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1.
Nature ; 602(7897): 481-486, 2022 02.
Article in English | MEDLINE | ID: covidwho-1585829

ABSTRACT

Humans have infected a wide range of animals with SARS-CoV-21-5, but the establishment of a new natural animal reservoir has not been observed. Here we document that free-ranging white-tailed deer (Odocoileus virginianus) are highly susceptible to infection with SARS-CoV-2, are exposed to multiple SARS-CoV-2 variants from humans and are capable of sustaining transmission in nature. Using real-time PCR with reverse transcription, we detected SARS-CoV-2 in more than one-third (129 out of 360, 35.8%) of nasal swabs obtained from O. virginianus in northeast Ohio in the USA during January to March 2021. Deer in six locations were infected with three SARS-CoV-2 lineages (B.1.2, B.1.582 and B.1.596). The B.1.2 viruses, dominant in humans in Ohio at the time, infected deer in four locations. We detected probable deer-to-deer transmission of B.1.2, B.1.582 and B.1.596 viruses, enabling the virus to acquire amino acid substitutions in the spike protein (including the receptor-binding domain) and ORF1 that are observed infrequently in humans. No spillback to humans was observed, but these findings demonstrate that SARS-CoV-2 viruses have been transmitted in wildlife in the USA, potentially opening new pathways for evolution. There is an urgent need to establish comprehensive 'One Health' programmes to monitor the environment, deer and other wildlife hosts globally.


Subject(s)
Animals, Wild/virology , COVID-19/veterinary , Deer/virology , Phylogeny , SARS-CoV-2/isolation & purification , Viral Zoonoses/transmission , Viral Zoonoses/virology , Amino Acid Sequence , Amino Acid Substitution , Animals , COVID-19/epidemiology , COVID-19/transmission , Evolution, Molecular , Humans , Male , Ohio/epidemiology , One Health/trends , SARS-CoV-2/chemistry , SARS-CoV-2/classification , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Viral Zoonoses/epidemiology
2.
Ann Epidemiol ; 67: 50-60, 2022 03.
Article in English | MEDLINE | ID: covidwho-1568496

ABSTRACT

Purpose To estimate the prevalence of current and past COVID-19 in Ohio adults. Methods We used stratified, probability-proportionate-to-size cluster sampling. During July 2020, we enrolled 727 randomly-sampled adult English- and Spanish-speaking participants through a household survey. Participants provided nasopharyngeal swabs and blood samples to detect current and past COVID-19. We used Bayesian latent class models with multilevel regression and poststratification to calculate the adjusted prevalence of current and past COVID-19. We accounted for the potential effects of non-ignorable non-response bias. Results The estimated statewide prevalence of current COVID-19 was 0.9% (95% credible interval: 0.1%-2.0%), corresponding to ∼85,000 prevalent infections (95% credible interval: 6,300-177,000) in Ohio adults during the study period. The estimated statewide prevalence of past COVID-19 was 1.3% (95% credible interval: 0.2%-2.7%), corresponding to ∼118,000 Ohio adults (95% credible interval: 22,000-240,000). Estimates did not change meaningfully due to non-response bias. Conclusions Total COVID-19 cases in Ohio in July 2020 were approximately 3.5 times as high as diagnosed cases. The lack of broad COVID-19 screening in the United States early in the pandemic resulted in a paucity of population-representative prevalence data, limiting the ability to measure the effects of statewide control efforts.


Subject(s)
COVID-19 , Adult , Bayes Theorem , COVID-19/epidemiology , Humans , Ohio/epidemiology , Prevalence , SARS-CoV-2 , United States
3.
Am Surg ; 88(3): 404-408, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1467789

ABSTRACT

INTRODUCTION: There is a growing concern that certain public health restrictions imposed to prevent the spread of coronavirus disease 2019 (COVID-19) could result in more violence against women (VAW). We sought to determine if the rates and types of VAW changed during the COVID-19 pandemic at our level 1 trauma center (L1TC). METHODS: We performed a retrospective review of female patients who presented to our L1TC because of violence from 2019 through 2020. Patients were grouped into a pre-COVID or COVID period. The primary aim of this study was to compare rates of VAW between groups. Secondary aims sought to evaluate for any difference in traumatic mechanism between periods and to determine if a temporal relationship existed between COVID-19 and VAW rates. RESULTS: There was no difference in rates of VAW between the pre-COVID and COVID period (3.1% vs 3.6%, P = .6); however, rates of penetrating trauma were greater during the COVID period (38.2% vs 10.3%, P = .01). After controlling for patient age and race, the odds of penetrating trauma increased during the pandemic (OR 5.8, 95% CI 1.6-28.5, P < .01). From February 2020 through October 2020, there was a direct relationship between rates of COVID-19 and VAW (r2 .78, P < .01). CONCLUSION: Rates of VAW were unchanged between the pre-COVID and COVID periods, yet the odds of penetrating VAW were 5 times greater during the pandemic. Moving forward, trauma surgeons must remain vigilant for signs of violence and ensure that support services are available during future crises.


Subject(s)
COVID-19/epidemiology , Gender-Based Violence/statistics & numerical data , Pandemics , Trauma Centers/statistics & numerical data , Wounds, Nonpenetrating/epidemiology , Wounds, Penetrating/epidemiology , Adult , COVID-19/prevention & control , Female , Gender-Based Violence/ethnology , Humans , Injury Severity Score , Intimate Partner Violence/ethnology , Intimate Partner Violence/statistics & numerical data , Linear Models , Ohio/epidemiology , Retrospective Studies , Wounds, Nonpenetrating/ethnology , Wounds, Penetrating/ethnology , Young Adult
5.
Public Health Rep ; 136(6): 782-790, 2021.
Article in English | MEDLINE | ID: covidwho-1374029

ABSTRACT

OBJECTIVE: COVID-19 mortality varies across demographic groups at the national level, but little is known about potential differences in COVID-19 mortality across states. The objective of this study was to estimate the number of all-cause excess deaths associated with COVID-19 in Florida and Ohio overall and by sex, age, and race. METHODS: We calculated the number of weekly and cumulative excess deaths among adults aged ≥20 from March 15 through December 5, 2020, in Florida and Ohio as the observed number of deaths less the expected number of deaths, adjusted for population, secular trends, and seasonality. We based our estimates on death certificate data from the previous 10 years. RESULTS: The results were based on ratios of observed-to-expected deaths. The ratios were 1.17 (95% prediction interval, 1.14-1.21) in Florida and 1.15 (95% prediction interval, 1.11-1.19) in Ohio. Although the largest number of excess deaths occurred in the oldest age groups, in both states the ratios of observed-to-expected deaths were highest among adults aged 20-49 (1.21; 95% prediction interval, 1.11-1.32). The ratio of observed-to-expected deaths for the Black population was especially elevated in Florida. CONCLUSIONS: Although excess deaths were largely concentrated among older cohorts, the high ratios of observed-to-expected deaths among younger age groups indicate widespread effects of COVID-19. The high levels of observed-to-expected deaths among Black adults may reflect in part disparities in infection rates, preexisting conditions, and access to care. The finding of high excess deaths among Black adults deserves further attention.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , COVID-19/mortality , Cause of Death , Child , Child, Preschool , Comorbidity , Female , Florida/epidemiology , Health Status , Humans , Infant , Male , Middle Aged , Ohio/epidemiology , Pandemics , SARS-CoV-2 , Sex Factors , Socioeconomic Factors , United States/epidemiology , Young Adult
6.
Public Health Nurs ; 38(6): 1019-1029, 2021 11.
Article in English | MEDLINE | ID: covidwho-1346002

ABSTRACT

OBJECTIVES: COVID-19 has highlighted differences in our engagement in health prevention behaviors. The Health Belief Model (HBM), personality traits (conscientiousness, extraversion, and neuroticism), and sociodemographic variables were used to evaluate social distancing during the first month of a state-mandated Stay At Home (SAH) order. DESIGN: A web-based convenience sample of 645 Ohioans was surveyed. Hierarchical linear regression and mediation analysis were used to examine predictors of social distancing attitudes and behaviors and whether health beliefs mediated the relationship between personality and social distancing. RESULTS: Most respondents agreed with and adhered to social distancing guidelines. HBM constructs were strong predictors of SAH attitudes, while personality accounted for little additional variance. Anxiety was indirectly related to overall social distancing attitudes and behavior through its relationship with health beliefs. However, violations of social distancing were best explained by situational factors (e.g., being an essential worker). CONCLUSION: The results demonstrate the power of components of the HBM to explain attitudes and behaviors regarding the SAH order beyond any contribution from personality. By examining the role of personality and health beliefs on social distancing attitudes and behaviors, this research will benefit public health nurses and others tasked with communicating and promoting preventative health behavior.


Subject(s)
COVID-19 , Health Knowledge, Attitudes, Practice , Physical Distancing , COVID-19/epidemiology , COVID-19/prevention & control , Health Behavior , Humans , Nurses, Public Health , Ohio/epidemiology , Surveys and Questionnaires
7.
PLoS One ; 16(8): e0255343, 2021.
Article in English | MEDLINE | ID: covidwho-1344153

ABSTRACT

BACKGROUND: Social and ecological differences in early SARS-CoV-2 pandemic screening and outcomes have been documented, but the means by which these differences have arisen are not well understood. OBJECTIVE: To characterize socioeconomic and chronic disease-related mechanisms underlying these differences. DESIGN: Observational cohort study. SETTING: Outpatient and emergency care. PATIENTS: 12900 Cleveland Clinic Health System patients referred for SARS-CoV-2 testing between March 17 and April 15, 2020. INTERVENTIONS: Nasopharyngeal PCR test for SARS-CoV-2 infection. MEASUREMENTS: Test location (emergency department, ED, vs. outpatient care), COVID-19 symptoms, test positivity and hospitalization among positive cases. RESULTS: We identified six classes of symptoms, ranging in test positivity from 3.4% to 23%. Non-Hispanic Black race/ethnicity was disproportionately represented in the group with highest positivity rates. Non-Hispanic Black patients ranged from 1.81 [95% confidence interval: 0.91-3.59] times (at age 20) to 2.37 [1.54-3.65] times (at age 80) more likely to test positive for the SARS-CoV-2 virus than non-Hispanic White patients, while test positivity was not significantly different across the neighborhood income spectrum. Testing in the emergency department (OR: 5.4 [3.9, 7.5]) and cardiovascular disease (OR: 2.5 [1.7, 3.8]) were related to increased risk of hospitalization among the 1247 patients who tested positive. LIMITATIONS: Constraints on availability of test kits forced providers to selectively test for SARS-Cov-2. CONCLUSION: Non-Hispanic Black patients and patients from low-income neighborhoods tended toward more severe and prolonged symptom profiles and increased comorbidity burden. These factors were associated with higher rates of testing in the ED. Non-Hispanic Black patients also had higher test positivity rates.


Subject(s)
COVID-19 Testing/trends , COVID-19/diagnosis , Socioeconomic Factors , Adult , Aged , COVID-19/economics , COVID-19/psychology , COVID-19 Testing/methods , Cohort Studies , Comorbidity , Female , Hospitalization , Humans , Male , Mass Screening/methods , Mass Screening/psychology , Middle Aged , Ohio/epidemiology , Pandemics , Risk Factors , SARS-CoV-2/pathogenicity
8.
Am J Med ; 134(11): 1424-1426, 2021 11.
Article in English | MEDLINE | ID: covidwho-1330598

ABSTRACT

BACKGROUND: A decrease in coronavirus disease 2019 (COVID-19) vaccination rates has led some states to consider various incentives to boost demand for vaccines. On May 13, 2021, Ohio announced a free weekly lottery for individuals who received at least 1 COVID-19 vaccination. This study seeks to rigorously quantify the impact of Ohio's vaccination lottery. METHODS: A synthetic control consisting of a weighted combination of other states was used to approximate the demographic characteristics, new cases, and vaccination rates in Ohio prior to the lottery announcement. The difference in vaccination rates in Ohio and the synthetic control following the lottery announcement was then used to estimate the lottery's impact. RESULTS: Prior to the lottery announcement, Ohio and synthetic Ohio had similar demographic characteristics and new case rates. Ohio and synthetic Ohio also had identical first vaccination rates. By the final lottery enrollment date of June 20, the percentage of the population with first vaccinations increased to 47.41% in Ohio and 46.43% in synthetic Ohio for a difference of 0.98% (95% confidence interval [CI] 0.42-1.54). CONCLUSION: An additional 114,553 Ohioans received vaccinations as a result of the Vax-a-Million program (95% CI 49,094-180,012) at a cost of approximately $49 per Ohioan vaccinated (95% CI $31-$114). However, a majority of Ohioans remained unvaccinated by the end of the lottery, indicating that additional efforts are needed to address barriers to vaccination. This synthetic control approach may also be useful to evaluate other COVID-19 incentive programs.


Subject(s)
Behavior Control/methods , COVID-19 , Immunization Programs , Mass Vaccination , Motivation , Vaccination Coverage , COVID-19/epidemiology , COVID-19/prevention & control , Female , Humans , Immunization Programs/methods , Immunization Programs/organization & administration , Immunization Programs/statistics & numerical data , Male , Mass Vaccination/psychology , Mass Vaccination/statistics & numerical data , Middle Aged , Ohio/epidemiology , SARS-CoV-2 , Vaccination Coverage/methods , Vaccination Coverage/statistics & numerical data , Vaccination Refusal/psychology
9.
Public Health Rep ; 136(4): 403-412, 2021.
Article in English | MEDLINE | ID: covidwho-1295312

ABSTRACT

OBJECTIVE: Data-informed decision making is valued among school districts, but challenges remain for local health departments to provide data, especially during a pandemic. We describe the rapid planning and deployment of a school-based COVID-19 surveillance system in a metropolitan US county. METHODS: In 2020, we used several data sources to construct disease- and school-based indicators for COVID-19 surveillance in Franklin County, an urban county in central Ohio. We collected, processed, analyzed, and visualized data in the COVID-19 Analytics and Targeted Surveillance System for Schools (CATS). CATS included web-based applications (public and secure versions), automated alerts, and weekly reports for the general public and decision makers, including school administrators, school boards, and local health departments. RESULTS: We deployed a pilot version of CATS in less than 2 months (August-September 2020) and added 21 school districts in central Ohio (15 in Franklin County and 6 outside the county) into CATS during the subsequent months. Public-facing web-based applications provided parents and students with local information for data-informed decision making. We created an algorithm to enable local health departments to precisely identify school districts and school buildings at high risk of an outbreak and active SARS-CoV-2 transmission in school settings. PRACTICE IMPLICATIONS: Piloting a surveillance system with diverse school districts helps scale up to other districts. Leveraging past relationships and identifying emerging partner needs were critical to rapid and sustainable collaboration. Valuing diverse skill sets is key to rapid deployment of proactive and innovative public health practices during a global pandemic.


Subject(s)
COVID-19/epidemiology , Intersectoral Collaboration , Public Health Surveillance , Schools/statistics & numerical data , COVID-19/prevention & control , Data Collection , Humans , Ohio/epidemiology , Pilot Projects , Socioeconomic Factors
10.
J Addict Med ; 16(2): e118-e122, 2022.
Article in English | MEDLINE | ID: covidwho-1281878

ABSTRACT

OBJECTIVE: During the COVID-19 pandemic, states have had to confront a drug overdose problem associated with the pandemic. The objective of this study was to identify the impact of the COVID-19 pandemic on the opioid epidemic in the state of Ohio by describing the changes in the quarterly opioid overdose deaths (OOD) over the last 10 years. METHODS: This longitudinal study included OOD data from death records obtained through the Ohio Department of Health. Temporal trend analysis and visualizations were performed on the OOD death rate per 100,000 quarterly from 2010 to 2020. Age, sex, and ethnicity were also analyzed. RESULTS: The OOD rate of 11.15 in Q2 of 2020 was statistically equivalent to the previous peak level of 10.87 in Q1 of 2017. There was a significant increase in the OOD rate from Q1 to Q2 of 2020 and a significant difference between the actual Q2 of 2020 OOD rate and the predicted OOD rate. The poisoning indicator fentanyl was present in 94% of OOD during Q2 of 2020. The total number of OOD remains highest in the White population. There was no significant difference between the actual and predicted OOD rates in the Black population of Q2 of 2020 based on the trend line. However, the OOD rate of 14.29 in Q2 of 2020 was significantly higher than the previous peak level of 8.34 in Q2 of 2017. The Q2 of 2020 OOD rates for 18 to 39 and 40+ age groups were significantly higher from what would be expected from the trend predictions. CONCLUSIONS: Based on these findings, Ohio has entered a COVID-19 pandemic mediated fourth wave in the opioid epidemic. These findings further suggest that as efforts are made to address the worldwide COVID-19 pandemic, states need to maintain their vigilance toward combating the local opioid epidemic.


Subject(s)
COVID-19 , Drug Overdose , Opiate Overdose , Analgesics, Opioid , Drug Overdose/epidemiology , Humans , Longitudinal Studies , Ohio/epidemiology , Opiate Overdose/epidemiology , Pandemics
11.
Proc Natl Acad Sci U S A ; 118(26)2021 06 29.
Article in English | MEDLINE | ID: covidwho-1281763

ABSTRACT

Globally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 59 million people and killed more than 1.39 million. Designing and monitoring interventions to slow and stop the spread of the virus require knowledge of how many people have been and are currently infected, where they live, and how they interact. The first step is an accurate assessment of the population prevalence of past infections. There are very few population-representative prevalence studies of SARS-CoV-2 infections, and only two states in the United States-Indiana and Connecticut-have reported probability-based sample surveys that characterize statewide prevalence of SARS-CoV-2. One of the difficulties is the fact that tests to detect and characterize SARS-CoV-2 coronavirus antibodies are new, are not well characterized, and generally function poorly. During July 2020, a survey representing all adults in the state of Ohio in the United States collected serum samples and information on protective behavior related to SARS-CoV-2 and coronavirus disease 2019 (COVID-19). Several features of the survey make it difficult to estimate past prevalence: 1) a low response rate; 2) a very low number of positive cases; and 3) the fact that multiple poor-quality serological tests were used to detect SARS-CoV-2 antibodies. We describe a Bayesian approach for analyzing the biomarker data that simultaneously addresses these challenges and characterizes the potential effect of selective response. The model does not require survey sample weights; accounts for multiple imperfect antibody test results; and characterizes uncertainty related to the sample survey and the multiple imperfect, potentially correlated tests.


Subject(s)
COVID-19 Serological Testing , COVID-19 , SARS-CoV-2 , Adolescent , Adult , Aged , Bayes Theorem , COVID-19/diagnosis , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Ohio/epidemiology , Prevalence , Seroepidemiologic Studies
12.
J Vasc Surg Venous Lymphat Disord ; 10(1): 8-13, 2022 01.
Article in English | MEDLINE | ID: covidwho-1281479

ABSTRACT

OBJECTIVE: Plasma D-dimer levels >5000 ng/mL are encountered in a number of conditions other than venous thromboembolism (VTE). Recent studies have used plasma D-dimer levels as a prognostic indicator for coronavirus disease 2019 (COVID-19) infection. The implications of abnormal levels are less clear for patients diagnosed with COVID-19 with a baseline elevation in plasma D-dimer levels. In the present study, we reviewed the occurrence of plasma D-dimer levels >5000 ng/mL and investigated the clinical significance of this finding before the onset of the COVID-19 pandemic. METHODS: Inpatient records for a 4-year period were screened for laboratory results of plasma D-dimer levels >5000 ng/mL. The patient data were reviewed for the clinical identifiers commonly associated with elevated plasma D-dimer levels, including VTE, cancer, sepsis, pneumonia, other infection, bleeding, and trauma. The patients were then categorized into groups stratified by the plasma D-dimer level to allow for comparisons between the various clinical diagnoses. RESULTS: A total of 671 patients were included in the present study. VTE was the most common diagnosis for patients with a plasma D-dimer level >5000 ng/mL, followed by cancer and pneumonia. Multiple clinical diagnoses were present in 61% of the patients. No clear cause for the ultra-high plasma D-dimer level could be identified in 11.3% of the patients. Among the patients lacking a clinical diagnosis at discharge, mortality was 24% in the 5000- to 10,000-ng/mL group, 28.6% in the 10,000- to 15,000-ng/mL group, and 75% in the >15,000-ng/mL group. CONCLUSIONS: VTE, cancer, and pneumonia were frequently present when ultra-high plasma D-dimer levels were encountered, and mortality was high when the levels were >15,000 ng/mL. The results from our study from a pre-COVID-19 patient population suggest that ultra-high plasma D-dimer levels indicate the presence of severe underlying disease. This should be considered when using the plasma D-dimer level as a screening tool or prognostic indicator for COVID-19 infection.


Subject(s)
COVID-19/complications , Fibrin Fibrinogen Degradation Products/metabolism , Venous Thromboembolism/blood , Aged , Biomarkers/blood , COVID-19/blood , COVID-19/epidemiology , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Male , Ohio/epidemiology , Pandemics , Retrospective Studies , Time Factors , Venous Thromboembolism/etiology
15.
Child Abuse Negl ; 117: 105090, 2021 07.
Article in English | MEDLINE | ID: covidwho-1213081

ABSTRACT

BACKGROUND: Emerging research suggests that parents are experiencing heightened stress during the COVID-19 pandemic. Parental stress is a risk factor for harsh or punitive parenting, and this association may be exacerbated by the use of alcohol. OBJECTIVE: We examine whether parental stress is associated with use of punitive parenting, as well as whether this association is modified by drinking pattern. PARTICIPANTS & SETTING: We used advertisements and word-of-mouth to recruit 342 parents living in Central Ohio during the initial stay-at-home order for COVID-19. METHODS: We used geographic ecological momentary assessment (gEMA) to measure parental stress and punitive parenting during three time periods (10 a.m., 3 p.m., and 9 p.m.) over a period of fourteen days using an app downloaded to their cellular telephone. Participants also completed a longer baseline survey. We used nested multilevel ordinal regression models, where at-the-moment assessments (Level 1) were nested within individuals (Level 2) to analyze data. RESULTS: Higher levels of parental stress [OR = 1.149 (95 % CI = 1.123, 1.176)] and later time of day [OR = 1.255 (95 % CI = 1.146, 1.373)] were positively related to odds of punitive parenting. Drinking pattern was not significantly related to punitive parenting in models with demographic covariates. Parents who drank alcohol both monthly and weekly and had higher levels of stress had greater odds of punitive parenting than parents with high levels of stress who abstain from alcohol. CONCLUSIONS: Alcohol may be an accelerant in the use of punitive parenting for parents experiencing stress. As alcohol use increases during COVID-19, children may be at higher risk for punitive parenting.


Subject(s)
Alcohol Drinking/psychology , COVID-19/psychology , Ecological Momentary Assessment , Parenting/psychology , Punishment/psychology , Stress, Psychological , Adult , Child , Child, Preschool , Female , Humans , Male , Ohio/epidemiology , SARS-CoV-2
16.
PLoS One ; 16(4): e0250400, 2021.
Article in English | MEDLINE | ID: covidwho-1197391

ABSTRACT

IMPORTANCE: The ongoing pandemic of the novel Corona Virus Disease 2019 (COVID-19) is an unprecedented challenge to global health, never experienced before. OBJECTIVE: This study aims to describe the clinical characteristics and outcomes of patients with COVID-19 admitted to Mercy Hospitals. DESIGN AND METHODS: Retrospective, observational cohort study designed to include every COVID-19 subject aged 18 years or older admitted to Mercy Saint (St) Vincent, Mercy St Charles, and Mercy St Anne's hospital in Toledo, Ohio from January 1, 2020 through June 15th, 2020. Primary Outcome Measure was mortality in the emergency department or as an in-patient. RESULTS: 470 subjects including 224 males and 246 females met the inclusion criteria for the study. Subjects with the following characteristics had higher odds (OR) of death: Older age [OR 8.3 (95% CI 1.1-63.1, p = 0.04)] for subjects age 70 or more compared to subjects age 18-29); Hypertension [OR 3.6 (95% CI 1.6-7.8, p = 0.001)]; Diabetes [OR 3.1 (95% CI 1.7-5.6, p<0.001)]; COPD [OR 3.4 (95% CI 1.8-6.3, p<0.001)] and CKD stage 2 or greater [OR 2.5 (95% CI 1.3-4.9, p = 0.006)]. Combining all age groups, subjects with hypertension had significantly greater odds of the following adverse outcomes: requiring hospital admission (OR 2.2, 95% CI 1.4-3.4, p<0.001); needing respiratory support in 24 hours (OR 2.5, 95% CI: 1.7-3.7, p<0.001); ICU admission (OR 2.7, 95% CI 1.7-4.4, p<0.001); and death (OR 3.6, 95% CI 1.6-7.8, p = 0.001). Hypertension was not associated with needing vent in 24 hours (p = 0.07). CONCLUSION: Age and hypertension were associated with significant comorbidity and mortality in Covid-19 Positive patients. Furthermore, people who were older than 70, and had hypertension, diabetes, COPD, or CKD had higher odds of dying from the disease as compared to patients who hadn't. Subjects with hypertension also had significantly greater odds of other adverse outcomes.


Subject(s)
COVID-19/epidemiology , Adolescent , Adult , Age Factors , Aged , COVID-19/diagnosis , COVID-19/mortality , COVID-19/therapy , Comorbidity , Diabetes Mellitus/epidemiology , Female , Hospital Mortality , Humans , Hypertension/epidemiology , Intensive Care Units , Male , Middle Aged , Ohio/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Renal Insufficiency, Chronic/epidemiology , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification , Young Adult
17.
Am J Health Promot ; 35(1): 77-83, 2021 01.
Article in English | MEDLINE | ID: covidwho-1197317

ABSTRACT

PURPOSE: To evaluate the feasibility, utility, and limitations of a rapid community behavioral diagnosis (RCBD) for social distancing behaviors to prevent coronavirus transmission during a global coronavirus pandemic. DESIGN: Using social media for recruitment, we partnered with a local community task force to administer a brief online survey. SETTING: Residential urban community. SAMPLE: Eighty-four community members, the majority of whom were white, female, college educated completed the survey. MEASURES: Theory of planned behavior constructs: behavioral intentions, attitudes, perceived norms, and perceived behavioral control for 3 social distancing behaviors: maintaining a 6-foot distance, avoiding places people congregate, and staying home as much as possible. ANALYSIS: Path analyses were conducted to understand significant determinants of intentions for each behavior to guide the development of locally tailored health promotion messages. RESULTS: The RCBD was implemented, and results were communicated to the community within 1 week. Intentions were high across the 3 behaviors but lowest for staying home as much as possible. Younger participants had lower intentions of maintaining a 6-foot distance than older participants. For each behavior, specific recommendations for health promotion messaging emerged based on how attitudes, norms, and perceived behavioral control related to intentions. CONCLUSION: In a situation where local community action is paramount for reducing coronavirus transmission, this RCBD process is feasible and useful for informing local health promotion.


Subject(s)
Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Guideline Adherence , Health Promotion/organization & administration , Pandemics/prevention & control , Physical Distancing , Social Isolation/psychology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Feasibility Studies , Female , Humans , Male , Ohio/epidemiology , Surveys and Questionnaires
18.
J Med Virol ; 93(5): 2875-2882, 2021 05.
Article in English | MEDLINE | ID: covidwho-1196523

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic continues to cause significant morbidity and mortality worldwide. This study aims to identify specific lab markers, complications, and treatments that may be associated with increased mortality in COVID-19 patients. This study is retrospective in nature; it included 217 COVID-19 positive patients who were admitted to a ProMedica Health System hospital in Northwest Ohio, United States, between March 25 and June 16, 2020. We collected various laboratory values, complications, and treatment courses. T test and χ2 analyses were used to predict mortality. COVID-19 test was confirmed via polymerase chain reaction. Of 217 patients included in the study, the mean age of the population was 63.13 (SD, 17.8), of which 194 (89.4%, mean age 61.7 years) survived while 23 (10.6%, mean age 74.6 years) died. Among them, 53% were females and 47% male. Laboratory values that were associated with mortality were low hemoglobin (p = .0046), elevated INR (p = .0005), low platelets (p = .0246) and elevated procalcitonin (p = .0472). Marginally significant laboratory values included elevated troponin (p = .0661), and elevated creatinine (p = .0741). Treatment with either antibiotic, antifungals, antivirals, blood transfusion, steroids, and intubation were all statistically significant for mortality. COVID-19 related complications with either ARDS, myocarditis, elevated INR, septic shock, or age greater than 63 were significant predictors of mortality. Low hemoglobin, elevated INR, Low platelet, elevated procalcitonin, treated with either antibiotic, antifungal, antiviral, blood transfusion, steroids, and intubation are associated with high mortality related to COVID-19 infection. Healthcare professionals must be aware of these predictors.


Subject(s)
COVID-19/mortality , Aged , Aged, 80 and over , Biomarkers/blood , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/therapy , Female , Hospital Mortality , Hospitalization , Humans , Male , Middle Aged , Odds Ratio , Ohio/epidemiology , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification
20.
Pediatr Pulmonol ; 56(7): 1951-1956, 2021 07.
Article in English | MEDLINE | ID: covidwho-1179015

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic profoundly impacted health care utilization. We evaluated asthma-related emergency department (ED) and inpatient health care utilization by a county-specific Medicaid population, ages 2-18, during the COVID-19 pandemic and compared it to utilization from a 3-year average including 2017-2019. All-cause ED utilization and asthma medication fill rates were evaluated during the same timeframes. Relative to the 2017-2019 3-year average, cumulative asthma-related ED visits from January through June decreased by 45.8% (p = .03) and inpatient admission rates decreased by 50.5% (p = .03). The decline in asthma-related ED utilization was greater than the reduction of overall ED use during the same time period, suggesting that the decline involved factors specific to asthma and was not due solely to avoidance of health care facilities. Fill rates for asthma controller medications decreased during this time (p = .03) and quick relief medication fill rates had no significant change (p = .31). Multiple factors may have contributed to the decrease in acute asthma health care visits. Locally, decreased air pollution and viral exposures coincided with the "Stay-at-home" order in Ohio, and increased utilization of telehealth for assessment during exacerbations may have impacted outcomes. Identification of the cause of the decline in visit rates could spur new interventions to limit the need for ED and inpatient visits for asthma patients, leading to both economic and health-associated benefits.


Subject(s)
Asthma/physiopathology , COVID-19/epidemiology , Pandemics , Adolescent , Air Pollution , Asthma/complications , Asthma/drug therapy , COVID-19/complications , COVID-19/virology , Child , Child, Preschool , Emergency Service, Hospital , Female , Humans , Inpatients , Male , Medicaid , Morbidity , Ohio/epidemiology , Patient Acceptance of Health Care , Patient Admission/statistics & numerical data , SARS-CoV-2 , Telemedicine , United States
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