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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-324619

ABSTRACT

Using data on imported and domestic COVID-19 cases from Taiwan and New Zealand between January and June 2020, we develop a Bayesian random-effects Poisson model to detect cluster infections from imported cases. We find remarkable consistency in the predictive power of the model. An increase in one imported case increased the risk of domestic cases by 9.54% in Taiwan and 10.97% in New Zealand. The Taiwan epidemic curve revealed that imported cases did not lead to a large-scale community-acquired outbreak. In New Zealand, a community-acquired outbreak during 29th March-4th April could have been averted if control actions had been taken one-week earlier prior to the predicted cluster infection between 22nd and 28th March. Our model can be used as an early warning of outbreaks during the initial stage of pandemic or the resurgence of outbreaks after lifting containment measures, such as lockdown orders and border control, during a pandemic.

2.
Matern Child Health J ; 2022 Jan 04.
Article in English | MEDLINE | ID: covidwho-1606432

ABSTRACT

INTRODUCTION: Over the past decade, foundational courses in MCH have been revised and revamped to integrate the life course perspective and social determinants of health in ways that bring these essential issues to the core of the learning experience. Yet the racial reckoning of 2020 and the racially disparate health impacts of the COVID-19 pandemic underscore that a deeper, more focused approach to anti-racist pedagogy is now imperative for MCH educators and others responsible for developing the MCH workforce. METHODS: In this paper, we discuss our experience of building a 'community of practice' of anti-racist MCH trainees through our course, 'Foundations of Maternal and Child Health Policy, Practice, and Science.' RESULTS: We identify four principles which guided our course: (1) building on students' experience, knowledge, identities and social justice commitments; (2) creating a common purpose and shared vocabulary related to racism; (3) organizing classroom activities to reflect real-world problems and professional practices related to addressing structural racism as a root cause of health inequities; and (4) building students' skills and confidence to recognize and address structural racism as MCH professionals. DISCUSSION: We hope that this description of our principles, along with examples of how they were put into practice, will be useful to MCH educators who seek to build anti-racist frameworks to guide MCH workforce development.

3.
J Infect Dis ; 225(4): 603-607, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1522224

ABSTRACT

Little is known regarding coronavirus disease 2019 (COVID-19) vaccination rates in people with HIV (PWH), a vulnerable population with significant morbidity from COVID-19. We assessed COVID-19 vaccination rates among 6952 PWH in the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) compared to region- and country-specific vaccination data. The global probability of COVID-19 vaccination through end of July 2021 was 55% among REPRIEVE participants with rates varying substantially by Global Burden of Disease (GBD) superregion. Among PWH, factors associated with COVID-19 vaccination included residence in high-income regions, age, white race, male sex, body mass index, and higher cardiovascular risk. Clinical Trials Registration. NCT02344290.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19 , HIV Infections , Vaccination/statistics & numerical data , COVID-19/prevention & control , HIV Infections/therapy , Humans , Male , Randomized Controlled Trials as Topic
4.
Vaccine ; 39(38): 5368-5375, 2021 09 07.
Article in English | MEDLINE | ID: covidwho-1377852

ABSTRACT

BACKGROUND: Anaphylaxis is a rare, serious allergic reaction. Its identification in large healthcare databases can help better characterize this risk. OBJECTIVE: To create an ICD-10 anaphylaxis algorithm, estimate its positive predictive values (PPVs) in a post-vaccination risk window, and estimate vaccination-attributable anaphylaxis rates in the Medicare Fee For Service (FFS) population. METHODS: An anaphylaxis algorithm with core and extended portions was constructed analyzing ICD-10 anaphylaxis claims data in Medicare FFS from 2015 to 2017. Cases of post-vaccination anaphylaxis among Medicare FFS beneficiaries were then identified from October 1, 2015 to February 28, 2019 utilizing vaccine relevant anaphylaxis ICD-10 codes. Information from medical records was used to determine true anaphylaxis cases based on the Brighton Collaboration's anaphylaxis case definition. PPVs were estimated for incident anaphylaxis and the subset of vaccine-attributable anaphylaxis within a 2-day post-vaccination risk window. Vaccine-attributable anaphylaxis rates in Medicare FFS were also estimated. RESULTS: The study recorded 66,572,128 vaccinations among 21,685,119 unique Medicare FFS beneficiaries. The algorithm identified a total of 190 suspected anaphylaxis cases within the 2-day post-vaccination window; of these 117 (62%) satisfied the core algorithm, and 73 (38%) additional cases satisfied the extended algorithm. The core algorithm's PPV was 66% (95% CI [56%, 76%]) for identifying incident anaphylaxis and 44% (95% CI [34%, 56%]) for vaccine-attributable anaphylaxis. The vaccine-attributable anaphylaxis incidence rate after any vaccination was 0.88 per million doses (95% CI [0.67, 1.16]). CONCLUSION: The ICD-10 claims algorithm for anaphylaxis allows the assessment of anaphylaxis risk in real-world data. The algorithm revealed vaccine-attributable anaphylaxis is rare among vaccinated Medicare FFS beneficiaries.


Subject(s)
Anaphylaxis , Vaccines , Aged , Algorithms , Anaphylaxis/chemically induced , Anaphylaxis/epidemiology , Humans , Incidence , International Classification of Diseases , Medicare , United States/epidemiology , Vaccines/adverse effects
5.
J Cardiovasc Comput Tomogr ; 15(2): 180-189, 2021.
Article in English | MEDLINE | ID: covidwho-1122961

ABSTRACT

The purpose of this review is to highlight the most impactful, educational, and frequently downloaded articles published in the Journal of Cardiovascular Computed Tomography (JCCT) for the year 2020. The JCCT reached new records in 2020 for the number of research submissions, published manuscripts, article downloads and social media impressions. The articles in this review were selected by the Editorial Board of the JCCT and are comprised predominately of original research publications in the following categories: Coronavirus disease 2019 (COVID-19), coronary artery disease, coronary physiology, structural heart disease, and technical advances. The Editorial Board would like to thank each of the authors, peer-reviewers and the readers of JCCT for making 2020 one of the most successful years in its history, despite the challenging circumstances of the global COVID-19 pandemic.


Subject(s)
Biomedical Research , COVID-19/virology , Heart Diseases/virology , Periodicals as Topic , SARS-CoV-2/pathogenicity , COVID-19/complications , COVID-19/diagnosis , Computed Tomography Angiography , Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/physiopathology , Coronary Artery Disease/virology , Heart Diseases/diagnostic imaging , Heart Diseases/physiopathology , Host-Pathogen Interactions , Humans , Prognosis , Risk Factors
6.
PLoS One ; 16(1): e0245765, 2021.
Article in English | MEDLINE | ID: covidwho-1048819

ABSTRACT

BACKGROUND: Colleges and universities across the country are struggling to develop strategies for effective control of COVID-19 transmission as students return to campus. METHODS AND FINDINGS: We conducted a prospective cohort study with students living on or near the UC Berkeley campus from June 1st through August 18th, 2020 with the goal of providing guidance for campus reopening in the safest possible manner. In this cohort, we piloted an alternative testing model to provide access to low-barrier, high-touch testing and augment student-driven testing with data-driven adaptive surveillance that targets higher-risk students and triggers testing notifications based on reported symptoms, exposures, or other relevant information. A total of 2,180 students enrolled in the study, 51% of them undergraduates. Overall, 6,247 PCR tests were administered to 2,178 students over the two-month period. Overall test positivity rate was 0.9%; 2.6% of students tested positive. Uptake and acceptability of regular symptom and exposure surveys was high; 98% of students completed at least one survey, and average completion rate was 67% (Median: 74%, IQR: 39%) for daily reporting of symptoms and 68% (Median: 75%, IQR: 40%) for weekly reporting of exposures. Of symptom-triggered tests, 5% were PCR-positive; of exposure-triggered tests, 10% were PCR-positive. The integrated study database augmented traditional contact tracing during an outbreak; 17 potentially exposed students were contacted the following day and sent testing notifications. At study end, 81% of students selected their desire "to contribute to UC Berkeley's response to COVID-19" as a reason for their participation in the Safe Campus study. CONCLUSIONS: Our results illustrate the synergy created by bringing together a student-friendly, harm reduction approach to COVID-19 testing with an integrated data system and analytics. We recommend the use of a confidential, consequence-free, incentive-based daily symptom and exposure reporting system, coupled with low-barrier, easy access, no stigma testing. Testing should be implemented alongside a system that integrates multiple data sources to effectively trigger testing notifications to those at higher risk of infection and encourages students to come in for low-barrier testing when needed.


Subject(s)
COVID-19/diagnosis , SARS-CoV-2/isolation & purification , Students , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Nucleic Acid Testing , California/epidemiology , Cohort Studies , Communicable Disease Control , Contact Tracing , Humans , Prospective Studies , Surveys and Questionnaires , Universities
7.
Health Aff (Millwood) ; 40(2): 212-218, 2021 02.
Article in English | MEDLINE | ID: covidwho-1040064

ABSTRACT

The health and well-being of childbearing women and children in the US should set a world standard. However, women and children in the US experience higher rates of morbidity and mortality than women and children in almost all other industrialized countries, with marked racial and ethnic disparities. The unfolding effects of the coronavirus disease 2019 (COVID-19) pandemic have highlighted such disparities. In this article, which is part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2021 initiative, we draw on a life-course framework to highlight promising interventions and recommend key improvements in programs and policies to optimize health and well-being among women and children in the US. The recommendations address ensuring access, transforming health care, and addressing social and environmental determinants.


Subject(s)
COVID-19/epidemiology , Child Health , Healthcare Disparities , Maternal-Child Health Services/standards , Child , Female , Health Services Accessibility , Humans , United States
8.
J Vasc Surg Venous Lymphat Disord ; 9(4): 835-844.e4, 2021 07.
Article in English | MEDLINE | ID: covidwho-969659

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with abnormal inflammatory and coagulation markers, potentially mediating thrombotic events. Our objective was to investigate the incidence, time course, laboratory features, and in-hospital outcomes of COVID-19 patients with suspected venous thromboembolism (VTE). METHODS: A retrospective observational cohort study was conducted of patients hospitalized with COVID-19 who had undergone ultrasound imaging for suspected VTE from March 13 to May 18, 2020. The medical records of the included patients were reviewed for D-dimer, fibrinogen, prothrombin time, partial thromboplastin time, platelet count, C-reactive protein (CRP), and high-sensitivity troponin T at admission and at up to seven time points before and after ultrasound examination. The clinical outcomes included superficial venous thrombosis, deep vein thrombosis, pulmonary embolism, intubation, and death. Mixed effects logistic, linear, and Cox proportional hazards methods were used to evaluate the relationships between the laboratory markers and VTE and other in-hospital outcomes. RESULTS: Of 138 patients who had undergone imaging studies, 44 (31.9%) had evidence of VTE. On univariable analysis, an elevated admission CRP (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01-1.09; P = .02; per 10-U increase in CRP), platelet count (OR, 1.48; 95% CI, 1.04-2.12; P = .03; per 1000-U increase in platelet count), and male sex (OR, 2.64; 95% CI, 1.19-5.84; P = .02), were associated with VTE. However only male sex remained significant on multivariable analysis (OR, 2.37; 95% CI, 1.01-5.56; P = .048). The independent predictors of death included older age (hazard ratio [HR], 1.04; 95% CI, 1.00-1.07; P = .04), active malignancy (HR, 4.39; 95% CI, 1.39-13.91; P = .01), elevated admission D-dimer (HR, 1.016; 95% CI, 1.003-1.029; P = .02), and evidence of disseminated intravascular coagulation (HR, 4.81; 95% CI, 1.76-13.10; P = .002). CONCLUSIONS: Male sex, elevated CRP, and elevated platelet count at admission were associated with VTE on univariable analysis. However, only male sex remained significant on multivariable analysis. Older age, active malignancy, disseminated intravascular coagulation, and elevated D-dimer at admission were independently associated with death for patients hospitalized with COVID-19.


Subject(s)
COVID-19/complications , Venous Thromboembolism/etiology , Venous Thrombosis/etiology , Adult , Aged , Biomarkers/blood , C-Reactive Protein/metabolism , COVID-19/therapy , Female , Humans , Inflammation/diagnosis , Inflammation/etiology , Length of Stay , Male , Middle Aged , Platelet Count , Pulmonary Embolism/etiology , Respiration, Artificial , Retrospective Studies , Risk Factors , SARS-CoV-2 , Sex Factors , Treatment Outcome , Venous Thromboembolism/diagnosis , Venous Thrombosis/diagnosis
9.
Journal of Infectious Diseases ; 222(Supplement_1):S20-S30, 2020.
Article in English | MEDLINE | ID: covidwho-662390

ABSTRACT

BACKGROUND: Reproductive aging may contribute to cardiometabolic comorbid conditions. We integrated data on gynecologic history with levels of an ovarian reserve marker (anti-müllerian hormone [AMH)] to interrogate reproductive aging patterns and associated factors among a subset of cisgender women with human immunodeficiency virus (WWH) enrolled in the REPRIEVE trial. METHODS: A total of 1449 WWH were classified as premenopausal (n = 482) (menses within 12 months;AMH level ≥20 pg/mL;group 1), premenopausal with reduced ovarian reserve (n = 224) (menses within 12 months;AMH <20 pg/mL;group 2), or postmenopausal (n = 743) (no menses within12 months;AMH <20 pg/mL;group 3). Proportional odds models, adjusted for chronologic age, were used to investigate associations of cardiometabolic and demographic parameters with reproductive aging milestones (AMH <20 pg/mL or >12 months of amenorrhea). Excluding WWH with surgical menopause, age at final menstrual period was summarized for postmenopausal WWH (group 3) and estimated among all WWH (groups 1-3) using an accelerated failure-time model. RESULTS: Cardiometabolic and demographic parameters associated with advanced reproductive age (controlling for chronologic age) included waist circumference (>88 vs ≤88 cm) (odds ratio [OR], 1.38;95% confidence interval, 1.06-1.80;P = .02), hemoglobin (≥12 vs <12 g/dL) (2.32;1.71-3.14;P <.01), and region of residence (sub-Saharan Africa [1.50;1.07-2.11;P = .02] and Latin America and the Caribbean [1.59;1.08-2.33;P = .02], as compared with World Health Organization Global Burden of Disease high-income regions). The median age (Q1, Q3) at the final menstrual period was 48 (45, 51) years when described among postmenopausal WWH, and either 49 (46, 52) or 50 (47, 53) years when estimated among all WWH, depending on censoring strategy. CONCLUSIONS: Among WWH in the REPRIEVE trial, more advanced reproductive age is associated with metabolic dysregulation and region of residence. Additional research on age at menopause among WWH is needed. CLINICAL TRIALS REGISTRATION: NCT0234429.

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