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1.
Int J Public Health ; 68: 1605839, 2023.
Article in English | MEDLINE | ID: covidwho-20241630

ABSTRACT

Objectives: To provide a thorough assessment of the impact of the COVID-19 pandemic on the utilization of inpatient and outpatient mental healthcare in Switzerland. Methods: Retrospective cohort study using nationwide hospital data (n > 8 million) and claims data from a large Swiss health insurer (n > 1 million) in 2018-2020. Incidence proportions of different types of psychiatric inpatient admissions, psychiatric consultations, and psychotropic medication claims were analyzed using interrupted time series models for the general population and for the vulnerable subgroup of young people. Results: Inpatient psychiatric admissions in the general population decreased by 16.2% (95% confidence interval: -19.2% to -13.2%) during the first and by 3.9% (-6.7% to -0.2%) during the second pandemic shutdown, whereas outpatient mental healthcare utilization was not substantially affected. We observed distinct patterns for young people, most strikingly, an increase in mental healthcare utilization among females aged <20 years. Conclusion: Mental healthcare provision for the majority of the population was largely maintained, but special attention should be paid to young people. Our findings highlight the importance of monitoring mental healthcare utilization among different populations.


Subject(s)
COVID-19 , Mental Health Services , Humans , Female , Adolescent , Retrospective Studies , Switzerland/epidemiology , COVID-19/epidemiology , Pandemics
2.
Seizure ; 110: 160-168, 2023 Jun 11.
Article in English | MEDLINE | ID: covidwho-20239511

ABSTRACT

OBJECTIVE: To examine whether epilepsy-related deaths increased during the COVID-19 pandemic and if the proportion with COVID-19 listed as the underlying cause is different between people experiencing epilepsy-related deaths and those experiencing deaths unrelated to epilepsy. METHODS: This was a Scotland-wide, population-based, cross-sectional study of routinely-collected mortality data pertaining to March-August of 2020 (COVID-19 pandemic peak) compared to the corresponding periods in 2015-2019. ICD-10-coded causes of death of deceased people of any age were obtained from a national mortality registry of death certificates in order to identify those experiencing epilepsy-related deaths (coded G40-41), deaths with COVID-19 listed as a cause (coded U07.1-07.2), and deaths unrelated to epilepsy (death without G40-41 coded). The number of epilepsy-related deaths in 2020 were compared to the mean observed through 2015-2019 on an autoregressive integrated moving average (ARIMA) model (overall, men, women). Proportionate mortality and odds ratios (OR) for deaths with COVID-19 listed as the underlying cause were determined for the epilepsy-related deaths compared to deaths unrelated to epilepsy, reporting 95% confidence intervals (CIs). RESULTS: A mean number of 164 epilepsy-related deaths occurred through March-August of 2015-2019 (of which a mean of 71 were in women and 93 in men). There were subsequently 189 epilepsy-related deaths during the pandemic March-August 2020 (89 women, 100 men). This was 25 more epilepsy-related deaths (18 women, 7 men) compared to the mean through 2015-2019. The increase in women was beyond the mean year-to-year variation seen in 2015-2019. Proportionate mortality with COVID-19 listed as the underlying cause was similar between people experiencing epilepsy-related deaths (21/189, 11.1%, CI 7.0-16.5%) and deaths unrelated to epilepsy (3,879/27,428, 14.1%, CI 13.7-14.6%), OR 0.76 (CI 0.48-1.20). Ten of 18 excess epilepsy-related deaths in women had COVID-19 listed as an additional cause. CONCLUSIONS: There is little evidence to suggest there have been any major increases in epilepsy-related deaths in Scotland during the COVID-19 pandemic. COVID-19 is a common underlying cause of both epilepsy-related and unrelated deaths.

3.
National Tax Journal ; : 000-000, 2023.
Article in English | Web of Science | ID: covidwho-2322620

ABSTRACT

After matching more than 3 million loans from the $669 billion Paycheck Protection Program (PPP) to administrative wage records, I estimate a dynamic difference-in-difference event study showing robust impacts of the loans on employment, wages, and opening status of establishments 15 months after PPP approval. Between $12,000 and $19,000 of PPP loans are spent per employee-month retained 15 months postapproval, with 43 percent of the PPP going toward wage retention in the baseline model. The smallest employers show the largest impact, explaining disparate results from prior papers focusing on larger employers. Properly accounting for closures is key to understanding the PPP's long-term impact.

4.
JACC Adv ; 2(3): 100307, 2023 May.
Article in English | MEDLINE | ID: covidwho-2312952

ABSTRACT

Background: While men have experienced higher risks of SARS-CoV-2 infection compared to women, an analysis of sex differences by age in severe outcomes during the acute phase of infection is lacking. Objectives: The purpose of this study was to assess heterogeneity in severe outcome risks by age and sex by conducting a retrospective cohort study of community-dwelling adults in Ontario who tested positive for SARS-CoV-2 infection during the first 3 waves. Methods: Adjusted odds ratios were estimated using multilevel multivariable logistic regression models including an interaction term for age and sex. The primary outcome was a composite of severe outcomes (hospitalization for a cardiovascular (CV) event, intensive care unit admission, mechanical ventilation, or death) within 30 days. Results: Among 30,736, 199,132, and 186,131 adults who tested positive during the first 3 waves, 1,908 (6.2%), 5,437 (2.7%), and 5,653 (3.0%) experienced a severe outcome within 30 days. For all outcomes, the sex-specific risk depended on age (all P for interaction <0.05). Men with SARS-CoV-2 infection experienced a higher risk of outcomes than infected women of the same age, except for the risk of all-cause hospitalization being higher for young women than men (ages 18-45 years) during waves 2 and 3. The sex disparity in CV hospitalization across all ages either persisted or increased with each subsequent wave. Conclusions: To mitigate risks in subsequent waves, it is helpful to further understand the factors that contribute to the generally higher risks faced by men across all ages, and the persistent or increasing sex disparity in the risk of CV hospitalization.

5.
International Workshops on EDBA, ML4PM, RPM, PODS4H, SA4PM, PQMI, EduPM, and DQT-PM, held at the International Conference on Process Mining, ICPM 2022 ; 468 LNBIP:315-327, 2023.
Article in English | Scopus | ID: covidwho-2292144

ABSTRACT

The discipline of process mining has a solid track record of successful applications to the healthcare domain. Within such research space, we conducted a case study related to the Intensive Care Unit (ICU) ward of the Uniklinik Aachen hospital in Germany. The aim of this work is twofold: developing a normative model representing the clinical guidelines for the treatment of COVID-19 patients, and analyzing the adherence of the observed behavior (recorded in the information system of the hospital) to such guidelines. We show that, through conformance checking techniques, it is possible to analyze the care process for COVID-19 patients, highlighting the main deviations from the clinical guidelines. The results provide physicians with useful indications for improving the process and ensuring service quality and patient satisfaction. We share the resulting model as an open-source BPMN file. © 2023, The Author(s).

6.
Geohealth ; 7(3): e2022GH000729, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2268305

ABSTRACT

Western North America experienced an unprecedented extreme heat event (EHE) in 2021, characterized by high temperatures and reduced air quality. There were approximately 740 excess deaths during the EHE in the province of British Columbia, making it one of the deadliest weather events in Canadian history. It is important to understand who is at risk of death during EHEs so that appropriate public health interventions can be developed. This study compares 1,614 deaths from 25 June to 02 July 2021 with 6,524 deaths on the same dates from 2012 to 2020 to examine differences in the prevalence of 26 chronic diseases between the two groups. Conditional logistic regression was used to estimate the odds ratio (OR) for each chronic disease, adjusted for age, sex, and all other diseases, and conditioned on geographic area. The OR [95% confidence interval] for schizophrenia among all EHE deaths was 3.07 [2.39, 3.94], and was larger than the ORs for other conditions. Chronic kidney disease and ischemic heart disease were also significantly increased among all EHE deaths, with ORs of 1.36 [1.18, 1.56] and 1.18 [1.00, 1.38], respectively. Chronic diseases associated with EHE mortality were somewhat different for deaths attributed to extreme heat, deaths with an unknown/pending cause, and non-heat-related deaths. Schizophrenia was the only condition associated with significantly increased odds of EHE mortality in all three subgroups. These results confirm the role of mental illness in EHE risk and provide further impetus for interventions that target specific groups of high-risk individuals based on underlying chronic conditions.

7.
Urol Oncol ; 41(3): 146.e13-146.e22, 2023 03.
Article in English | MEDLINE | ID: covidwho-2272629

ABSTRACT

PURPOSE: We sought to quantify mCRPC patient treatment patterns and survival across multiple lines of therapy after prior androgen-receptor-axis-targeted therapy (ARAT) failure. METHODS: Individuals diagnosed with prostate cancer between 2010 and 2018 were identified in the Ontario Cancer Registry (OCR). An algorithm was created to identify patients with mCRPC that was aligned to Prostate Cancer Clinical Trials Working Group 3 criteria (PCWG3) and validated with Canadian clinical experts. In the mCRPC setting, treatment patterns were assessed by line of therapy, and survival was calculated from treatment initiation until death or lost to follow-up. RESULTS: 64,484 men were diagnosed withprostate cancer in Ontario between 2010 and 2018with 5,588 men assessed to have mCRPC and 2,970 (53%) of those received first-line systemic treatment. Across the first-, second- and third-line of therapy, ARATs (abiraterone and enzalutamide) were the most used therapies. Survival for mCRPC patients treated with ARATs in first-, second- and third-line were 13.0 (95% CI, 11.6 - 14.5), 11.5 (95% CI, 10.1 - 13.4) and 8.9 (95% CI, 7.4 - 10.2) months, respectively. Survival for mCRPC patients treated with taxanes in first, second- and third-line were 16.7 (95% CI, 14.8 - 18.0), 11.3 (95% CI, 10.1 - 12.5) and 7.8 (95% CI, 6.5 - 10.6) months, respectively. No statistical difference in overall survival was found between taxanes and ARATs. CONCLUSION: In this analysis of a large retrospective cohort of Canadian men with mCRPC, we found that survival in patients treated with ARATs and taxanes was fairly similar across all lines of therapy. Importantly, this trend was maintained in ARAT-exposed patients, where sequential ARAT and taxanes offered similar survival. These data may help inform optimal sequencing of therapies in mCRPC.


Subject(s)
Prostatic Neoplasms, Castration-Resistant , Male , Humans , Prostatic Neoplasms, Castration-Resistant/drug therapy , Retrospective Studies , Treatment Outcome , Ontario , Taxoids/therapeutic use
8.
Respir Investig ; 61(3): 314-320, 2023 May.
Article in English | MEDLINE | ID: covidwho-2250625

ABSTRACT

BACKGROUND: Validating the information recorded in administrative databases is essential. However, no study has comprehensively validated the accuracy of Japanese Diagnosis Procedure Combination (DPC) data on various respiratory diseases. Therefore, this study aimed to evaluate the validity of diagnoses of respiratory diseases in the DPC database. METHODS: We conducted chart reviews of 400 patients hospitalized in the departments of respiratory medicine in two acute-care hospitals in Tokyo, between April 1, 2019 and March 31, 2021, and used them as reference standards. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DPC data on 25 respiratory diseases were determined. RESULTS: Sensitivity ranged from 22.2% (aspiration pneumonia) to 100% (chronic eosinophilic pneumonia and malignant pleural mesothelioma) and was <50% for eight diseases, while specificity was >90% for all diseases. PPV ranged from 40.0% (aspiration pneumonia) to 100% (coronavirus disease 2019, bronchiectasis, chronic eosinophilic pneumonia, pulmonary hypertension, squamous cell carcinoma, small cell carcinoma, lung cancer of other histological types, and malignant pleural mesothelioma) and was >80% for 16 diseases. Except for chronic obstructive pulmonary disease (82.9%) and interstitial pneumonia (other than idiopathic pulmonary fibrosis) (85.4%), NPV was >90% for all diseases. These validity indices were similar in both hospitals. CONCLUSIONS: The validity of diagnoses of respiratory diseases in the DPC database was high in general, thereby providing an important basis for future studies.


Subject(s)
Databases, Factual , Respiratory Tract Diseases , Humans , COVID-19/diagnosis , COVID-19/epidemiology , Databases, Factual/standards , Databases, Factual/statistics & numerical data , East Asian People/statistics & numerical data , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Mesothelioma, Malignant/diagnosis , Mesothelioma, Malignant/epidemiology , Pneumonia, Aspiration/diagnosis , Pneumonia, Aspiration/epidemiology , Pulmonary Eosinophilia/diagnosis , Pulmonary Eosinophilia/epidemiology , Respiration Disorders/diagnosis , Respiration Disorders/epidemiology , Japan/epidemiology , Reproducibility of Results , Sensitivity and Specificity , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/epidemiology
10.
Front Public Health ; 10: 1028062, 2022.
Article in English | MEDLINE | ID: covidwho-2142359

ABSTRACT

Background: This study compared patient profiles and clinical courses of SARS-CoV-2 infected inpatients over different pandemic periods. Methods: In a retrospective cross-sectional analysis, we examined administrative data of German Helios hospitals using ICD-10-codes at discharge. Inpatient cases with SARS-CoV-2 infection admitted between 03/04/2020 and 07/19/2022 were included irrespective of the reason for hospitalization. All endpoints were timely assigned to admission date for trend analysis. The first pandemic wave was defined by change points in time-series of incident daily infections and compared with different later pandemic phases according to virus type predominance. Results: We included 72,459 inpatient cases. Patients hospitalized during the first pandemic wave (03/04/2020-05/05/2020; n = 1,803) were older (68.5 ± 17.2 vs. 64.4 ± 22.6 years, p < 0.01) and severe acute respiratory infections were more prevalent (85.2 vs. 53.3%, p < 0.01). No differences were observed with respect to distribution of sex, but comorbidity burden was higher in the first pandemic wave. The risk of receiving intensive care therapy was reduced in all later pandemic phases as was in-hospital mortality when compared to the first pandemic wave. Trend analysis revealed declines of mean age and Elixhauser comorbidity index over time as well as a decline of the utilization of intensive care therapy, mechanical ventilation and in-hospital mortality. Conclusion: Characteristics and outcomes of inpatients with SARS-CoV-2 infection changed throughout the observational period. An ongoing evaluation of trends and care pathways will allow for the assessment of future demands.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Inpatients , Pandemics , Cross-Sectional Studies , Retrospective Studies , SARS-CoV-2
11.
Cancers (Basel) ; 14(22)2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2115996

ABSTRACT

Cancer and obesity are well-known prognostic factors in COVID-19. Our objective was to study the effect of obesity (and its severity) on the risk of intensive care unit (ICU) admission, severe complications, and in-hospital mortality, in a population of cancer patients hospitalized with or without COVID-19. All patients hospitalized in France for cancer from 1 March 2020 to 28 February 2022 were included from the French national administrative database. The effect of obesity was estimated in COVID-19 and in non-COVID-19 cancer patients using logistic and survival regressions, taking into account age, sex, comorbidities, and different types of cancer. Among the 992,899 cancer patients, we identified 53,090 patients with COVID-19 (5.35%), of which 3260 were obese (6.1%). After adjustment, for patients with or without COVID-19, there is an increased risk of ICU admission or severe complications in obese patients, regardless of the type of obesity. Regarding in-hospital mortality, there is no excess risk associated with overall obesity. However, massive obesity appears to be associated with an increased risk of in-hospital mortality, with a significantly stronger effect in solid cancer patients without COVID-19 and a significantly stronger effect in hematological cancer patients with COVID-19. This study showed that in France, among hospitalized patients with cancer and with or without COVID-19, increased vigilance is needed for obese patients, both in epidemic and non-epidemic periods. This vigilance should be further strengthened in patients with massive obesity for whom the risk of in-hospital mortality is higher, particularly in epidemic periods for patients with hematological cancers.

12.
J Labour Mark Res ; 56(1): 18, 2022.
Article in English | MEDLINE | ID: covidwho-2118635

ABSTRACT

Establishment surveys around the globe have measured the impact of the COVID-19 pandemic on establishments' conditions and business practices. At the same time, the consequences of the pandemic, such as closures, hygiene standards, or remote work arrangements, may have also altered patterns of survey participation and introduced nonresponse bias, threatening the quality of establishment survey data. To investigate these issues, this article examines fieldwork outcomes, nonresponse bias, and predictors of survey participation in the IAB-Job Vacancy Survey. As comparisons with previous survey years show, it became more difficult to successfully interview establishments during the COVID-19 pandemic. Using linked administrative data, we show that nonresponse bias was higher in 2020 compared to previous years, even after applying the standard weighting adjustment. However, general patterns of survey participation in 2020 were similar to previous years and COVID-19 related measures were not strong predictors of survey participation in 2020. Further, we provide evidence that nonresponse bias during the pandemic can be reduced by incorporating additional administrative variables into the weighting procedure relative to the standard weighting variables. We conclude this article with a discussion of the findings and implications for survey practitioners. Supplementary Information: The online version contains supplementary material available at 10.1186/s12651-022-00321-8.

13.
Statistical Journal of the IAOS ; : 1-7, 2022.
Article in English | Academic Search Complete | ID: covidwho-2089737

ABSTRACT

This paper presents the statistical contingency plan for the 2021 Canadian Census of Population, developed in response to the COVID-19 pandemic, wherein administrative data was to impute non-responding households in areas with a low response rate and where the administrative data were of sufficient quality. We describe the modeling approach for predicting the quality of data available for administrative households, including important extensions to existing approaches. As well, we provide a framework for evaluating direct imputation using administrative data, relative to traditional donor imputation, in the absence of a simulation study. We conclude by discussing the evaluation using preliminary data and subsequent implementation for the 2021 Canadian Census of Population. [ FROM AUTHOR]

14.
Journal of Gender-Based Violence ; 6(2):383-392, 2022.
Article in English | Scopus | ID: covidwho-1951485

ABSTRACT

COVID-19 quickly changed the context of domestic abuse in England. Within weeks of the first COVID-19 related death, the country was in lockdown. A quick response was essential for understanding the needs of survivors. With limited time to establish new data collection mechanisms, the role of administrative data was central in shaping the response by the Women’s Aid Federation of England. This article explores the opportunities and challenges of using administrative data to understand and respond to the impact of COVID-19 on survivors of domestic abuse in England, using analysis by Women’s Aid of administrative data as a case study. The article discusses the challenges, such as the complexity of analysing a longitudinal administrative dataset, and the need for increased skills and capacity within the NGO research environment. We also reflect on ethical considerations in light of the context of frontline workers responding to the pandemic, the opportunities for collaboration with other sector partners and academics and the benefits of being able to undertake reactive analysis to inform policy. The article concludes that our access to administrative data bolstered our ability to respond expediently to the pandemic, and achieve the long-term benefits of the partnerships that we built during this time. © Centre for Gender and Violence Research.

15.
Journal of African Economies ; : 30, 2022.
Article in English | Web of Science | ID: covidwho-1816135

ABSTRACT

There are substantial differences in the spread of the covid-19 pandemic and policy responses to it between high- and low-income countries. While evidence on the former is growing, there remain more unanswered questions on the latter. This paper addresses this gap by providing insights on the impact of the pandemic in Rwanda, based on firm-level administrative data from Value Added Tax (VAT) returns. We find that VAT sales in 2020 declined by 11.4 % compared to 2019. These losses are particularly associated with a lockdown imposed around April 2020, after which sales quickly rebounded to pre-crisis levels once restrictions were lifted. In absolute terms, the economic cost is concentrated among the largest firms. However, small firms have been most affected in proportional terms. Disaggregating our results further, we show that firms in accommodation and food, transport services, wholesale and retail trade, as well as those registered in the capital, have been particularly affected by the crisis. Overall, the decline in sales translated to a similarly large percentage loss in VAT revenue for the government.

16.
Journal of Agricultural Economics ; : 20, 2021.
Article in English | Web of Science | ID: covidwho-1583723

ABSTRACT

A rapidly growing literature examines the impacts of COVID-19 on consumer spending and business operations. However, little is yet known about its effects on the food industry. We contribute to this topic by quantifying the effects of COVID-19 on the Taiwanese food industry, including food manufacturing, wholesale, retail and service sectors. Using administrative data on the business transactions of food industry firms in Taiwan with a difference-in-differences model, we find that COVID-19 reduced the total sales value of the food industry by 24%. However, the negative effects are unequally distributed among different sectors of the food industry. The negative effect is more pronounced in the food manufacturing sector. We also find a substantial impact in urban areas, high-income areas and areas with a larger proportion of elderly population. Compared to most of the countries that implemented mandatory lockdowns to cope with COVID-19, Taiwan maintained good control over the pandemic in 2020. The mobility of Taiwanese residents is much higher than those of other countries with severe infection rates. However, we show that there are still significant economic impacts on the food industry in Taiwan.

17.
Clin Cardiol ; 45(1): 75-82, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1589152

ABSTRACT

BACKGROUND: Reduced hospital admission rates for heart failure (HF) and evidence of increased in-hospital mortality were reported during the COVID-19 pandemic. The aim of this study was to apply a machine learning (ML)-based mortality prediction model to examine whether the latter is attributable to differing case mixes and exceeds expected mortality rates. METHODS AND RESULTS: Inpatient cases with a primary discharge diagnosis of HF non-electively admitted to 86 German Helios hospitals between 01/01/2016 and 08/31/2020 were identified. Patients with proven or suspected SARS-CoV-2 infection were excluded. ML-based models were developed, tuned, and tested using cases of 2016-2018 (n = 64,440; randomly split 75%/25%). Extreme gradient boosting showed the best model performance indicated by a receiver operating characteristic area under the curve of 0.882 (95% confidence interval [CI]: 0.872-0.893). The model was applied on data sets of 2019 and 2020 (n = 28,556 cases) and the hospital standardized mortality ratio (HSMR) was computed as the observed to expected death ratio. Observed mortality rates were 5.84% (2019) and 6.21% (2020), HSMRs based on an individual case-based mortality probability were 100.0 (95% CI: 93.3-107.2; p = 1.000) for 2019 and 99.3 (95% CI: 92.5-106.4; p = .850) for 2020. Within subgroups of age or hospital volume, there were no significant differences between observed and expected deaths. When stratified for pandemic phases, no excess death during the COVID-19 pandemic was observed. CONCLUSION: Applying an ML algorithm to calculate expected inpatient mortality based on administrative data, there was no excess death above expected event rates in HF patients during the COVID-19 pandemic.


Subject(s)
COVID-19 , Heart Failure , Heart Failure/diagnosis , Hospital Mortality , Hospitals , Humans , Machine Learning , Pandemics , SARS-CoV-2
18.
Cancers (Basel) ; 13(24)2021 Dec 14.
Article in English | MEDLINE | ID: covidwho-1572372

ABSTRACT

Few studies have investigated the link between SARS-CoV-2 and health restrictions and its effects on the health of lung cancer (LC) patients. The aim of this study was to assess the impact of the SARS-CoV-2 epidemic on surgical activity volume, postoperative complications and in-hospital mortality (IHM) for LC resections in France. All data for adult patients who underwent pulmonary resection for LC in France in 2020, collected from the national administrative database, were compared to 2018-2019. The effect of SARS-CoV-2 on the risk of IHM and severe complications within 30 days among LC surgery patients was examined using a logistic regression analysis adjusted for age, sex, comorbidities and type of resection. There was a slight decrease in the volume of LC resections in 2020 (n = 11,634), as compared to 2018 (n = 12,153) and 2019 (n = 12,227), with a noticeable decrease in April 2020 (the peak of the first wave of epidemic in France). We found that SARS-CoV-2 (0.43% of 2020 resections) was associated with IHM and severe complications, with, respectively, a sevenfold (aOR = 7.17 (3.30-15.55)) and almost a fivefold (aOR = 4.76 (2.31-9.80)) increase in risk. Our study suggests that LC surgery is feasible even during a pandemic, provided that general guidance protocols edited by the surgical societies are respected.

19.
Respir Res ; 22(1): 298, 2021 Nov 20.
Article in English | MEDLINE | ID: covidwho-1526637

ABSTRACT

BACKGROUND: This study assessed the impact of the COVID-19 epidemic on overall hospitalizations for pulmonary embolism (PE) in France in comparison with previous years, and by COVID-19 and non-COVID-19 status. METHODS: Hospitalization data (2017-2020) were extracted from the French National Discharge database (all public and private hospitals). We included all patients older than 18 years hospitalized during the 3 years and extracted PE status and COVID-19 status (from March 2020). Age, sex and risk factors for PE (such as obesity, cancer) were identified. We also extracted transfer to an intensive care unit (ICU) and hospital death. The number of PE and the frequency of death in patients in 2019 and 2020 were described by month and by COVID-19 status. Logistic regressions were performed to identify the role of COVID-19 among other risk factors for PE in hospitalized patients. RESULTS: The overall number of patients hospitalized with PE increased by about 16% in 2020 compared with 2019, and mortality also increased to 10.3% (+ 1.2%). These increases were mostly linked to COVID-19 waves, which were associated with PE hospitalization in COVID-19 patients (PE frequency was 3.7%; 2.8% in non-ICU and 8.8% in ICU). The final PE odds ratio for COVID-19 hospitalized patients was 4 compared with other hospitalized patients in 2020. The analyses of PE in non-COVID-19 patients showed a 2.7% increase in 2020 compared with the previous three years. CONCLUSION: In 2020, the overall number of patients hospitalized with PE in France increased compared to the previous three years despite a considerable decrease in scheduled hospitalizations. Nevertheless, proactive public policy focused on the prevention of PE in all patients should be encouraged.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/trends , Hospitalization/trends , Pulmonary Embolism/epidemiology , Pulmonary Embolism/therapy , Aged , Aged, 80 and over , Cohort Studies , Communicable Disease Control/methods , Female , France/epidemiology , Humans , Male , Middle Aged , Pulmonary Embolism/diagnosis , Retrospective Studies
20.
Ann Epidemiol ; 66: 5-12, 2022 02.
Article in English | MEDLINE | ID: covidwho-1509563

ABSTRACT

PURPOSE: The Veterans Health Administration (VA) is the largest single integrated healthcare system in the US and is likely the largest healthcare provider for people with minoritized sexual orientations (e.g., gay, lesbian, bisexual). The purpose of this study was to use electronic health record (EHR) data to replicate self-reported survey findings from the general US population and assess whether sexual orientation is associated with diagnosed physical health conditions that may elevate risk of COVID-19 severity among veterans who utilize the VA. METHODS: A retrospective analysis of VA EHR data from January 10, 1999-January 07, 2019 analyzed in 2021. Veterans with minoritized sexual orientations were included if they had documentation of a minoritized sexual orientation within clinical notes identified via natural language processing. Veterans without minoritized sexual orientation documentation comprised the comparison group. Adjusted prevalence and prevalence ratios (aPR) were calculated overall and by race/ethnicity while accounting for differences in distributions of sex assigned at birth, age, calendar year of first VA visit, volumes of healthcare utilization, and VA priority group. RESULTS: Data from 108,401 veterans with minoritized sexual orientation and 6,511,698 controls were analyzed. After adjustment, veterans with minoritized sexual orientations had a statistically significant elevated prevalence of 10 of the 11 conditions. Amongst the highest disparities observed were COPD (aPR:1.24 [95% confidence interval:1.23-1.26]), asthma (1.22 [1.20-1.24]), and stroke (1.26 [1.24-1.28]). CONCLUSIONS: Findings largely corroborated patterns among the general US population. Further research is needed to determine if these disparities translate to poorer COVID-19 outcomes for individuals with minoritized sexual orientation.


Subject(s)
COVID-19 , Homosexuality, Female , Veterans , Bisexuality , COVID-19/epidemiology , Female , Humans , Infant, Newborn , Male , Retrospective Studies , Sexual Behavior , United States/epidemiology , United States Department of Veterans Affairs
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