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1.
Nursing ; 51(10): 42-48, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1440657

ABSTRACT

ABSTRACT: Patient safety attendants (PSAs) provide constant direct observation to patients who have cognitive impairments or thoughts. Some estimates report that an acute care hospital in the United States may spend more than $1 million annually on PSAs, an expenditure often not reimbursed. With no national defined standards to regulate or monitor PSA use, this study sought to determine the impact of COVID-19 on a PSA reduction program in a large Midwestern healthcare system.


Subject(s)
Allied Health Personnel/statistics & numerical data , COVID-19/epidemiology , Patient Safety , Allied Health Personnel/economics , Cognitive Dysfunction/nursing , Humans , Midwestern United States/epidemiology , Program Evaluation
2.
Med Care ; 59(10): 888-892, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1337299

ABSTRACT

BACKGROUND: Despite many studies reporting disparities in coronavirus disease-2019 (COVID-19) incidence and outcomes in Black and Hispanic/Latino populations, mechanisms are not fully understood to inform mitigation strategies. OBJECTIVE: The aim was to test whether neighborhood factors beyond individual patient-level factors are associated with in-hospital mortality from COVID-19. We hypothesized that the Area Deprivation Index (ADI), a neighborhood census-block-level composite measure, was associated with COVID-19 mortality independently of race, ethnicity, and other patient factors. RESEARCH DESIGN: Multicenter retrospective cohort study examining COVID-19 in-hospital mortality. SUBJECTS: Inclusion required hospitalization with positive SARS-CoV-2 test or COVID-19 diagnosis at three large Midwestern academic centers. MEASURES: The primary study outcome was COVID-19 in-hospital mortality. Patient-level predictors included age, sex, race, insurance, body mass index, comorbidities, and ventilation. Neighborhoods were examined through the national ADI neighborhood deprivation rank comparing in-hospital mortality across ADI quintiles. Analyses used multivariable logistic regression with fixed site effects. RESULTS: Among 5999 COVID-19 patients median age was 61 (interquartile range: 44-73), 48% were male, 30% Black, and 10.8% died. Among patients who died, 32% lived in the most disadvantaged quintile while 11% lived in the least disadvantaged quintile; 52% of Black, 24% of Hispanic/Latino, and 8.5% of White patients lived in the most disadvantaged neighborhoods.Living in the most disadvantaged neighborhood quintile predicted higher mortality (adjusted odds ratio: 1.74; 95% confidence interval: 1.13-2.67) independent of race. Age, male sex, Medicare coverage, and ventilation also predicted mortality. CONCLUSIONS: Neighborhood disadvantage independently predicted in-hospital COVID-19 mortality. Findings support calls to consider neighborhood measures for vaccine distribution and policies to mitigate disparities.


Subject(s)
COVID-19/epidemiology , Hospital Mortality/trends , Residence Characteristics/statistics & numerical data , Age Factors , COVID-19 Testing , Comorbidity , Humans , Insurance, Health/statistics & numerical data , Male , Middle Aged , Midwestern United States/epidemiology , Poverty/statistics & numerical data , Retrospective Studies , Sex Factors
3.
J Occup Environ Med ; 63(5): 374-380, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1301396

ABSTRACT

OBJECTIVE: Determine the industries with the highest proportion of accepted COVID-19 related workers' compensation (WC) claims. METHODS: Study included 21,336 WC claims (1898 COVID-19 and 19,438 other claims) that were filed between January 1, 2020 and August 31, 2020 from 11 states in the Midwest United States. RESULT: The overwhelming proportion of all COVID-19 related WC claims submitted and accepted were from healthcare workers (83.77%). Healthcare was the only industrial classification that was at significantly higher COVID-19 WC claim submission risk (odds ratio [OR]: 4.00; 95% confidence intervals [CI]: 2.77 to 5.79) controlling for type of employment, sex, age, and presumption of COVID-19 work-relatedness. Within healthcare employment, WC claims submitted by workers in medical laboratories had the highest risk (crude rate ratio of 8.78). CONCLUSION: Healthcare employment is associated with an increased risk of developing COVID-19 infections and submitting a workers' compensation claim.


Subject(s)
COVID-19/economics , Health Personnel/classification , Industry/classification , Occupational Diseases/economics , Workers' Compensation/statistics & numerical data , Adult , Aged , Female , Health Personnel/statistics & numerical data , Humans , Industry/statistics & numerical data , Male , Medical Laboratory Personnel/statistics & numerical data , Middle Aged , Midwestern United States/epidemiology , Odds Ratio , SARS-CoV-2
4.
Mycopathologia ; 186(4): 499-505, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1274891

ABSTRACT

Pulmonary aspergillosis has been reported at high rates in patients with coronavirus disease 2019 (COVID-19) and is associated with high morbidity and mortality. We retrospectively assessed all patients admitted to an intensive care unit during the early COVID-19 surge (3/17/20-5/10/20) at our medical center in the midwestern USA for the presence of COVID-19-associated pulmonary aspergillosis (CAPA). Patients were not routinely screened for CAPA; diagnostic work-up for fungal infections was pursued when clinically indicated. Among 256 patients admitted to the ICU with severe COVID-19, 188 (73%) were intubated and 62 (24%) ultimately expired within 30 days of admission to the ICU. Only three patients (1%) were found to have CAPA; diagnosis was made by tracheal aspirate cultures in two cases and by bronchoalveolar lavage fluid Aspergillus galactomannan in one case. None of the patients who developed CAPA had classic risk factors for invasive fungal infection. The occurrence of CAPA was much lower than that reported at other centers, likely reflecting the local epidemiology.


Subject(s)
COVID-19 , Pulmonary Aspergillosis , Academic Medical Centers , Adult , Aged , Aged, 80 and over , COVID-19/complications , Female , Humans , Intensive Care Units , Male , Middle Aged , Midwestern United States/epidemiology , Pulmonary Aspergillosis/diagnosis , Pulmonary Aspergillosis/epidemiology , Retrospective Studies , Young Adult
5.
PLoS One ; 16(6): e0243676, 2021.
Article in English | MEDLINE | ID: covidwho-1264208

ABSTRACT

Since March 2020, the United States has lost over 580,000 lives to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. A growing body of literature describes population-level SARS-CoV-2 exposure, but studies of antibody seroprevalence within school systems are critically lacking, hampering evidence-based discussions on school reopenings. The Lake Central School Corporation (LCSC), a public school system in suburban Indiana, USA, assessed SARS-CoV-2 seroprevalence in its staff and identified correlations between seropositivity and subjective histories and demographics. This study is a cross-sectional, population-based analysis of the seroprevalence of SARS-CoV-2 in LCSC staff measured in July 2020. We tested for seroprevalence with the Abbott Alinity™ SARS-CoV-2 IgG antibody test. The primary outcome was the total seroprevalence of SARS-CoV-2, and secondary outcomes included trends of antibody presence in relation to baseline attributes. 753 participants representative of the staff at large were enrolled. 22 participants (2.9%, 95% CI: 1.8% - 4.4%) tested positive for SARS-CoV-2 antibodies. Correcting for test performance parameters, the seroprevalence is estimated at 1.7% (90% Credible Interval: 0.27% - 3.3%). Multivariable logistic regression including mask wearing, travel history, symptom history, and contact history revealed a 48-fold increase in the odds of seropositivity if an individual previously tested positive for COVID-19 (OR: 48, 95% CI: 4-600). Amongst individuals with no previous positive test, exposure to a person diagnosed with COVID-19 increased the odds of seropositivity by 7-fold (OR: 7.2, 95% CI: 2.6-19). Assuming the presence of antibodies is associated with immunity against SARS-CoV-2 infection, these results demonstrate a broad lack of herd immunity amongst the school corporation's staff irrespective of employment role or location. Protective measures like contact tracing, face coverings, and social distancing are therefore vital to maintaining the safety of both students and staff as the school year progresses.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , School Teachers , Schools , Adolescent , Adult , Aged , Antibodies, Viral/blood , Antibodies, Viral/immunology , COVID-19/blood , COVID-19/immunology , COVID-19 Serological Testing , Cross-Sectional Studies , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Male , Middle Aged , Midwestern United States/epidemiology , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Seroepidemiologic Studies , Young Adult
7.
Psychiatry Res ; 302: 114034, 2021 08.
Article in English | MEDLINE | ID: covidwho-1244805

ABSTRACT

Given concerns of increased suicide risk among university students during the COVID-19 pandemic, this study examined rates of lifetime and past-year suicidal ideation (SI) among university students in Fall 2020 (vs. two earlier semesters), overall and across gender, racial/ethnic background, and sexual identity. Participants included 1700 university students enrolled in a general education psychology course in Fall 2020, Fall 2014, or Fall 2013. Rates of SI were not significantly higher in Fall 2020 versus the earlier semesters and did not differ across racial/ethnic background. However, rates of SI in Fall 2020 were significantly higher among sexual minority than heterosexual students.


Subject(s)
COVID-19/psychology , Pandemics , Students/psychology , Suicidal Ideation , Adolescent , COVID-19/epidemiology , /statistics & numerical data , Female , Humans , Male , Midwestern United States/epidemiology , /statistics & numerical data , Risk Factors , Sexual and Gender Minorities/psychology , Sexual and Gender Minorities/statistics & numerical data , Students/statistics & numerical data , Surveys and Questionnaires , Universities , Young Adult
8.
Int J Eat Disord ; 54(7): 1213-1223, 2021 07.
Article in English | MEDLINE | ID: covidwho-1196375

ABSTRACT

OBJECTIVE: This study tested the association between food insecurity and eating disorder (ED) pathology, including probable ED diagnosis, among two cohorts of university students before and during the beginning of the COVID-19 pandemic. METHOD: Students (n = 579) from a large Midwestern American university completed self-report questionnaires assessing frequency of ED behaviors, ED-related impairment, and individual food insecurity as measured by the Eating Disorder Diagnostic Scale 5, Clinical Impairment Assessment, and Radimer/Cornell, respectively. Chi-square tests and MANOVA with post-hoc corrections were conducted to compare demographic characteristics, ED pathology, and probable ED diagnosis prevalence between students with and without individual food insecurity. RESULTS: Partially supporting hypotheses, MANOVA indicated significantly greater frequency of objective binge eating, compensatory fasting, and ED-related impairment for students with food insecurity compared with individuals without food insecurity. Chi-squared tests showed higher prevalence of ED diagnoses among individuals with food insecurity compared with those without food security (47.6 vs. 31.1%, respectively, p < .01, NNT = 6.06), specifically bulimia nervosa and other specified feeding and eating disorder. There were no differences in food insecurity before or during the beginning of the COVID-19 pandemic. DISCUSSION: Consistent with prior literature, food insecurity was associated with elevated ED psychopathology in this sample. Findings emphasize the importance of proper ED screening for college students vulnerable to food insecurity and EDs.


Subject(s)
COVID-19/epidemiology , Feeding and Eating Disorders/epidemiology , Food Insecurity , Pandemics , Students/psychology , Adolescent , Adult , Cohort Studies , Feeding and Eating Disorders/diagnosis , Female , Humans , Male , Midwestern United States/epidemiology , Students/statistics & numerical data , Surveys and Questionnaires , Universities , Young Adult
9.
J Prim Care Community Health ; 12: 21501327211010991, 2021.
Article in English | MEDLINE | ID: covidwho-1186538

ABSTRACT

OBJECTIVE: To describe the process and outcome of creating a patient cohort in the early stages of the COVID-19 pandemic in order to better understand the process of and predict the outcomes of COVID-19. PATIENTS AND METHODS: A total of 1169 adults aged 18 years of age or older who tested positive in Mayo Clinic Rochester or the Mayo Clinic Midwest Health System between January 1 and May 23 of 2020. RESULTS: Patients were on average 43.9 years of age and 50.7% were female. Most patients were white (69.0%), and Blacks (23.4%) and Asians (5.8%) were also represented in larger numbers. Hispanics represented 16.3% of the sample. Just under half of patients were married (48.4%). Common comorbid conditions included: cardiovascular diseases (25.1%), dyslipidemia (16.0%), diabetes mellitus (11.2%), chronic obstructive pulmonary disease (6.6%), asthma (7.5%), and cancer (5.1%). All other comorbid conditions were less the 5% in prevalence. Data on 3 comorbidity indices are also available including the: DHHS multi-morbidity score, Charlson Comorbidity Index, and Mayo Clinic COVID-19 Risk Factor Score. CONCLUSION: In addition to managing the ever raging pandemic and growing death rates, it is equally important that we develop adequate resources for the investigation and understanding of COVID-19-related predictors and outcomes.


Subject(s)
COVID-19/epidemiology , Databases, Factual , Adult , Aged , Aged, 80 and over , Cohort Studies , Comorbidity , Female , Humans , Male , Middle Aged , Midwestern United States/epidemiology , Multimorbidity , Retrospective Studies , Risk Factors , SARS-CoV-2 , Young Adult
10.
Public Health Rep ; 136(3): 361-367, 2021 05.
Article in English | MEDLINE | ID: covidwho-1119365

ABSTRACT

OBJECTIVES: Increased exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a result of having an essential job is compounded by factors such as age, race, and ethnicity. We used a cross-sectional study design to describe disparities in the seroprevalence of SARS-CoV-2 immunoglobulin G (IgG) test results by demographic characteristics and clinical roles among a cohort of health care workers employed by the largest Midwestern health care system in the United States. METHODS: We collected 16 233 SARS-CoV-2 IgG serum samples from June 8 through July 10, 2020, from a convenience sample of Illinois- and Wisconsin-based adult health care workers. The research team, in collaboration with ACL Laboratories, used a SARS-CoV-2 IgG assay to detect the presence of SARS-CoV-2 IgG antibodies. Study data included SARS-CoV-2 IgG assay results and demographic characteristics of workers (age, sex, race, ethnicity, clinical role, zip code). We generated crude and adjusted odds ratios (ORs) to describe disparities in seroprevalence distribution among demographic and social factors. RESULTS: Of 16 233 IgG serum samples tested, 622 (3.8%) test results were positive for SARS-CoV-2. We found significant disparities in SARS-CoV-2 positivity by age, race, ethnicity, and clinical role. Participants aged 32-82 had lower adjusted ORs (aORs) of positive IgG than participants aged 18-31 (aOR range, 0.54-0.66). Odds of positivity were higher among Black (aOR = 3.86), Asian (aOR = 1.42), and mixed-race (aOR = 1.99) workers than among White workers; among Hispanic workers (aOR = 1.80) than among non-Hispanic workers; and among coronavirus disease 2019 (COVID-19) clinical workers (aOR = 1.86) than among nonclinical workers. CONCLUSIONS: Public health efforts should focus on increasing COVID-19 safety messaging, testing, vaccination, and other prevention efforts for people who are young, non-White, Hispanic, and working in COVID-19-clinical units.


Subject(s)
COVID-19 Serological Testing , COVID-19/diagnosis , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Immunoglobulin G/blood , SARS-CoV-2 , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Cross-Sectional Studies , Delivery of Health Care , Female , Humans , Male , Middle Aged , Midwestern United States/epidemiology , Race Factors , Seroepidemiologic Studies , Young Adult
11.
Transbound Emerg Dis ; 67(3): 1284-1294, 2020 May.
Article in English | MEDLINE | ID: covidwho-832791

ABSTRACT

In recent years, reports indicated that PCV3 may be involved in porcine dermatitis and nephropathy syndrome (PDNS)-like disease similar to that linked to PCV2. A total of 2,125 porcine samples from 910 cases were collected during 2016-2018 and tested for presence of PCV3 and PCV2 by real-time PCR assays. Results showed high prevalence of PCV3 and PCV2: 28.4% samples from 41.2% cases were PCV3 positive and 16.4% samples from 16.7% cases were PCV2 positive. The overall coinfection rate was 5.4% and 8.4% at the sample and case level, respectively. Temporal analysis indicated that PCV3 positive case rate increased from 31.6% in 2016, 40.9% in 2017, to 55.6% in 2018. Although its prevalence was lower, PCV2-positive case rate in 2018 (28.8%) doubled that in 2017 (14.4%). The coinfection case rate also increased from 3.4% in 2016, 8.0% in 2017 to 16.1% in 2018. The high positive rate of PCV3 (56.9%) and PCV2 (33.8%) in oral fluids, PCV3 in foetuses (57.1%) and PCV2 in tonsils (54.8%) implied viral transmission route and tissue tropism. In phylogenetic analysis, two small PCV3 clusters (1 and 2) were separated but others were clustered with low bootstrapping values indicating overall low genetic diversity. Genotypes, PCV2a-h, were confirmed by analysing 2,944 strains, with a new genotype proposed as PCV2i. In this study, 61 PCV3 unique whole genomes were sequenced; 12 belonged to a separate cluster that were characterized by five consistent amino acid changes in the capsid protein (24V, 27K, 56D, 98R and 168K) and may be associated with potential differences in immunogenicity. Among the 43 unique PCV2 whole genomes sequenced, 31 belonged to PCV2d, 7 to PCV2a and 5 to PCV2b. Thus, our study demonstrates that PCV2d is the predominant genotype and PCV3 is widely circulating in the Midwest of the USA.


Subject(s)
Circoviridae Infections/virology , Circovirus/genetics , Genetic Variation , Swine Diseases/virology , Animals , Capsid Proteins/genetics , Circovirus/classification , Coinfection , Genotype , Midwestern United States/epidemiology , Phylogeny , Prevalence , Swine , Swine Diseases/epidemiology
13.
Mo Med ; 117(2): 89-94, 2020.
Article in English | MEDLINE | ID: covidwho-95997

ABSTRACT

Background: There is lack of specific data on imported infections in the mid-west United States (U.S.). Methods: Retrospective data on demographic and geographic data of imported infections seen by the infectious diseases clinics and consultation service from 2001-2018 was collected. Results: Of the 64 infections, tuberculosis(TB) was most common [20(31.3%); pulmonary(11,55%), lymphadenopathy(8,40%), gastrointestinal(4,20%), disseminated(2,10%), and 1(5%) each of genitourinary and vertebral spine infection, 4 Human immune-deficiency virus infection and 1 echinococcosis)] followed by malaria(11,17.2%). Other infections: Cysticercosis [7,10.9%], giardiasis (4,6.3%), 3 each (4.7%) Human T-lymphotrophic Virus infection and schistosomiasis, 2 each (3.1%) leprosy, strongyloidiasis, and typhoid fever, one each (1.6%) of ascariasis, brucellosis, Chagas disease, Chikungunya virus, hepatitis A virus, echinococcosis, Japanese encephalitis virus, loiasis, paratyphoid fever, Q fever, and unspecified parasitosis. Geographic origins: Africa(26,40.6%), Asia(16,25%), Central America(11,17.2%), Europe(2,3.1%), Oceania(2,3.1%), South America(2,3.1%), and Unknown(5). More cases were seen after 2015. Conclusions: With increasing tourism, it is important to educate rural mid-west healthcare professionals on travel medicine. The current COVID-19 pandemic illustrates the importance of this type of education and data accumulation now and in the future.


Subject(s)
Communicable Diseases, Imported/epidemiology , COVID-19 , Coronavirus Infections/epidemiology , Humans , Midwestern United States/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Population Surveillance , Retrospective Studies , Rural Population/statistics & numerical data , Tertiary Care Centers , Travel , Typhoid Fever , United States
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