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1.
Disaster Med Public Health Prep ; : 1-5, 2021 Apr 20.
Article in English | MEDLINE | ID: covidwho-1707669

ABSTRACT

A research initiative was launched during the initial coronavirus disease (COVID-19) outbreak by 3 New York metropolitan area institutions. Collaborators recruited community members and patients from previous research studies to examine COVID-19 experiences and mental health symptoms through self-report surveys. The current report descriptively presents findings from the initial survey characterized by both community and clinical cohorts, and discusses challenges encountered with rapid implementation. The clinical cohort exhibited higher rates of symptoms of mental health difficulties (depression, anxiety, and posttraumatic stress disorder [PTSD]) as compared to the community cohort. COVID-19 positivity rates were similar among both groups and lower than the national average. While both groups reported low rates of job loss, community members reported higher rates of financial difficulty resulting from the pandemic. Findings indicate the need for further collaborative research on the mental health impact of COVID-19.

2.
Open Forum Infect Dis ; 8(12): ofab534, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1560777

ABSTRACT

BACKGROUND: We characterized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody test prevalence and positive test prevalence across New York City (NYC) in order to investigate disparities in testing outcomes by race and socioeconomic status (SES). METHODS: Serologic data were downloaded from the NYC Coronavirus data repository (August 2020-December 2020). Area-level characteristics for NYC neighborhoods were downloaded from United States census data and a socioeconomic vulnerability index was created. Spatial generalized linear mixed models were performed to examine the association between SES and antibody testing and positivity. RESULTS: The proportion of Hispanic population (posterior median, 0.001 [95% credible interval, 0.0003-0.002]), healthcare workers (0.003 [0.0001-0.006]), essential workers (0.003 [0.001-0.005]), age ≥65 years (0.003 [0.00002-0.006]), and high SES (SES quartile 3 vs 1: 0.034 [0.003-0.062]) were positively associated with antibody tests per 100000 residents. The White proportion (-0.002 [-0.003 to -0.001]), SES index (quartile 3 vs 1, -0.068 [-0.115 to -0.017]; quartile 4 vs 1, -0.077 [-0.134 to -0.018]) and age ≥65 years (-0.005 [-0.009 to -0.002]) were inversely associated with positive test prevalence (%), whereas the Hispanic (0.004 [0.002-0.006]) and essential worker (0.008 [0.003-0.012]) proportions had positive coefficients. CONCLUSIONS: Disparities in serologic testing and seropositivity exist on SES and race/ethnicity across NYC, indicative of excess coronavirus disease burden in vulnerable and marginalized populations.

3.
BMC Public Health ; 21(1): 1717, 2021 09 21.
Article in English | MEDLINE | ID: covidwho-1435238

ABSTRACT

BACKGROUND: Given the interplay between race and comorbidities on COVID-19 morbidity and mortality, it is vital that testing be performed in areas of greatest need, where more severe cases are expected. The goal of this analysis is to evaluate COVID-19 testing data in NYC relative to risk factors for COVID-19 disease severity and demographic characteristics of NYC neighborhoods. METHODS: COVID-19 testing and the racial/ethnic composition of NYC Zip Code Tabulation Areas (ZCTA) were obtained from the NYC Coronavirus data repository and the American Community Survey, respectively. The prevalence of neighborhood-level risk factors for COVID-19 severity according to the Centers for Disease Control and Prevention criteria for risk of severe illness and complications from COVID-19 were used to create a ZCTA-level risk index. Poisson regressions were performed to study the ratio of total tests relative to the total ZCTA population and the proportion of positive tests relative to the total tests performed over time. RESULTS: From March 2nd-April 6th, the total tests/population (%) was positively associated with the proportion of white residents (IRRadj: 1.0003, 95% CI: 1.0003-1.0004) and the COVID risk index (IRRadj: 1.038, 95% CI: 1.029-1.046). The risk index (IRRadj: 1.017, 95% CI: 0.939-1.101) was not associated with total tests performed from April 6th-May 12th, and inversely associated from May 12th-July 6th (IRRadj: 0.862, 95% CI: 0.814-0.913). From March 2nd-April 6th the COVID risk index was not statistically associated (IRRadj: 1.010, 95% CI: 0.987-1.034) with positive tests/total tests. From April 6th-May 12th, the COVID risk index was positively associated (IRRadj: 1.031, 95% CI: 1.002-1.060), while from May 12th-July 6th, the risk index was inversely associated (IRRadj: 1.135, 95% CI: 1.042-1.237) with positivity. CONCLUSIONS: Testing in NYC has suffered from the lack of availability in high-risk populations, and was initially limited as a diagnostic tool for those with severe symptoms, which were mostly concentrated in areas where vulnerable residents live. Subsequent time periods of testing were not targeted in areas according to COVID-19 disease risk, as these areas still experience more positive tests.


Subject(s)
COVID-19 , COVID-19 Testing , Humans , New York City/epidemiology , Residence Characteristics , SARS-CoV-2
4.
BMC Public Health ; 21(1): 1452, 2021 07 24.
Article in English | MEDLINE | ID: covidwho-1322931

ABSTRACT

BACKGROUND: New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. METHODS: A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020-07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. RESULTS: The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (ßadj = - 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (ßadj = 0.90, SE = 0.38, p = 0.0200), median age (ßadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (ßadj = 5.84, SE = 0.82, p <  0.001) were statistically significantly positively associated with death rates. CONCLUSIONS: Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Humans , New York City/epidemiology , SARS-CoV-2 , Socioeconomic Factors
5.
J Community Health ; 46(6): 1177-1182, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1242807

ABSTRACT

This study aimed to assess the coronavirus disease (COVID-19) school-related information New York City residents sought through the 311 Call Center. July to November inquiries were downloaded from the NYC Open Data website for 2018-2020. Calls were categorized as related to "Schools", "Access", "Food", "Hospitals", "Transportation", and "Unemployment". Overall call types, and among school-related calls, detailed call types, were compared over the years, using chi-squared tests. School-related inquiries increased by 71% from 2018 to 2020. During 2020, the most common (49%, n = 22,471) call description was "Coronavirus and Schools", encompassing calls about learning options, safety, and resources. Spikes in these calls corresponded to official announcements, including those about Fall reopening plans (August 31: n = 678; September 1: n = 624) and schedules and staffing (September 16th: n = 1043; September 17th: n = 713), and after the start of in-person learning (September 21: n = 680). This study demonstrates that as government officials updated NYC schooling plans for Fall 2020, there were increased concerns among NYC residents. Future COVID-19 schooling changes need to be conveyed clearly and disseminated effectively in order to avoid confusion about NYC's pandemic learning strategy and to address health and safety concerns.


Subject(s)
COVID-19 , Humans , New York City/epidemiology , Pandemics , SARS-CoV-2 , Schools
6.
EJHaem ; 2021 May 06.
Article in English | MEDLINE | ID: covidwho-1222636

ABSTRACT

The coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led to an unprecedented international health crisis. COVID-19 clinical presentations cover a wide range from asymptomatic to severe illness and death. Given the limited therapeutic resources and unexpected clinical features of the disease, readily accessible predictive biomarkers are urgently needed to improve patient care and management. We asked the degree to which anemia may influence the outcome of patients with COVID-19. To this end, we identified 3777 patients who were positively diagnosed with COVID-19 between March 1 and April 1 2020 in New York City. We evaluated 2,562 patients with available red blood cell, hemoglobin, and related laboratory values. Multivariable cox proportional hazards regression showed that anemia was a significant independent predictor of mortality (hazard ratio (HR): 1.26, 95% Confidence Interval [CI]: 1.06-1.51), independent of age, sex, and comorbidities. There was a direct correlation between the degree of anemia and the risk of mortality when hemoglobin was treated as a continuous variable (HRadj 1.05; [CI]: 1.01-1.09). The hemoglobin level that was maximally predictive of mortality, was 11.5 g/dL in males and 11.8 g/dL in females. These findings identify a routinely measured biomarker that is predictive of disease outcomes and will aid in refining clinical care algorithms and optimize resource allocation. Mechanisms of impacts of anemia on COVID-19 outcome are likely to be multiple in nature and require further investigation.

9.
JNCI Cancer Spectr ; 5(1): Pkaa085, 2021 02.
Article in English | MEDLINE | ID: covidwho-900441

ABSTRACT

Background: Complications in cancer patients with coronavirus disease 2019 (COVID-19) have not been examined. This analysis aimed to compare characteristics of COVID-19 patients with and without cancer and assess whether cancer is associated with COVID-19 morbidity or mortality. Methods: COVID-19-positive patients with an inpatient or emergency encounter at the Mount Sinai Health System between March 1, 2020, and May 27, 2020, were included and compared across cancer status on demographics and clinical characteristics. Multivariable logistic regressions were used to model the associations of cancer with sepsis, venous thromboembolism, acute kidney injury, intensive care unit admission, and all-cause mortality. Results: There were 5556 COVID-19-positive patients included, 421 (7.6%) with cancer (325 solid, 96 nonsolid). Those with cancer were statistically significantly older, more likely to be non-Hispanic Black and to be admitted to the hospital during their encounter, and had more comorbidities than noncancer COVID-19 patients. Cancer patients were statistically significantly more likely to develop sepsis (adjusted odds ratio [ORadj] = 1.31, 95% confidence interval [CI] = 1.06 to 1.61) and venous thromboembolism (ORadj = 1.77, 95% CI = 1.01 to 3.09); there was no statistically significant difference in acute kidney injury (ORadj = 1.10, 95% CI = 0.87 to 1.39), intensive care unit admissions (ORadj = 1.04, 95% CI = 0.80 to 1.34), or mortality (ORadj = 1.02, 95% CI = 0.81 to 1.29). Conclusions: COVID-19 patients with cancer may have a higher risk for adverse outcomes. Although there was no statistically significant difference in mortality, COVID-19 patients with cancer have statistically significantly higher risk of thromboembolism and sepsis. Further research is warranted into the potential effects of cancer treatments on inflammatory and immune responses to COVID-19 and on the efficacy of anticoagulant therapy in these patients.


Subject(s)
COVID-19/complications , Hospitalization/statistics & numerical data , Intensive Care Units/statistics & numerical data , Neoplasms/complications , Acute Kidney Injury/complications , Aged , COVID-19/epidemiology , COVID-19/virology , Female , Hospital Mortality , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Neoplasms/mortality , Pandemics , Retrospective Studies , Risk Factors , SARS-CoV-2/physiology , Venous Thromboembolism/complications
10.
Clinical Cancer Research ; 26(18), 2020.
Article in English | Web of Science | ID: covidwho-839337
11.
Am J Prev Med ; 59(3): 326-332, 2020 09.
Article in English | MEDLINE | ID: covidwho-614429

ABSTRACT

INTRODUCTION: Existing socioeconomic and racial disparities in healthcare access in New York City have likely impacted the public health response to COVID-19. An ecological study was performed to determine the spatial distribution of COVID-19 testing by ZIP code Tabulation Area and investigate if testing was associated with race or SES. METHODS: Data were obtained from the New York City coronavirus data repository and 2018 American Community Survey 5-year estimates. A combined index of SES was created using principal component analysis and incorporated household income, gross rent, poverty, education, working class status, unemployment, and occupants per room. Multivariable Poisson regressions were performed to predict the number of total tests and the ratio of positive tests to total tests performed, using the SES index, racial composition, and Hispanic composition as predictors. RESULTS: The number of total tests significantly increased with the increasing proportion of white residents (ß=0.004, SE=0.001, p=0.0032) but not with increasing Hispanic composition or SES index score. The ratio of positive tests to total tests significantly decreased with the increasing proportion of white residents in the ZIP code Tabulation Area (ß= -0.003, SE=0.000 6, p<0.001) and with increasing SES index score (ß= -0.001 6, SE=0.0007, p=0.0159). CONCLUSIONS: In New York City, COVID-19 testing has not been proportional to need; existing socioeconomic and racial disparities in healthcare access have likely impacted public health response. There is urgent need for widespread testing and public health outreach for the most vulnerable communities in New York City.


Subject(s)
Clinical Laboratory Techniques , Coronavirus Infections/epidemiology , Health Services Accessibility , Healthcare Disparities , Pneumonia, Viral/epidemiology , COVID-19 , COVID-19 Testing , Coronavirus Infections/diagnosis , Coronavirus Infections/ethnology , /statistics & numerical data , Humans , New York City/epidemiology , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/ethnology , Poverty , Socioeconomic Factors , /statistics & numerical data
12.
J Public Health (Oxf) ; 42(3): 448-450, 2020 Aug 18.
Article in English | MEDLINE | ID: covidwho-599278

ABSTRACT

In the midst of widespread community transmission of coronavirus disease 2019 (COVID-19) in New York, residents have sought information about COVID-19. We analyzed trends in New York State (NYS) and New York City (NYC) data to quantify the extent of COVID-19-related queries. Data on the number of 311 calls in NYC, Google Trend data on the search term 'Coronavirus' and information about trends in COVID-19 cases in NYS and the USA were compiled from multiple sources. There were 1228 994 total calls to 311 between 22 January 2020 and 22 April 2020, with 50 845 calls specific to COVID-19 in the study period. The proportion of 311 calls related to COVID-19 increased over time, while the 'interest over time' of the search term 'Coronavirus' has exponentially increased since the end of February 2020. It is vital that public health officials provide clear and up-to-date information about protective measures and crucial communications to respond to information-seeking behavior across NYC.


Subject(s)
Coronavirus Infections/epidemiology , Information Seeking Behavior , Pneumonia, Viral/epidemiology , Public Health/statistics & numerical data , Public Health/trends , Betacoronavirus , COVID-19 , Forecasting , Humans , New York , New York City/epidemiology , Pandemics , Population Surveillance , SARS-CoV-2
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