-dimer levels with COVID-19 severity. Elevated D-dimer is reported to be associated with patient demographics, comorbidities, lab results, and overall higher incidence of critical illness. However, due to small sample sizes, limited availability of data on essential covariates, and lack of standardization of the admission laboratory protocol, the role of D-dimer in the progression of COVID-19 remains uncertain and needs further investigation using data from larger cohorts. The objectives of this study were to study the factors predicting elevated D-dimer level and to characterize the risk factors that predict D-dimer elevation over the course of inpatient admission. We used statistical modeling, applying machine learning methods to maximally leverage all the available clinical and care variables without being limited by the assumptions of traditional regression analysis methods. Our sample consisted of 1005 COVID-19 inpatients admitted to a large US hospital from March 2020 to July 2020, using detailed data on various clinical and biochemical laboratory test results at admission and throughout the course of hospital stay. Analytic methods used in this study included a) descriptive statistics at baseline using chi-square tests to compare patients with normal and elevated D-dimer at baseline, b) adjusted multivariable regression modeling, and c) evaluation of importance of each feature using two decision-tree-based supervised machine learning algorithms, random forest and XGBoost methods. Results show that machine learning methods could identify 20 important features that predict D-dimer some of which could be used to prevent the processes that lead to D-dimer elevation. Our study suggests that continual laboratory monitoring of D-dimer levels from the time of detection of COVID-19 infection, and monitoring of selected risk factors out of the panel of identified risk factors may enable clinicians to triage patients into risk levels, initiate appropriate therapeutic strategies, and tailor care management to each patient in order to minimize the morbidity and mortality of COVID-19. © 2022 IEEE.

14.
Chest ; 162(4 Supplement):A2087-A2088, 2022.
Article in English | EMBASE | ID: covidwho-2060897

ABSTRACT

SESSION TITLE: Lung Nodule Biopsy: Yield and Accuracy SESSION TYPE: Original Investigations PRESENTED ON: 10/16/2022 10:30 am - 11:30 am PURPOSE: A variety of endpoints have been used to evaluate the diagnostic performance of navigational bronchoscopy for sampling peripheral pulmonary lesions (PPLs), including diagnostic yield (rate of biopsies with a specific diagnosis that facilitates clinical decisions) and diagnostic accuracy (yield plus a follow-up to assess for false negative/positive initial results). There is also significant variation in what non-malignant findings are considered diagnostic, especially regarding nonspecific inflammatory changes. We hypothesized a diagnostic yield definition excluding nonspecific findings as diagnostic would lead to few false negative PPL biopsies. METHOD(S): Our center maintains a prospective cohort of consecutive PPLs targeted via navigational bronchoscopy. Diagnostic yield was defined as specific findings readily explaining the presence of a PPL (malignancy, organizing pneumonia, granulomatous inflammation, frank purulence, other specific finding) permitting management without immediate additional diagnostic intervention. "Other specific finding" required pulmonologist and lung pathologist agreement. All other findings were considered non-diagnostic. RESULT(S): A total of 450 PPLs biopsied 2017-2019 with complete two-year follow-up were included in the analysis. Ultimately, 274 of 450 (60.9%) PPLs were determined to be malignant. Diagnostic biopsies were obtained in 331 cases (73.6%). There was a single false-positive among 228 malignant biopsies (0.4%, carcinoid tumor on cytopathology, alveolar adenoma on resection surgical pathology). Among 223 PPLs without malignant diagnosis at initial bronchoscopy, 48 were later determined to be malignant. Most (n=39) exhibited nonspecific abnormalities on initial pathology. Two of 104 specific benign biopsies were false negative (1.9%). Both demonstrated organizing pneumonia on initial pathology but re-biopsy months after index bronchoscopy revealed Hodgkin's lymphoma and metastatic renal cell carcinoma, respectively. The sensitivity, specificity, and positive predictive value of specific benign findings for an ultimately benign nodule were 58% (95% CI, 51-66%), 95% (86-99%), and 90% (70-97%). The sensitivity, specificity, and positive predictive value of nonspecific benign findings for an ultimately benign PPL diagnosis were 32% (95% CI, 25-39%), 19% (9-33%), and 20% (16-24%). CONCLUSION(S): A definition of diagnostic yield excluding nonspecific benign findings had low false positive/negative rates. If bronchoscopy is not diagnostic of malignancy, a specific benign finding was highly predictive of an ultimately benign PPL, while nonspecific findings poorly predicted benignity. CLINICAL IMPLICATIONS: This definition of diagnostic yield could be used as the primary outcome in future studies, permitting distribution of reliable diagnostic results without requiring years of follow-up. DISCLOSURES: No relevant relationships by Joyce Johnson No relevant relationships by Robert Lentz No relevant relationships by Kaele Leonard No relevant relationships by See-Wei Low PI ofan investigator-initiated study relationship with Medtronic Please note: >$100000 by Fabien Maldonado, value=Grant/Research Support PI on investigator-initiated relationship with Erbe Please note: $5001 - $20000 by Fabien Maldonado, value=Grant/Research Support Consulting relationship with Medtronic Please note: $5001 - $20000 by Fabien Maldonado, value=Honoraria co-I industry-sponsored trial relationship with Lung Therapeutics Please note: $5001 - $20000 by Fabien Maldonado, value=Grant/Research Support Board of director member relationship with AABIP Please note: $1-$1000 by Fabien Maldonado, value=Travel Consultant relationship with Medtronic/Covidien Please note: $1001 - $5000 by Otis Rickman, value=Consulting fee No relevant relationships by Briana Swanner Copyright © 2022 American College of Chest Physicians

15.
Chest ; 162(4):A949, 2022.
Article in English | EMBASE | ID: covidwho-2060737

ABSTRACT

SESSION TITLE: What Lessons Will We Take From the Pandemic? SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Since the emergence of COVID-19, many serious complications have arisen especially in the setting of Acute Respiratory Distress Syndrome (ARDS) in the intensive care unit. Historically, ARDS and mechanical ventilation is associated with higher rates of pneumothorax. It has been well described that ARDS is the result of inflammatory lung injury, with increased activation of circulating neutrophils, complement and proinflammatory mediators leading to loss of surfactant, alveolar atelectasis, and fibrin deposition. This leads to a less compliant lung parenchyma, and higher airway pressures, which has been attributed as a risk factor for pneumothorax. The management of pneumothorax varies depending on the etiology of the pneumothorax. In the case of iatrogenic pneumothorax (i.e. mechanical ventilation), tube thoracostomy is generally recommended, however the size of the chest tube inserted remains less clear. METHODS: This is a multi-center retrospective cohort study of 88 hospitalized patients with a diagnosis of COVID-19 and pneumothorax or pneumomediastinum between the dates of 3/11/2020 to 01/26/2021. Patient demographics, comorbidities, laboratory and hemodynamic data were collected as well as ventilator settings, lung mechanics, and clinical patient outcome data including type of intervention and rate of resolution of pneumothorax. Final statistical analysis is pending. RESULTS: Our preliminary results reveal that there was a higher rate of resolution of pneumothorax with a large bore chest tube (LBCT) compared to a small bore chest tube (SBCT). There was no significant difference in lung compliance or tidal volume in cc/kg between the patients with a resolving pneumothorax compared to the patients with a nonresolving pneumothorax. Overall mortality rate among all patients was 70.4%. CONCLUSIONS: Patients with a large bore chest tube placed are more likely to have resolution of pneumothorax compared to small bore chest tube or serial X-ray. Lung compliance and tidal volume were not significantly different between patients that had a resolving pneumothorax compared to nonresolving pneumothorax. It is important to manage a pneumothorax early on to reduce associated morbidity. CLINICAL IMPLICATIONS: The development of pneumothorax in COVID patients with ARDS has significant associated morbidity and mortality. Utilization of a large bore chest tube may result in improved rates of resolution of pneumothorax. DISCLOSURES: No relevant relationships by Nathalie Antonios No relevant relationships by Colby Baker No relevant relationships by Jessica Johnson No relevant relationships by Karen Sayad

16.
Infect Control Hosp Epidemiol ; : 1-9, 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2050198

ABSTRACT

OBJECTIVE: Hospital readmission is unsettling to patients and caregivers, costly to the healthcare system, and may leave patients at additional risk for hospital-acquired infections and other complications. We evaluated the association between comorbidities present during index coronavirus disease 2019 (COVID-19) hospitalization and the risk of 30-day readmission. DESIGN, SETTING, AND PARTICIPANTS: We used the Premier Healthcare database to perform a retrospective cohort study of COVID-19 hospitalized patients discharged between April 2020 and March 2021 who were followed for 30 days after discharge to capture readmission to the same hospital. RESULTS: Among the 331,136 unique patients in the index cohort, 36,827 (11.1%) had at least 1 all-cause readmission within 30 days. Of the readmitted patients, 11,382 (3.4%) were readmitted with COVID-19 as the primary diagnosis. In the multivariable model adjusted for demographics, hospital characteristics, coexisting comorbidities, and COVID-19 severity, each additional comorbidity category was associated with an 18% increase in the odds of all-cause readmission (adjusted odds ratio [aOR], 1.18; 95% confidence interval [CI], 1.17-1.19) and a 10% increase in the odds of readmission with COVID-19 as the primary readmission diagnosis (aOR, 1.10; 95% CI, 1.09-1.11). Lymphoma (aOR, 1.86; 95% CI, 1.58-2.19), renal failure (aOR, 1.32; 95% CI, 1.25-1.40), and chronic lung disease (aOR, 1.29; 95% CI, 1.24-1.34) were most associated with readmission for COVID-19. CONCLUSIONS: Readmission within 30 days was common among COVID-19 survivors. A better understanding of comorbidities associated with readmission will aid hospital care teams in improving postdischarge care. Additionally, it will assist hospital epidemiologists and quality administrators in planning resources, allocating staff, and managing bed-flow issues to improve patient care and safety.

17.
Digital Innovation for Healthcare in COVID-19 Pandemic: Strategies and Solutions ; : 189-199, 2022.
Article in English | Scopus | ID: covidwho-2027780

ABSTRACT

Coronavirus disease 2019 (COVID-19) has become a global pandemic that significantly challenged healthcare systems worldwide, with over 4 million deaths among 18.6 million identified cases as of June 2021. Understanding the current COVID-19 cases and determining clinical solutions is of paramount importance. In this chapter, we describe an exploratory study of identifying risk factors associated with COVID-19 inpatient care. Based on a set of COVID-19 inpatient medical health records in a US hospital system, we used both unsupervised and supervised machine learning methods to explore risk factors associated with hospitalized COVID-19 patients. We found that the most important features related to the COVID-19 disease include (1) influenza vaccines, (2) pneumococcal vaccines, and (3) weight-related variables (i.e., weight, height, and BMI). As such, we provide a use case that machine learning methods are valuable for predicting COVID-19 inpatient risk factors, and the results are promising to guide further research in this area. © 2022 Elsevier Inc. All rights reserved.

18.
Rural Educator ; 43(2):47-59, 2022.
Article in English | Scopus | ID: covidwho-2026905

ABSTRACT

The COVID-19 pandemic has exposed the many existing inequalities in education systems across the world. Not all children have easy access to educational online resources or digital technologies, a situation more amplified in rural contexts where access, connectivity and affordability play a significant factor. This qualitative account reveals examples of how rural school leaders were able to find innovative ways early in the COVID-19 pandemic to address the remote learning needs of their students and families. This paper shares in-the-moment experiences of rural principals, and those who supported them, in quickly transitioning to address student needs when school buildings closed. Support actions of regional and state education agencies are also described. Principals’ schools are located in rural areas of Kansas, Pennsylvania and Queensland, Australia. Principals’ attention to place and teacher capacity enabled students and families to access educational offerings and supports in new ways. © 2022. This work is licensed under a CC BY 4.0 license.

20.
Innovation in Aging ; 5:231-231, 2021.
Article in English | Web of Science | ID: covidwho-2011663
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