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2.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329321

ABSTRACT

Background: There has been a significant disparity in familiarity regarding the public interest in gastroenterology terminologies during the COVID-19 pandemic. This study aimed to understand how the public’s view on gastrointestinal topics changed throughout the pandemic. Methods A comparative analysis of American Google search volume trends of gastrointestinal terminology in the first six seasons (March 1, 2018, to August 31, 2021) of the COVID-19 pandemic was used as the basis of this infodemiology study. Then, data were compared to a similar time frame (March 2018-February 2020) to determine how trends in the patient-seeking behavior of gastrointestinal terminology changed during the pandemic. Results The analysis discovered a substantial decrease in search volumes of gastrointestinal topics, more significantly in the first pandemic months. As the months progressed, search volumes appeared to trend toward pre-pandemic years in terms of public interest and, in the case of procedures, surpassed pre-pandemic interest levels. Conclusion The public’s decreased interest in gastrointestinal topics at the beginning of the COVID-19 pandemic may have adverse effects on the health care maintenance of patients who could have had a positive outcome in their gastrointestinal health with proper monitoring. Although gastrointestinal internet searches increased toward pre-pandemic levels as the seasons progressed, further research is needed to determine the long-term impact of decreased public interest.

5.
J Clin Neurosci ; 97: 21-24, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1611872

ABSTRACT

There is minimal information on COVID-19 pandemic's national impact on pediatric neurosurgical operative volumes. In this study, using a national database, TriNetX, we compared the overall and seasonal trends of pediatric neurosurgical procedure volumes in the United States during the pandemic to pre-pandemic periods. In the United States, the incidence of COVID-19 began to rise in September 2020 and reached its maximum peak between December 2020 and January 2021. During this time, there was an inverse relationship between pediatric neurosurgical operative volumes and the incidence of COVID-19 cases. From March 2020 to May 2021, there was a significant decrease in the number of pediatric shunt (-11.7% mean change, p = 0.006), epilepsy (-16.6%, p < 0.001), and neurosurgical trauma (-13.8%, p < 0.001) surgeries compared to pre-pandemic years. The seasonal analysis also yielded a broad decrease in most subcategories in spring 2020 with significant decreases in pediatric spine, epilepsy, and trauma cases. To the best of our knowledge, this is the first study to report a national decline in pediatric shunt, epilepsy, and neurosurgical trauma operative volumes during the pandemic. This could be due to fear-related changes in health-seeking behavior as well as underdiagnosis during the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Child , Humans , Neurosurgical Procedures , SARS-CoV-2 , Spine , United States/epidemiology
6.
Clin Rheumatol ; 41(1): 317-319, 2022 01.
Article in English | MEDLINE | ID: covidwho-1607031
7.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS ; 2021.
Article in English | EuropePMC | ID: covidwho-1564516

ABSTRACT

Introduction This study aims to define the impact that the novel Coronavirus Disease 2019 (COVID-19) pandemic has had on the volume of common plastic and reconstructive procedures. Methods TrinetX is a national, federated database that was utilitzed in surveying plastic and reconstructive procedural volumes among 53 Healthcare organizations (HCO) between March 2018 and May 2021. This timeframe was divided into pre-pandemic (March 2018 to February 2020) and pandemic periods (March 2020 to May 2021). Each period was then sub-divided into the four seasons of the year and mean monthly procedural volume per HCO was compared. A student's t-tests comparing pre-pandemic and pandemic seasonal mean procedural volumes were used for statistical analysis. Results A total of 366,032 patient encounters among 53 HCO were included. The average seasonal volume per HCO of all procedures decreased from 872.11 procedures during pre-pandemic seasons to 827.36 during pandemic seasons. Spring 2020 volumes declined for most procedures as 15 of 24 (63%) assessed procedure categories experienced statistically significant decreases. Spring 2021 experienced rebounds with 15 of 24 (63%) assessed procedures showing statistically significant increases. Conclusion During the pandemic period, the average procedural volume per HCO of 14 procedure categories was significantly less than the pre-pandemic average procedural volume. As a whole, there was a inverse relationship between new United States COVID-19 cases and plastic and reconstructive surgery procedure volumes.

8.
J Plast Reconstr Aesthet Surg ; 2021 Dec 03.
Article in English | MEDLINE | ID: covidwho-1556384

ABSTRACT

INTRODUCTION: This study aims to define the impact of the novel Coronavirus Disease 2019 (COVID-19) pandemic on the volume of common plastic and reconstructive procedures in the United States. METHODS: TrinetX is a national, federated database that was utilized in surveying plastic and reconstructive procedural volumes among 53 Healthcare organizations (HCO) between March 2018 and May 2021. This timeframe was divided into pre-pandemic (March 2018 to February 2020) and pandemic periods (March 2020 to May 2021). Each period was then sub-divided into four seasons of the year and the mean monthly procedural volume per HCO was compared. A student's t-tests comparing pre-pandemic and pandemic seasonal mean procedural volumes were used for statistical analysis. RESULTS: A total of 366,032 patient encounters among 53 HCO were included. The average seasonal volume per HCO of all procedures reduced from 872.11 procedures during pre-pandemic seasons to 827.36 during pandemic seasons. Spring 2020 vol declined for most procedures as 15 of 24 (63%) assessed procedure categories experienced statistically significant decreases. Spring 2021 experienced rebounds with 15 of 24 (63%) assessed procedures showing statistically significant increases. CONCLUSION: During the pandemic period, the average procedural volume per HCO of 14 procedure categories was significantly less than the pre-pandemic average procedural volume. Overall, an inverse relationship was observed between novel COVID-19 cases and plastic and reconstructive surgery procedure volumes in the United States.

9.
Clin Rheumatol ; 41(3): 721-730, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1536315

ABSTRACT

INTRODUCTION: The outcomes of COVID-19 in patients with axial spondyloarthritis (ax-SpA) have not been explored in detail. Tumour necrosis factor inhibitors (TNFi) are commonly used for ax-SpA patients, and how they influence outcomes may have implications on COVID-19 management. METHODS: A nationwide multi-centric research network was queried for patients with ax-SpA, including ankylosing spondylitis (AS) and non-radiographic SpA (nr-SpA) who had developed COVID-19. An equal number of propensity score(PS) matched controls were extracted from the database amongst patients with COVID-19 who did not have any inflammatory arthritis. Outcomes included mortality and others including hospitalization, intensive care unit, ventilation, acute kidney injury (AKI), renal replacement therapy, acute respiratory distress syndrome, cerebral infarction, venous thromboembolism (VTE), and sepsis. RESULTS: We identified 9766 patients with ax-SpA (924 AS and 8842 nr-SpA) and 691,862 without SpA who had COVID-19. In the unmatched comparison, patients with ax-SpA had higher risk ratios (RR) for all outcomes. After matching for demographics and comorbidities, patients with ax-SpA had lower RR for mortality [RR: 0.707 (95% CI: 0.598-0.836), p < 0.0001], severe COVID-19 [RR: 0.791 (0.69-0.906), p = 0.0007], hospitalization [RR: 0.872 (0.826-0.921), p < 0.0001], and AKI [RR: 0.902 (0.816-0.997), p = 0.044]. Only the risk of VTE was higher in ax-SpA patients [RR: 1.219 (1.037-1.433), p = 0.016]. Amongst the ax-SpA group, males had worse outcomes in 9 out of the 11 domains except for VTE and cerebral infarction, while blacks had worse outcomes in all except for mortality and the need for renal replacement therapy. AS had similar risk ratios for all outcomes compared with nr-SpA except hospitalization [RR: 1.457 (1.03-2.06), p = 0.0318]. There was no difference in outcomes in patients who had received TNFi in the year previous to COVID-19 infection. Ax-SpA patients who had been prescribed non-steroidal anti-inflammatory drugs in the 3 months prior to COVID-19 had poorer outcomes. CONCLUSION: In conclusion, COVID-19 outcomes were better in patients with ax-SpA as compared with PS matched controls except for increased risk for VTE. The use of TNFi is not associated with better or worse outcomes. These apparently protective effects observed need to be validated and explored further. Key Points • Patients with axial spondyloarthritis have lower mortality and morbidity during COVID-19 infections as compared with propensity score matched controls. • Axial spondyloarthritis is associated with higher risks for venous thromboembolism during COVID-19. • There is no difference in outcomes between ankylosing spondylitis and non-radiographic spondyloarthritis except in rates of hospitalization, which were higher in ankylosing spondylitis. • Use of tumour necrosis factor inhibitors did not influence COVID-19 outcomes.


Subject(s)
COVID-19 , Spondylarthritis , Spondylitis, Ankylosing , Humans , Male , Propensity Score , SARS-CoV-2 , Spondylarthritis/drug therapy , Spondylitis, Ankylosing/drug therapy
10.
J Autoimmun ; 125: 102730, 2021 12.
Article in English | MEDLINE | ID: covidwho-1458772

ABSTRACT

OBJECTIVES: To determine the severity and outcome of COVID-19 among individuals with lupus as compared to controls. The secondary objective was to identify the risk association of sex, race, presence of nephritis, and use of various immunomodulators with COVID-19 outcomes. METHODS: Retrospective data of individuals with lupus with and without COVID-19 between January 2020 to May 2021 was retrieved from the TriNetX. A one-to-one matched COVID-19 positive control was selected using propensity score(PS) matching. We assessed several outcomes, including all-cause mortality, hospitalisation, intensive care unit (ICU) admission, mechanical ventilation, severe COVID, acute kidney injury (AKI), Haemodialysis, acute respiratory distress syndrome (ARDS), ischemic stroke, venous thromboembolism (VTE) and sepsis were assessed. RESULTS: We identified 2140 SLE patients with COVID-19, 29,853 SLE without COVID-19 and 732,291controls. Mortality within 30 days of COVID-19 diagnosis was comparable among SLE and controls [RR-1.26; 95%CI-0.85,1.8]. SLE with COVID-19 had a higher risk of hospitalisation [RR-1.28; 95% CI 1.14-1.44], ICU admission [RR-1.35; 95% CI 1.01-1.83], mechanical ventilation [RR- 1.58 95% CI 1.07-2.33], stroke [RR-2.18; 95% CI 1.32,3.60], VTE [RR-2.22; 95% CI 1.57-03.12] and sepsis [RR-1.37; 95% CI 1.06-1.78].Individuals with SLE who contracted COVID-19 had higher mortality, hospitalisation, ICU admission, mechanical ventilation, AKI, VTE and sepsis (p < 0.001) compared to SLE without COVID-19. Males with SLE had a higher risk of AKI [RR-2.05; 95% CI 1.27-3.31] than females. Lupus nephritis was associated with higher risk of hospitalisation [RR-1.36; 95% CI 1.05-1.76], AKI [RR-2.32; 95% CI 1.50-3.59] and sepsis [RR-2.07; 95% CI-1.12-3.83]. CONCLUSION: The mortality of individuals with SLE due to COVID-19 is comparable to the general population but with higher risks of hospitalisation, ICU admission, mechanical ventilation, stroke, VTE and sepsis. The presence of nephritis increases the risk of AKI, thus probably increasing hospitalisation and sepsis.


Subject(s)
COVID-19/mortality , COVID-19/pathology , Critical Care/statistics & numerical data , Lupus Erythematosus, Systemic/pathology , Lupus Nephritis/epidemiology , Acute Kidney Injury/epidemiology , COVID-19/complications , Female , Hospitalization/statistics & numerical data , Humans , Lupus Erythematosus, Systemic/complications , Male , Middle Aged , Propensity Score , Respiration, Artificial/statistics & numerical data , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , Stroke/epidemiology , Treatment Outcome , Venous Thromboembolism/epidemiology
11.
Cureus ; 13(8): e17207, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1372148

ABSTRACT

Purpose To assess national internet search trends/public interest in refractive diseases and treatments during the first year of the COVID-19 pandemic. Methods A Google Trends search for refractive terms was performed during the first year of the COVID-19 pandemic. Refractive terms were divided into disease and treatment terms. Relative search volume (RSV) indices were assessed in the United States from the initial lockdown period (March 1 - June 28), summer reopening period (July 5 - November 1), and winter case surge/vaccine rollout period (November 8 - February 28). A t-test of two independent samples assuming unequal variances was utilized in comparing the pandemic year to pooled data of overlapping weeks between 2016-2019.  Results The majority of disease and treatment terms showed a significant decrease in RSV during the initial lockdown period (p<0.05). There was a significant increase in RSV for cataract, astigmatism, cataract surgery, and photorefractive keratotomy (PRK) (p<0.05), accompanied by a significant decrease in RSV for contact lens during the summer reopening period. There was a significant increase in RSV for cataract, astigmatism, glasses, and PRK, accompanied by a significant decrease in RSV for hyperopia, keratoconus, contact lens, and LASIK during the winter case surge/vaccine rollout period.  Conclusion There was a significant decrease in the public interest in refractive diseases and treatments during the lockdown period, accompanied by an increase in interest later in the year. Decreased public interest can lead to delays in care, poorer health literacy, and potentially worse outcomes. Strategies to enhance public interest and care during the pandemic may prove to be beneficial.

12.
Environ Sci Pollut Res Int ; 29(4): 5771-5776, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1368514

ABSTRACT

An important gap of knowledge exists regarding the public interest in hepato-pancreato-biliary (HPB) diseases during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to understand the public interest in HPB diseases in the COVID-19 era. In this infodemiology study, we performed a comparative analysis of Google search volume of HPB terms in 2020-2021 and compared it to a similar time frame (2016-2019) in 3 periods to assess how trends in patient seeking behavior of HPB terms changed during the course of the pandemic in the USA and worldwide. Our analysis showed a substantial decrease in search volume of HPB diseases and procedure terms early in the pandemic. However, search volumes appeared to revert back to pre-pandemic years closer to the 1-year mark in USA and worldwide. Patients may have initially neglected HPB-related issues during the early phase of the COVID-19 pandemic, which could lead to worse outcomes. While HPB-related terms reverted closer to pre-pandemic levels later in the pandemic, further research is needed to assess the long-term impacts.


Subject(s)
COVID-19 , Humans , Pandemics , SARS-CoV-2
13.
Semin Arthritis Rheum ; 51(5): 1057-1066, 2021 10.
Article in English | MEDLINE | ID: covidwho-1364468

ABSTRACT

OBJECTIVES: To investigate outcomes of Coronavirus Disease-2019 (COVID-19) in patients with rheumatoid arthritis (RA) as compared to the general population. Additionally, outcomes were explored among RA patients stratified by sex, race, and medications use through sub-cohort analyses. METHODS: This comparative cohort study used a US multicenter research network (TriNetX) to extract data on all adult RA patients who were diagnosed with COVID-19, and adults without RA who were diagnosed with COVID-19 (comparative cohort) anytime from January 20, 2020 to April 11, 2021. COVID-19 outcomes were assessed within 30 days after its diagnosis. Baseline characteristics that included demographics and comorbidities were controlled in propensity score matching. RESULTS: A total of 9730 RA patients with COVID-19 and 656,979 non-RA with COVID-19 were identified. Before matching, the risk of all outcomes including mortality (RR: 2.11, 95%CI: 1.90 to 2.34), hospitalization (RR: 1.60, 1.55 to 1.66), intensive care unit-ICU admission (RR: 1.86, 1.71 to 2.05), mechanical ventilation (RR: 1.62, 1.44 to 1.82), severe COVID-19 (RR: 1.89, 1.74 to 2.06), acute kidney injury (RR: 2.13, 1.99 to 2.29), kidney replacement therapy/hemodialysis (RR: 1.40, 1.03 to 1.89), acute respiratory distress syndrome-ARDS (RR: 1.76, 1.53 to 2.02), ischemic stroke (RR: 2.62, 2.24 to 3.07), venous thromboembolism-VTE (RR: 2.30, 2.07 to 2.56), and sepsis (RR: 1.97, 1.81 to 2.13) was higher in RA compared to non-RA. After matching, the risks did not differ in both cohorts except for VTE (RR: 1.18, 1.01 to 1.38) and sepsis (RR: 1.27, 1.12 to 1.43), which were higher in the RA cohort. Male sex, black race, and glucocorticoid use increased the risk of adverse outcomes. The risk of hospitalization was higher in rituximab or interleukin 6 inhibitors (IL-6i) users compared to tumor necrosis factor inhibitors (TNFi) users, with no significant difference between Janus kinase inhibitors (JAKi) or abatacept users and TNFi users. CONCLUSION: This large cohort study of RA-COVID-19 found that the risk of all outcomes was higher in the RA compared to the non-RA cohort before matching, with no difference in the majority of outcomes after matching, implying the risk being attributed to adjusted factors. However, the risk of VTE and sepsis was higher in RA cohort even after matching, indicating RA as an independent risk factor. Male sex, black race, and glucocorticoid use were associated with adverse outcomes in RA with COVID-19. Rituximab or IL-6i users were associated with an increased risk of hospitalization compared to TNFi users.


Subject(s)
Antirheumatic Agents , Arthritis, Rheumatoid , COVID-19 , Adult , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Cohort Studies , Humans , Male , SARS-CoV-2 , Tumor Necrosis Factor Inhibitors , United States/epidemiology
18.
Clin Rheumatol ; 40(5): 2047-2055, 2021 May.
Article in English | MEDLINE | ID: covidwho-898035

ABSTRACT

INTRODUCTION/OBJECTIVE: The general public may utilize online information through search engines for implications and risks of some anti-rheumatic drugs. These drugs have been used in the management of coronavirus disease 2019 (COVID-19) and associated inflammatory sequelae or cytokine storm of infection. Therefore, the objective of this study was to investigate the population-level interest in anti-rheumatic drugs during the COVID-19 era, by analyzing changes in Google search frequency data. METHOD: To obtain the relative search volume (RSV) of anti-rheumatic drugs, we queried Google Trends for 78 search terms representing non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, antigout agents, conventional disease-modifying anti-rheumatic drugs (DMARDs), immunosuppressants, biologics, and Janus kinase (JAK) inhibitors within the USA. Three 8-week periods in 2020 (March 15-May 9), (May 10-July 4), and (July 5-August 29) representing the initial- and short-term periods were compared to overlapping periods of the preceding 3 years (2017-2019). RESULTS: We found statistically significant increases in RSV for colchicine, hydroxychloroquine, tocilizumab (and its brand name-Actemra), and anakinra, and statistically significant decreases among brand names of immunosuppressive agents (i.e., mycophenolate mofetil, azathioprine, cyclophosphamide, tacrolimus, cyclosporine) during both the initial- and short-term COVID-19 periods as compared to overlapping periods of the preceding 3 years. CONCLUSION: There were significant increases in RSV of colchicine, hydroxychloroquine, tocilizumab, and anakinra during both initial- and short-term COVID-19 periods when compared to overlapping periods of the preceding 3 years reflecting a heightened level of information-seeking on these drugs during the pandemic. Rheumatologists should address this increase in informational demand. Further research assessing medium- and long-term interest in anti-rheumatic drugs is required to increase our knowledge on this new pandemic. Key Points •This study was aimed to investigate the population-level interest in anti-rheumatic drugs in the COVID-19 era, by analyzing changes in Google search frequency data. •Significant increases were seen in relative searches for colchicine, hydroxychloroquine, tocilizumab, and anakinra during both initial and short-term COVID-19 periods when compared to similar periods of 2017-2019 reflecting a heightened level of information-seeking on these drugs during the pandemic. •Rheumatologists should address this increase in informational demand for colchicine, hydroxychloroquine, tocilizumab, and anakinra.


Subject(s)
Antirheumatic Agents , COVID-19 , Antirheumatic Agents/therapeutic use , Humans , Hydroxychloroquine , Pandemics , SARS-CoV-2
19.
Rheumatol Int ; 41(2): 329-334, 2021 02.
Article in English | MEDLINE | ID: covidwho-871457

ABSTRACT

To evaluate the public interest in rheumatic diseases during the coronavirus disease 2019 (COVID-19) pandemic. Google Trends was queried to analyze search trends in the United States for numerous rheumatic diseases and also the interest in a rheumatologist. Three 8-week periods in 2020 ((March 15-May 9), (May 10-July 4), and (July 5-August 29)) were compared to similar periods of the prior 4 years (2016-2019). Compared to a similar time period between 2016 and 2019, a significant decrease was found in the relative search volume for more than half of the search terms during the initial March 15-May 9, 2020 period. However, this trend appeared to reverse during the July 5-August 29, 2020 period where the relative volume for nearly half of the search terms were not statistically significant compared to similar periods of the prior 4 years. In addition, this period showed a significant increase in relative volume for the terms: Axial spondyloarthritis, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, Sjögren's syndrome, antiphospholipid syndrome, scleroderma, Kawasaki disease, Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis, and rheumatologist. There was a significant decrease in relative search volume for many rheumatic diseases between March 15 and May 9, 2020 when compared to similar periods during the prior 4 years. However, the trends reversed after the initial period ended. There was an increase in relative search for the term "rheumatologist" between July and August 2020 suggesting the need for rheumatologists during the COVID-19 pandemic. Policymakers and healthcare providers should address the informational demands on rheumatic diseases and needs for rheumatologists by the general public during pandemics like COVID-19.


Subject(s)
Information Seeking Behavior , Internet Use/statistics & numerical data , Rheumatic Diseases/psychology , Rheumatology/statistics & numerical data , COVID-19 , Humans , Pandemics , SARS-CoV-2 , Search Engine
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