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1.
Am Surg ; 86(6): 567-571, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-656872

ABSTRACT

A surgeon was among the teams caring for critically-ill patients with COVID-19 infection during the height of the pandemic in March and April 2020 in Brooklyn. He recorded his experiences and thoughts as events unfolded, a chronicle of the landmark public health event of the century. Working to exhaustion alongside his colleagues from Mount Sinai Hospital, he encountered tragedy and inspiration.


Subject(s)
Coronavirus Infections/therapy , Pandemics , Patient Care Team , Physician's Role/psychology , Pneumonia, Viral/therapy , Surgeons/psychology , Betacoronavirus , Coronavirus Infections/epidemiology , Critical Care , Humans , New York City/epidemiology , Physician-Patient Relations , Pneumonia, Viral/epidemiology , Social Support
2.
J Hematol Oncol ; 13(1): 94, 2020 07 14.
Article in English | MEDLINE | ID: covidwho-647080

ABSTRACT

BACKGROUND: The COVID-19 pandemic, caused by SARS-CoV-2 virus, has resulted in over 100,000 deaths in the USA. Our institution has treated over 2000 COVID-19 patients during the pandemic in New York City. The pandemic directly impacted cancer patients and the organization of cancer care. Mount Sinai Hospital has a large and diverse multiple myeloma (MM) population. Herein, we report the characteristics of COVID-19 infection and serological response in MM patients in a large tertiary care institution in New York. METHODS: We performed a retrospective study on a cohort of 58 patients with a plasma-cell disorder (54 MM, 4 smoldering MM) who developed COVID-19 between March 1, 2020, and April 30, 2020. We report epidemiological, clinical, and laboratory characteristics including the persistence of viral detection by polymerase chain reaction (PCR) and anti-SARS-CoV-2 antibody testing, treatments initiated, and outcomes. RESULTS: Of the 58 patients diagnosed with COVID-19, 36 were hospitalized and 22 were managed at home. The median age was 67 years; 52% of patients were male and 63% were non-White. Hypertension (64%), hyperlipidemia (62%), obesity (37%), diabetes mellitus (28%), chronic kidney disease (24%), and lung disease (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age (> 70 years), male sex, cardiovascular risk, and patients not in complete remission (CR) or stringent CR were significantly (p < 0.05) associated with hospitalization. Among hospitalized patients, laboratory findings demonstrated elevation of traditional inflammatory markers (CRP, ferritin, D-dimer) and a significant (p < 0.05) association between elevated inflammatory markers, severe hypogammaglobulinemia, non-White race, and mortality. Ninety-six percent (22/23) of patients developed antibodies to SARS-CoV-2 at a median of 32 days after initial diagnosis. The median time to PCR negativity was 43 (range 19-68) days from initial positive PCR. CONCLUSIONS: Drug exposure and MM disease status at the time of contracting COVID-19 had no bearing on mortality. Mounting a severe inflammatory response to SARS-CoV-2 and severe hypogammaglobulinemia was associated with higher mortality. The majority of patients mounted an antibody response to SARS-CoV-2. These findings pave a path to the identification of vulnerable MM patients who need early intervention to improve outcomes in future outbreaks of COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Multiple Myeloma/complications , Pneumonia, Viral/complications , Tertiary Care Centers , Agammaglobulinemia/mortality , Agammaglobulinemia/pathology , Aged , Cohort Studies , Coronavirus Infections/mortality , Female , Humans , Immunocompromised Host , Inflammation/mortality , Inflammation/pathology , Male , Middle Aged , Multiple Myeloma/immunology , New York City/epidemiology , Pandemics , Pneumonia, Viral/mortality , Retrospective Studies , Risk Factors
3.
Stroke ; 51(7): 2002-2011, 2020 07.
Article in English | MEDLINE | ID: covidwho-640230

ABSTRACT

BACKGROUND AND PURPOSE: With the spread of coronavirus disease 2019 (COVID-19) during the current worldwide pandemic, there is mounting evidence that patients affected by the illness may develop clinically significant coagulopathy with thromboembolic complications including ischemic stroke. However, there is limited data on the clinical characteristics, stroke mechanism, and outcomes of patients who have a stroke and COVID-19. METHODS: We conducted a retrospective cohort study of consecutive patients with ischemic stroke who were hospitalized between March 15, 2020, and April 19, 2020, within a major health system in New York, the current global epicenter of the pandemic. We compared the clinical characteristics of stroke patients with a concurrent diagnosis of COVID-19 to stroke patients without COVID-19 (contemporary controls). In addition, we compared patients to a historical cohort of patients with ischemic stroke discharged from our hospital system between March 15, 2019, and April 15, 2019 (historical controls). RESULTS: During the study period in 2020, out of 3556 hospitalized patients with diagnosis of COVID-19 infection, 32 patients (0.9%) had imaging proven ischemic stroke. Cryptogenic stroke was more common in patients with COVID-19 (65.6%) as compared to contemporary controls (30.4%, P=0.003) and historical controls (25.0%, P<0.001). When compared with contemporary controls, COVID-19 positive patients had higher admission National Institutes of Health Stroke Scale score and higher peak D-dimer levels. When compared with historical controls, COVID-19 positive patients were more likely to be younger men with elevated troponin, higher admission National Institutes of Health Stroke Scale score, and higher erythrocyte sedimentation rate. Patients with COVID-19 and stroke had significantly higher mortality than historical and contemporary controls. CONCLUSIONS: We observed a low rate of imaging-confirmed ischemic stroke in hospitalized patients with COVID-19. Most strokes were cryptogenic, possibly related to an acquired hypercoagulability, and mortality was increased. Studies are needed to determine the utility of therapeutic anticoagulation for stroke and other thrombotic event prevention in patients with COVID-19.


Subject(s)
Betacoronavirus , Brain Ischemia/epidemiology , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Stroke/epidemiology , Adult , Aged , Biomarkers , Blood Sedimentation , Brain Ischemia/blood , Brain Ischemia/etiology , Brain Ischemia/therapy , Causality , Cerebral Small Vessel Diseases/complications , Cerebral Small Vessel Diseases/diagnostic imaging , Cerebral Small Vessel Diseases/epidemiology , Comorbidity , Coronavirus Infections/blood , Coronavirus Infections/complications , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Incidence , Male , Middle Aged , Neuroimaging , New York City/epidemiology , Patient Admission/statistics & numerical data , Pneumonia, Viral/blood , Pneumonia, Viral/complications , Retrospective Studies , Severity of Illness Index , Stroke/blood , Stroke/etiology , Stroke/therapy , Thrombophilia/etiology , Troponin/blood
5.
Obesity (Silver Spring) ; 28(7): 1184-1186, 2020 07.
Article in English | MEDLINE | ID: covidwho-638210

ABSTRACT

Health inequities exist throughout the life course, resulting in racial/ethnic and socioeconomic disparities in obesity and obesity-related health complications. Obesity and its comorbidities appear to be linked to coronavirus disease 2019 (COVID-19) mortality. Approaches to reduce obesity in the time of COVID-19 closures are urgently needed and should start early in life. In New York City, a telehealth pediatric weight-management collaborative spanning NewYork-Presbyterian, Columbia University Vagelos College of Physicians and Surgeons, and Weill Cornell Medicine was developed during COVID-19 with show rates from 76% to 89%. To stave off the impending exacerbation of health disparities related to obesity risk factors in the aftermath of the COVID-19 pandemic, effective interventions that can be delivered remotely are urgently needed among vulnerable children with obesity. Challenges in digital technology access, social and linguistic differences, privacy security, and reimbursement must be overcome to realize the full potential of telehealth for pediatric weight management among low-income and racial/ethnic-minority children.


Subject(s)
Coronavirus Infections/prevention & control , Obesity Management/methods , Obesity/therapy , Pandemics/prevention & control , Pediatrics/methods , Pneumonia, Viral/prevention & control , Telemedicine/methods , Betacoronavirus , Child , Coronavirus Infections/ethnology , Coronavirus Infections/virology , Female , Humans , Male , Minority Health , New York City/epidemiology , Obesity/ethnology , Obesity/virology , Pneumonia, Viral/ethnology , Pneumonia, Viral/virology , Poverty/ethnology , Risk Factors , Vulnerable Populations
8.
J Transl Med ; 18(1): 251, 2020 06 23.
Article in English | MEDLINE | ID: covidwho-611325

ABSTRACT

BACKGROUND: With the aim of providing a dynamic evaluation of the effects of basic environmental parameters on COVID-19-related death rate, we assessed the correlation between average monthly high temperatures and population density, with death/rate (monthly number of deaths/1 M people) for the months of March (start of the analysis and beginning of local epidemic in most of the Western World, except in Italy where it started in February) and April 2020 (continuation of the epidemic). Different geographical areas of the Northern Hemisphere in the United States and in Europe were selected in order to provide a wide range among the different parameters. The death rates were gathered from an available dataset. As a further control, we also included latitude, as a proxy for temperature. METHODS: Utilizing a publicly available dataset, we retrieved data for the months of March and April 2020 for 25 areas in Europe and in the US. We computed the monthly number of deaths/1 M people of confirmed COVID-19 cases and calculated the average monthly high temperatures and population density for all these areas. We determined the correlation between number of deaths/1 M people and the average monthly high temperatures, the latitude and the population density. RESULTS: We divided our analysis in two parts: analysis of the correlation among the different variables in the month of March and subsequent analysis in the month of April. The differences were then evaluated. In the month of March there was no statistical correlation between average monthly high temperatures of the considered geographical areas and number of deaths/1 M people. However, a statistically significant inverse correlation became significant in the month of April between average monthly high temperatures (p = 0.0043) and latitude (p = 0.0253) with number of deaths/1 M people. We also observed a statistically significant correlation between population density and number of deaths/1 M people both in the month of March (p = 0.0297) and in the month of April (p = 0.0116), when three areas extremely populated (NYC, Los Angeles and Washington DC) were included in the calculation. Once these three areas were removed, the correlation was not statistically significant (p = 0.1695 in the month of March, and p = 0.7076 in the month of April). CONCLUSIONS: The number of COVID-19-related deaths/1 M people was essentially the same during the month of March for all the geographical areas considered, indicating essentially that the infection was circulating quite uniformly except for Lombardy, Italy, where it started earlier. Lockdown measures were implemented between the end of March and beginning of April, except for Italy which started March 9th. We observed a strong, statistically significant inverse correlation between average monthly high temperatures with the number of deaths/1 M people. We confirmed the data by analyzing the correlation with the latitude, which can be considered a proxy for high temperature. Previous studies indicated a negative effect of high climate temperatures on Sars-COV-2 spreading. Our data indicate that social distancing measure are more successful in the presence of higher average monthly temperatures in reducing COVID-19-related death rate, and a high level of population density seems to negatively impact the effect of lockdown measures.


Subject(s)
Coronavirus Infections/mortality , Environment , Mortality , Pneumonia, Viral/mortality , Temperature , Betacoronavirus/physiology , Coronavirus Infections/epidemiology , District of Columbia/epidemiology , Environmental Monitoring/methods , Europe/epidemiology , Geography , Humans , Italy/epidemiology , Los Angeles/epidemiology , New York City/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Population Density , Social Behavior
9.
A A Pract ; 14(7): e01243, 2020 May.
Article in English | MEDLINE | ID: covidwho-600869

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic created an unprecedented need for mechanical ventilation in critically ill patients. To meet this increased demand, some facilities were forced to use anesthesia gas machines (AGMs) as intensive care unit (ICU) ventilators. While an off-label use, AGM manufacturers, the Anesthesia Patient Safety Foundation, and the American Society of Anesthesiologists have guidelines for AGM use in the ICU, however, there is scant literature describing their use. This article describes our experiences at New York University Langone Medical Center using AGMs in the ICU for ventilating critically ill COVID-19 patients.


Subject(s)
Anesthesiology/instrumentation , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Respiration, Artificial/instrumentation , Respiration, Artificial/methods , Ventilators, Mechanical/supply & distribution , Betacoronavirus , Coronavirus Infections/epidemiology , Critical Care , Hospitals, University , Humans , Intensive Care Units , New York City/epidemiology , Nurse Anesthetists , Off-Label Use , Pandemics , Pneumonia, Viral/epidemiology , Workforce
10.
J Rural Health ; 36(3): 433-445, 2020 06.
Article in English | MEDLINE | ID: covidwho-599268

ABSTRACT

PURPOSE: This ecological analysis investigates the spatial patterns of the COVID-19 epidemic in the United States in relation to socioeconomic variables that characterize US counties. METHODS: Data on confirmed cases and deaths from COVID-19 for 2,814 US counties were obtained from Johns Hopkins University. We used Geographic Information Systems (GIS) to map the spatial aspects of this pandemic and investigate the disparities between metropolitan and nonmetropolitan communities. Multiple regression models were used to explore the contextual risk factors of infections and death across US counties. We included population density, percent of population aged 65+, percent population in poverty, percent minority population, and percent of the uninsured as independent variables. A state-level measure of the percent of the population that has been tested for COVID-19 was used to control for the impact of testing. FINDINGS: The impact of COVID-19 in the United States has been extremely uneven. Although densely populated large cities and their surrounding metropolitan areas are hotspots of the pandemic, it is counterintuitive that incidence and mortality rates in some small cities and nonmetropolitan counties approximate those in epicenters such as New York City. Regression analyses support the hypotheses of positive correlations between COVID-19 incidence and mortality rates and socioeconomic factors including population density, proportions of elderly residents, poverty, and percent population tested. CONCLUSIONS: Knowledge about the spatial aspects of the COVID-19 epidemic and its socioeconomic correlates can inform first responders and government efforts. Directives for social distancing and to "shelter-in-place" should continue to stem the spread of COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Residence Characteristics/statistics & numerical data , Age Factors , Betacoronavirus , Coronavirus Infections/mortality , Geographic Information Systems , Humans , New York City/epidemiology , Pandemics , Pneumonia, Viral/mortality , Risk Factors , Socioeconomic Factors , Spatial Analysis , United States/epidemiology
11.
Sex Transm Dis ; 47(7): 434-436, 2020 07.
Article in English | MEDLINE | ID: covidwho-599018

ABSTRACT

As the COVID-19 pandemic causes upheaval in New York City (NYC), 1 consequence is the accessibility of sexual health services. The NYC STD Prevention Training Center at Columbia University administered an online provider survey to understand how the COVID-19 pandemic is affecting the availability of sexual health care services regionally.


Subject(s)
Coronavirus Infections/epidemiology , Health Services Accessibility/organization & administration , Pneumonia, Viral/epidemiology , Reproductive Health Services/supply & distribution , Sexual Health , Betacoronavirus , Coronavirus Infections/virology , Humans , New York City/epidemiology , Pandemics , Pneumonia, Viral/virology
12.
MMWR Morb Mortal Wkly Rep ; 69(24): 751-758, 2020 Jun 19.
Article in English | MEDLINE | ID: covidwho-598344

ABSTRACT

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is thought to be transmitted mainly by person-to-person contact (1). Implementation of nationwide public health orders to limit person-to-person interaction and of guidance on personal protective practices can slow transmission (2,3). Such strategies can include stay-at-home orders, business closures, prohibitions against mass gatherings, use of cloth face coverings, and maintenance of a physical distance between persons (2,3). To assess and understand public attitudes, behaviors, and beliefs related to this guidance and COVID-19, representative panel surveys were conducted among adults aged ≥18 years in New York City (NYC) and Los Angeles, and broadly across the United States during May 5-12, 2020. Most respondents in the three cohorts supported stay-at-home orders and nonessential business closures* (United States, 79.5%; New York City, 86.7%; and Los Angeles, 81.5%), reported always or often wearing cloth face coverings in public areas (United States, 74.1%, New York City, 89.6%; and Los Angeles 89.8%), and believed that their state's restrictions were the right balance or not restrictive enough (United States, 84.3%; New York City, 89.7%; and Los Angeles, 79.7%). Periodic assessments of public attitudes, behaviors, and beliefs can guide evidence-based public health decision-making and related prevention messaging about mitigation strategies needed as the COVID-19 pandemic evolves.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Health Knowledge, Attitudes, Practice , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Public Health/legislation & jurisprudence , Adolescent , Adult , Aged , Commerce/legislation & jurisprudence , Female , Humans , Los Angeles/epidemiology , Male , Middle Aged , New York City/epidemiology , Social Isolation , Surveys and Questionnaires , United States/epidemiology , Young Adult
13.
Sex Transm Dis ; 47(7): 434-436, 2020 07.
Article in English | MEDLINE | ID: covidwho-589624

ABSTRACT

As the COVID-19 pandemic causes upheaval in New York City (NYC), 1 consequence is the accessibility of sexual health services. The NYC STD Prevention Training Center at Columbia University administered an online provider survey to understand how the COVID-19 pandemic is affecting the availability of sexual health care services regionally.


Subject(s)
Coronavirus Infections/epidemiology , Health Services Accessibility/organization & administration , Pneumonia, Viral/epidemiology , Reproductive Health Services/supply & distribution , Sexual Health , Betacoronavirus , Coronavirus Infections/virology , Humans , New York City/epidemiology , Pandemics , Pneumonia, Viral/virology
14.
Int J Environ Res Public Health ; 17(11)2020 Jun 05.
Article in English | MEDLINE | ID: covidwho-548961

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19), caused by the virus SARS-CoV-2, has been rapidly increasing in the United States. Boroughs of New York City, including Queens county, turn out to be the epicenters of this infection. According to the data provided by the New York State Department of Health, most of the cases of new COVID-19 infections in New York City have been found in the Queens county where 42,023 people have tested positive, and 3221 people have died as of 20 April 2020. Person-to-person transmission and travels were implicated in the initial spread of the outbreaks, but factors related to the late phase of rapidly spreading outbreaks in March and April are still uncertain. A few previous studies have explored the links between air pollution and COVID-19 infections, but more data is needed to understand the effects of short-term exposures of air pollutants and meteorological factors on the spread of COVID-19 infections, particularly in the U.S. disease epicenters. In this study, we have focused on ozone and PM2.5, two major air pollutants in New York City, which were previously found to be associated with respiratory viral infections. The aim of our regression modeling was to explore the associations among ozone, PM2.5, daily meteorological variables (wind speed, temperature, relative humidity, absolute humidity, cloud percentages, and precipitation levels), and COVID-19 confirmed new cases and new deaths in Queens county, New York during March and April 2020. The results from these analyses showed that daily average temperature, daily maximum eight-hour ozone concentration, average relative humidity, and cloud percentages were significantly and positively associated with new confirmed cases related to COVID-19; none of these variables showed significant associations with new deaths related to COVID-19. The findings indicate that short-term exposures to ozone and other meteorological factors can influence COVID-19 transmission and initiation of the disease, but disease aggravation and mortality depend on other factors.


Subject(s)
Air Pollution/analysis , Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Ozone/analysis , Pneumonia, Viral/epidemiology , Female , Health Surveys , Humans , Meteorological Concepts , New York City/epidemiology , Pandemics
15.
MEDICC Rev ; 22(2): 69-71, 2020 Jan.
Article in English | MEDLINE | ID: covidwho-477563

ABSTRACT

Speaking remotely with US graduates of Havana's Latin American School of Medicine (ELAM), I found them at work on hospital floors, in ICUs and health centers across the United States, putting their professional and personal commitment to the test against COVID-19. Nowhere was that more evident than in New York City, the disease's epicenter, where one grad told me virtually every hospital has at least one MD from the Cuban school, which has provided free 6-year medical training for some 30,000 doctors since the school's founding in 1999. The student body comes primarily from low- and middle-income countries worldwide, but Cuba also provided 200 US students with scholarships. One of them is Dr Joaquín Morante (ELAM Class of 2012), who did his medical residency in internal medicine, followed by fellowships in pulmonary disease and critical care medicine. Triple-licensed in internal medicine, pulmonary and critical care medicine, he is now an attending physician on staff at Jacobi Medical Center in The Bronx, one of New York City's public hospitals, and considered a 'hot spot' due to its COVID-19 caseload. I spoke with him during a break at home in mid-April.Dr Joaquín Morante, ELAM Class of 2012: Pulmonologist, critical care attending physician at Jacobi Medical Center, New York City.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Physicians , Pneumonia, Viral/epidemiology , Cuba , Hospital Administration , Humans , Intensive Care Units/organization & administration , Male , New York City/epidemiology , Pandemics , Protective Clothing/supply & distribution , Ventilators, Mechanical/supply & distribution
16.
Hastings Cent Rep ; 50(3): 50-53, 2020 May.
Article in English | MEDLINE | ID: covidwho-619245

ABSTRACT

When confronted by the novel ethical challenges posed by a pandemic, it is helpful to turn to history for guidance and direction. In this essay, the author revisits Thucydides's description of the Plague of Athens from The Peloponnesian War as he considers the New York State Task Force on Life and the Law's 2015 guidelines on ventilator allocation. Confronted by the exigencies of the Covid-19 surge that struck New York, he questions the task force's decision not to give any degree of preference to health care workers who might become ill. He posits that they are due a compensatory ethic and some deference given the risks they have assumed, often with inadequate protective gear. Reflecting on his ambivalence, he asks if his change of heart reflects the impact of experiential learning or the erosion of nomos-or governing norms-described by Thucydides when the plague struck Athens.


Subject(s)
Bioethical Issues , Clinical Protocols/standards , Coronavirus Infections/epidemiology , Health Personnel , Personal Protective Equipment/supply & distribution , Pneumonia, Viral/epidemiology , Betacoronavirus , Greece/epidemiology , Humans , New York City/epidemiology , Pandemics , Plague/epidemiology
17.
BMJ ; 369: m1996, 2020 05 29.
Article in English | MEDLINE | ID: covidwho-423282

ABSTRACT

OBJECTIVE: To characterize patients with coronavirus disease 2019 (covid-19) in a large New York City medical center and describe their clinical course across the emergency department, hospital wards, and intensive care units. DESIGN: Retrospective manual medical record review. SETTING: NewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center in New York City. PARTICIPANTS: The first 1000 consecutive patients with a positive result on the reverse transcriptase polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented to the emergency department or were admitted to hospital between 1 March and 5 April 2020. Patient data were manually abstracted from electronic medical records. MAIN OUTCOME MEASURES: Characterization of patients, including demographics, presenting symptoms, comorbidities on presentation, hospital course, time to intubation, complications, mortality, and disposition. RESULTS: Of the first 1000 patients, 150 presented to the emergency department, 614 were admitted to hospital (not intensive care units), and 236 were admitted or transferred to intensive care units. The most common presenting symptoms were cough (732/1000), fever (728/1000), and dyspnea (631/1000). Patients in hospital, particularly those treated in intensive care units, often had baseline comorbidities including hypertension, diabetes, and obesity. Patients admitted to intensive care units were older, predominantly male (158/236, 66.9%), and had long lengths of stay (median 23 days, interquartile range 12-32 days); 78.0% (184/236) developed acute kidney injury and 35.2% (83/236) needed dialysis. Only 4.4% (6/136) of patients who required mechanical ventilation were first intubated more than 14 days after symptom onset. Time to intubation from symptom onset had a bimodal distribution, with modes at three to four days, and at nine days. As of 30 April, 90 patients remained in hospital and 211 had died in hospital. CONCLUSIONS: Patients admitted to hospital with covid-19 at this medical center faced major morbidity and mortality, with high rates of acute kidney injury and inpatient dialysis, prolonged intubations, and a bimodal distribution of time to intubation from symptom onset.


Subject(s)
Coronavirus Infections/epidemiology , Hospitalization/statistics & numerical data , Pneumonia, Viral/epidemiology , Academic Medical Centers/statistics & numerical data , Acute Kidney Injury/virology , Adolescent , Adult , Aged , Betacoronavirus , Comorbidity , Coronavirus Infections/mortality , Coronavirus Infections/therapy , Cough/virology , Dyspnea/virology , Emergency Service, Hospital/statistics & numerical data , Female , Fever/virology , Humans , Intensive Care Units/statistics & numerical data , Intubation , Length of Stay , Male , Middle Aged , New York City/epidemiology , Pandemics , Pneumonia, Viral/mortality , Pneumonia, Viral/therapy , Respiration, Artificial , Retrospective Studies , Young Adult
18.
Science ; 369(6501): 297-301, 2020 07 17.
Article in English | MEDLINE | ID: covidwho-418857

ABSTRACT

New York City (NYC) has emerged as one of the epicenters of the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. To identify the early transmission events underlying the rapid spread of the virus in the NYC metropolitan area, we sequenced the virus that causes coronavirus disease 2019 (COVID-19) in patients seeking care at the Mount Sinai Health System. Phylogenetic analysis of 84 distinct SARS-CoV-2 genomes indicates multiple, independent, but isolated introductions mainly from Europe and other parts of the United States. Moreover, we found evidence for community transmission of SARS-CoV-2 as suggested by clusters of related viruses found in patients living in different neighborhoods of the city.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Genome, Viral , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Adult , Aged , Aged, 80 and over , Coronavirus Infections/mortality , Epidemiological Monitoring , Female , Geography, Medical , Humans , Male , Middle Aged , New York City/epidemiology , Pandemics , Phylogeny , Pneumonia, Viral/mortality , Residence Characteristics , Young Adult
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