ABSTRACT
BACKGROUNDReports on medium and long-term sequelae of SARS-CoV-2 infections largely lack quantification of incidence and relative risk. We describe the rationale and methods of the Innovative Support for Patients with SARS-CoV-2 Registry (INSPIRE) that combines patient-reported outcomes with data from digital health records to understand predictors and impacts of SARS-CoV-2 infection. METHODSINSPIRE is a prospective, multicenter, longitudinal study of individuals with symptoms of SARS-CoV-2 infection in eight regions across the US. Adults are eligible for enrollment if they are fluent in English or Spanish, reported symptoms suggestive of acute SARS-CoV-2 infection, and if they are within 42 days of having a SARS-CoV-2 viral test (i.e., nucleic acid amplification test or antigen test), regardless of test results. Recruitment occurs in-person, by phone or email, and through online advertisement. A secure online platform is used to facilitate the collation of consent-related materials, digital health records, and responses to self-administered surveys. Participants are followed for up to 18 months, with patient-reported outcomes collected every three months via survey and linked to concurrent digital health data; follow-up includes no in-person involvement. Our planned enrollment is 4,800 participants, including 2,400 SARS-CoV-2 positive and 2,400 SARS-CoV-2 negative participants (as a concurrent comparison group). These data will allow assessment of longitudinal outcomes from SARS-CoV-2 infection and comparison of the relative risk of outcomes in individuals with and without infection. Patient-reported outcomes include self-reported health function and status, as well as clinical outcomes including health system encounters and new diagnoses. RESULTSParticipating sites obtained institutional review board approval. Enrollment and follow-up are ongoing. CONCLUSIONSThis study will characterize medium and long-term sequelae of SARS-CoV-2 infection among a diverse population, predictors of sequelae, and their relative risk compared to persons with similar symptomatology but without SARS-CoV-2 infection. These data may inform clinical interventions for individuals with sequelae of SARS-CoV-2 infection.
ABSTRACT
PurposeEvidence suggests that older adults, racial/ethnic minorities, and those with comorbidities all face elevated risk for morbidity and mortality from COVID-19; but there are limited reports describing the potential for interactions between these factors. MethodsWe sought to evaluate age-based heterogeneity in observed disparities in hospitalization, ICU admission, and mortality related to COVID-19 using CDC public use surveillance data on 3,662,325 COVID-19 cases reported from January 1 to August 30, 2020. ResultsRacial/ethnic and comorbidity disparities in hospitalization were most pronounced during ages 20-29 and ages 10-19, with similar elevation seen for disparities in ICU risk. Racial/ethnic disparities in mortality were most pronounced during ages 20-29 while risk from comorbidity peaks among ages 10-39. ConclusionsAs COVID-19 continues to affect younger populations, special attention to the implications for the most vulnerable subgroups are clearly warranted. Implications and ContributionAdolescents and young adults appear to have experienced the greatest inequities in COVID-19 outcomes by race/ethnicity and comorbidity. Careful monitoring of trends in this population is warranted as they re-enter school, work, and social settings while being the last group to receive priority for vaccination.
