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Fasoulakis Z, Kurjak A, Sapantzoglou I, Daskalaki AM, Daskalakis G, Antsaklis P. KANET evaluation in patients with SARS-CoV-2. J Perinat Med 2024; 52:811-816. [PMID: 39217455 DOI: 10.1515/jpm-2024-0258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES To determine a possible correlation between SARS-CoV-2 infection during pregnancy and altered fetal behavior. METHODS Kurjak's antenatal neurodevelopmental test (KANET) was applied from 28 to 40 weeks in 38 gestations (group A) diagnosed with COVID-19 infection during the first week and 43 non-COVID pregnant women (group B). RESULTS No statistically significant differences considering maternal age (33±3.9 years for group A vs. 31±4.1 years for group B) and gestational age (33±1.6 weeks for group A compared to 33±2.1 weeks for group B) were observed. KANET scores were not different between the two groups. CONCLUSIONS Fetal behavior differences are not altered in women diagnosed with SARS-CoV-2 infection during the third trimester of pregnancy.
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Affiliation(s)
- Zacharias Fasoulakis
- 1st Department of Obstetrics and Gynecology, 68989 National and Kapodistrian University of Athens , Athens, Greece
| | - Asim Kurjak
- Department of Obstetrics and Gynecology, Medical School University of Zagreb, Zagreb, Croatia
| | - Ioakeim Sapantzoglou
- 1st Department of Obstetrics and Gynecology, 68989 National and Kapodistrian University of Athens , Athens, Greece
| | - Anastasia Maria Daskalaki
- 1st Department of Obstetrics and Gynecology, 68989 National and Kapodistrian University of Athens , Athens, Greece
| | - George Daskalakis
- 1st Department of Obstetrics and Gynecology, 68989 National and Kapodistrian University of Athens , Athens, Greece
| | - Panos Antsaklis
- 1st Department of Obstetrics and Gynecology, 68989 National and Kapodistrian University of Athens , Athens, Greece
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Schwalbe N, Nunes MC, Cutland C, Wahl B, Reidpath D. Assessing New York City's COVID-19 Vaccine Rollout Strategy: A Case for Risk-Informed Distribution. J Urban Health 2024; 101:923-933. [PMID: 38578336 DOI: 10.1007/s11524-024-00853-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/06/2024]
Abstract
This study reviews the impact of eligibility policies in the early rollout of the COVID-19 vaccine on coverage and probable outcomes, with a focus on New York City. We conducted a retrospective ecological study assessing age 65+, area-level income, vaccination coverage, and COVID-19 mortality rates, using linked Census Bureau data and New York City Health administrative data aggregated at the level of modified zip code tabulation areas (MODZCTA). The population for this study was all individuals in 177 MODZCTA in New York City. Population data were obtained from Census Bureau and New York City Health administrative data. The total mortality rate was examined through an ordinary least squares (OLS) regression model, using area-level wealth, the proportion of the population aged 65 and above, and the vaccination rate among this age group as predictors. Low-income areas with high proportions of older people demonstrated lower coverage rates (mean vaccination rate 52.8%; maximum coverage 67.9%) than wealthier areas (mean vaccination rate 74.6%; maximum coverage 99% in the wealthiest quintile) in the first 3 months of vaccine rollout and higher mortality over the year. Despite vaccine shortages, many younger people accessed vaccines ahead of schedule, particularly in high-income areas (mean coverage rate 60% among those 45-64 years in the wealthiest quintile). A vaccine program that prioritized those at greatest risk of COVID-19-associated morbidity and mortality would have prevented more deaths than the strategy that was implemented. When rolling out a new vaccine, policymakers must account for local contexts and conditions of high-risk population groups. If New York had focused limited vaccine supply on low-income areas with high proportions of residents 65 or older, overall mortality might have been lower.
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Affiliation(s)
- Nina Schwalbe
- School of Pathology, Faculty of Health Science, University of the Witwatersrand, January 1 Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa.
- Heilbrunn Department of Population and Family Health, Columbia University, 722 W 168Th St, New York, NY, 10032, USA.
| | - Marta C Nunes
- Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2000, South Africa
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon (HCL), and Centre International de Recherche en Infectiologie (CIRI), Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard Lyon 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Clare Cutland
- Wits African Leadership in Vaccinology Expertise (Wits-Alive), School of Pathology, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Brian Wahl
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Daniel Reidpath
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU, UK
- School of Social Sciences, Monash University, Clayton, VIC, 3125, Australia
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3
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De Ridder D, Ladoy A, Choi Y, Jacot D, Vuilleumier S, Guessous I, Joost S, Greub G. Environmental and geographical factors influencing the spread of SARS-CoV-2 over 2 years: a fine-scale spatiotemporal analysis. Front Public Health 2024; 12:1298177. [PMID: 38957202 PMCID: PMC11217542 DOI: 10.3389/fpubh.2024.1298177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
Introduction Since its emergence in late 2019, the SARS-CoV-2 virus has led to a global health crisis, affecting millions and reshaping societies and economies worldwide. Investigating the determinants of SARS-CoV-2 diffusion and their spatiotemporal dynamics at high spatial resolution is critical for public health and policymaking. Methods This study analyses 194,682 georeferenced SARS-CoV-2 RT-PCR tests from March 2020 and April 2022 in the canton of Vaud, Switzerland. We characterized five distinct pandemic periods using metrics of spatial and temporal clustering like inverse Shannon entropy, the Hoover index, Lloyd's index of mean crowding, and the modified space-time DBSCAN algorithm. We assessed the demographic, socioeconomic, and environmental factors contributing to cluster persistence during each period using eXtreme Gradient Boosting (XGBoost) and SHapley Additive exPlanations (SHAP), to consider non-linear and spatial effects. Results Our findings reveal important variations in the spatial and temporal clustering of cases. Notably, areas with flatter epidemics had higher total attack rate. Air pollution emerged as a factor showing a consistent positive association with higher cluster persistence, substantiated by both immission models and, to a lesser extent, tropospheric NO2 estimations. Factors including population density, testing rates, and geographical coordinates, also showed important positive associations with higher cluster persistence. The socioeconomic index showed no significant contribution to cluster persistence, suggesting its limited role in the observed dynamics, which warrants further research. Discussion Overall, the determinants of cluster persistence remained across the study periods. These findings highlight the need for effective air quality management strategies to mitigate air pollution's adverse impacts on public health, particularly in the context of respiratory viral diseases like COVID-19.
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Affiliation(s)
- David De Ridder
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Geospatial Molecular Epidemiology Group (GEOME), Laboratory for Biological Geochemistry (LGB), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Anaïs Ladoy
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Geospatial Molecular Epidemiology Group (GEOME), Laboratory for Biological Geochemistry (LGB), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Yangji Choi
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Damien Jacot
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Séverine Vuilleumier
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Idris Guessous
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Joost
- Geographic Information Research and Analysis in Population Health (GIRAPH) Lab, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland
- Geospatial Molecular Epidemiology Group (GEOME), Laboratory for Biological Geochemistry (LGB), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
- Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- La Source School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Infectious Diseases Service, Lausanne University Hospital, Lausanne, Switzerland
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4
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Dubois B, Mills AN, Jessel RH, Lieb W, Glazer KB. Disparities in perinatal COVID-19 infection and vaccination. Semin Perinatol 2024; 48:151923. [PMID: 38960750 DOI: 10.1016/j.semperi.2024.151923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
The COVID-19 pandemic exposed and exacerbated persistent health inequities in perinatal populations, resulting in disparities of maternal and fetal complications. In this narrative review, we present an adapted conceptual framework of perinatal social determinants of health in the setting of the COVID-19 pandemic and use this framework to contextualize the literature regarding disparities in COVID-19 vaccination and infection. We synthesize how elements of the structural context, individual socioeconomic position, and concrete intermediary determinants influence each other and perinatal COVID-19 vaccination and infection, arguing that systemic inequities at each level contribute to observed disparities in perinatal health outcomes. From there, we identify gaps in the literature, propose mechanisms for observed disparities, and conclude with a discussion of strategies to mitigate them.
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Affiliation(s)
- Bethany Dubois
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandra N Mills
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rebecca H Jessel
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Whitney Lieb
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kimberly B Glazer
- Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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5
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Christenson RH, Hansel S, II'yasova D, Meyer WA, Puckrein G, Lee L, Landry LG, Akinboboye O. Nucleocapsid and Spike Protein-Based Anti-SARS-CoV-2 Assay Performance in the Minority and Rural Coronavirus Insights Study: Characteristics of Socioeconomically Disadvantaged Populations with Health Disparities. J Appl Lab Med 2024; 9:493-501. [PMID: 38384143 DOI: 10.1093/jalm/jfad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/14/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND COVID-19 has had a devastating impact on Black, Hispanic, and other underserved, disadvantaged populations. Here anti-SARS-CoV-2 tests are characterized in disadvantaged patients to examine equivalence in US populations. METHODS Underserved participant adults (age > 18 years) were enrolled before the availability of SARS-CoV-2 vaccines in Federal Qualified Health Centers in California, Florida, Louisiana, Illinois, and Ohio and contributed samples to the Minority and Rural Coronavirus Insights Study (MRCIS). A subset coined the MRCIS SARS-CoV-2 Antibody Cohort of 2365 participants was tested with the Roche Anti-SARS-CoV-2 assay (Cobas e601). Five hundred ninety-five of these were also tested with the Ortho Clinical Diagnostics VITROS Anti-SARS-CoV-2 IgG assay (VITROS-5600); 1770 were also tested with the Abbott ARCHITECT SARS-CoV-2 IgG assay (ARCHITECT-2000). Assay-specific cutoffs classified negative/positive results. RESULTS Eight point four percent (199/2365) of the MRCIS SARS-CoV-2 Antibody Cohort was SARS-CoV-2 RNA positive at enrollment. Agreement between the Ortho/Roche and the Abbott/Roche antibody testing did not vary by enrollment RNA status. The Ortho (anti-spike protein) vs Roche (anti-nucleocapsid protein) comparison agreed substantially: kappa = 0.63 (95% CI: 0.57-0.69); overall agreement, 83%. However, agreement was even better for the Abbott vs Roche assays (both anti-nucleocapsid protein tests): kappa = 0.85 (95% CI: 0.81-0.87); overall agreement, 95%. Anti-SARS-CoV-2 comparisons stratified by demographic criteria demonstrated no significant variability in agreement by sex, race/ethnicity, or age. CONCLUSIONS Analytical agreement is 96.4% for anti-spike-protein vs anti-nucleocapsid-protein comparisons. Physiologically, seroreversion of anti-nucleocapsid reactivity after infection occurred in the disadvantaged population similarly to general populations. No anti-SARS-CoV-2 assays included demonstrated a clinically significant difference due to the demographics of the disadvantaged MRCIS SARS-CoV-2 Antibody Cohort.
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Affiliation(s)
- Robert H Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Shantoy Hansel
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
| | - Dora II'yasova
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, United States
| | - William A Meyer
- Medical Affairs, Quest Diagnostics, Secaucus, NJ, United States
| | - Gary Puckrein
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
| | - LaTasha Lee
- Center for Clinical & Social Research, National Minority Quality Forum, Washington, DC, United States
- Department of Clinical Research and Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States
| | - Latrice G Landry
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Fitzsimmons K, Hood M, Grattan K, Laing J, Sparer-Fine E. COVID-19 mortality among Massachusetts workers and the association with telework ability, 2020. Am J Ind Med 2024; 67:364-375. [PMID: 38430201 DOI: 10.1002/ajim.23579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Working outside the home put some workers at risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and might partly explain elevated coronavirus disease 2019 (COVID-19) mortality rates in the first months of the pandemic in certain groups of Massachusetts workers. To further investigate this premise, we examined COVID-19 mortality among Massachusetts workers, with a specific focus on telework ability based on occupation. METHODS COVID-19-associated deaths between January 1 and December 31, 2020 among Massachusetts residents aged 18-64 years were analyzed. Deaths were categorized into occupation-based quadrants (Q) of telework ability. Age-adjusted rates were calculated by key demographics, industry, occupation, and telework quadrant using American Community Survey workforce estimates as denominators. Rate ratios (RRs) and 95% confidence intervals comparing rates for quadrants with workers unlikely able to telework (Q2, Q3, Q4) to that among those likely able to telework (Q1) were calculated. RESULTS The overall age-adjusted COVID-19-associated mortality rate was 26.4 deaths per 100,000 workers. Workers who were male, Black non-Hispanic, Hispanic, born outside the US, and with lower than a high school education level experienced the highest rates among their respective demographic groups. The rate varied by industry, occupation and telework quadrant. RRs comparing Q2, Q3, and Q4 to Q1 were 0.99 (95% confidence interval [CI]: 0.8-1.2), 3.2 (95% CI: 2.6-3.8) and 2.5 (95% CI: 2.0-3.0), respectively. CONCLUSION Findings suggest a positive association between working on-site and COVID-19-associated mortality. Work-related factors likely contributed to COVID-19 among Massachusetts workers and should be considered in future studies of COVID-19 and similar diseases.
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Affiliation(s)
- Kathleen Fitzsimmons
- Massachusetts Department of Public Health, Occupational Health Surveillance Program, Boston, USA
| | - Malena Hood
- Massachusetts Department of Public Health, Special Analytic Projects, Office of Population Health, Boston, USA
| | - Kathleen Grattan
- Massachusetts Department of Public Health, Occupational Health Surveillance Program, Boston, USA
| | - James Laing
- Massachusetts Department of Public Health, Occupational Health Surveillance Program, Boston, USA
| | - Emily Sparer-Fine
- Massachusetts Department of Public Health, Occupational Health Surveillance Program, Boston, USA
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Wang WH, Chiu FY, Kuo TT, Shao YHJ. Maternal Prenatal Infections and Biliary Atresia in Offspring. JAMA Netw Open 2024; 7:e2350044. [PMID: 38170523 PMCID: PMC10765264 DOI: 10.1001/jamanetworkopen.2023.50044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/15/2023] [Indexed: 01/05/2024] Open
Abstract
Importance Investigations into the association of antepartum maternal infections with the pathogenesis of biliary atresia (BA) in human offspring are insufficient. Objective To examine the association between prenatal infections in mothers and the development of BA in their offspring. Design, Setting, and Participants This population-based case-control study obtained administrative data from the Taiwan National Health Insurance Research Database with linkage to the Taiwan Maternal and Child Health Database, capturing demographic and medical information on nearly all 23 million of the Taiwan population. The cohort comprised 2 905 978 singleton live births among mother-infant dyads between January 1, 2004, and December 31, 2020, in Taiwan. The case group of infants with BA was identified from use of International Classification of Diseases diagnostic codes for BA and subsequent Kasai procedure or liver transplant. The control group was randomly selected from infants without BA, representing approximately 1 in 1000 study population. Data analyses were performed from May 1 to October 31, 2023. Exposure Prenatal maternal infections, including intestinal infection, influenza, upper airway infection, pneumonia, soft-tissue infection, and genitourinary tract infection. Main Outcomes and Measures The main outcome was exposure to prenatal maternal infections. Inverse probability weighting analysis was performed by building a logistic regression model to estimate the probability of the exposure observed for a particular infant and using the estimated probability as a weight in subsequent analyses. The weighted odds ratio (OR) estimated by logistic regressions was then used to assess the risk of BA in offspring after prenatal maternal infections. Results Among the mother-infant dyads included, 447 infants with BA were cases (232 females [51.9%]) and 2912 infants without BA were controls (1514 males [52.0%]). The mean (SD) maternal age at childbirth was 30.7 (4.9) years. Offspring exposed to prenatal intestinal infection (weighted OR, 1.46; 95% CI, 1.17-1.82) and genitourinary tract infection (weighted OR, 1.22; 95% CI, 1.05-1.41) in mothers exhibited a significantly higher risk of BA. Furthermore, maternal intestinal infection (weighted OR, 6.05; 95% CI, 3.80-9.63) and genitourinary tract infection (weighted OR, 1.55; 95% CI, 1.13-2.11) that occurred during the third trimester were associated with an increased risk of BA in offspring. Conclusions and Relevance Results of this case-control study indicate an association between prenatal intestinal infection and genitourinary tract infection in mothers and BA occurrence in their offspring. Further studies are warranted to explore the underlying mechanisms of this association.
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Affiliation(s)
- Wei-Hao Wang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan
| | - Fang-Yu Chiu
- Department of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Lienchiang County Hospital, Lienchiang, Taiwan
| | - Tzu-Tung Kuo
- Health Data Analytics and Statistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Yu-Hsuan Joni Shao
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Vidal MJ, Martínez-Solanas È, Mendoza S, Sala N, Jané M, Mendioroz J, Ciruela P. Impact of SARS-CoV-2 infection in pregnant women and their babies: clinical and epidemiological features. GACETA SANITARIA 2023; 37:102332. [PMID: 38007961 DOI: 10.1016/j.gaceta.2023.102332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/02/2023] [Accepted: 08/29/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE Assess the risk associated with COVID-19 in pregnant women on maternal and neonatal outcomes in Catalonia (Spain) in 2020, before the beginning of COVID-19 vaccination campaign. METHOD Cross-sectional descriptive study with all pregnant women (41,560) and their live newborns (42,097) (1st March to 31st December 2020). Women were classified: positive and negative COVID-19 diagnosis during pregnancy. The outcomes analysed were complications during pregnancy, gestational age, admission of newborns to neonatal intensive care unit (NICU) and birth weight. Associations among positive COVID-19 and maternal and infant variables were measured with logistic regression models. Results were expressed as odds ratios and 95% confidence intervals. Models were adjusted for nationality, maternal age, socioeconomic status, type of pregnancy and type of centre where the delivery occurred (public or private management hospital). RESULTS A total of 696 women (1.7%) were diagnosed with COVID-19 during pregnancy. Women with COVID-19 were 4.37 times more likely to have complications during pregnancy (4.37; 3.52-5.40). A total of 713 newborns (1.7%) were from mothers with COVID-19. A positive diagnosis of COVID-19 increased the risk of preterm birth (1.41; 1.03-1.89), admission to NICU (1.40; 1.06-1.82) and low birth weight (1.35; 0.99-1.80) in babies. CONCLUSIONS Pregnant women with COVID-19 had higher risk of developing complications during pregnancy and their newborns were more likely to be admitted to NICU and had prematurity.
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Affiliation(s)
- María José Vidal
- Public Health Agency of Catalonia, Department of Health, Generalitat de Catalunya, Barcelona, Spain.
| | - Èrica Martínez-Solanas
- Public Health Agency of Catalonia, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Sergi Mendoza
- Public Health Agency of Catalonia, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Núria Sala
- Public Health Agency of Catalonia, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Mireia Jané
- Public Health Agency of Catalonia, Department of Health, Generalitat de Catalunya, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Jacobo Mendioroz
- Public Health Agency of Catalonia, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Pilar Ciruela
- Public Health Agency of Catalonia, Department of Health, Generalitat de Catalunya, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
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9
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Escobar Vidarte MF, Echavarria MP, Carvajal JA, Albornoz LL, Peña-Zarate EE, Libreros L, Nasner D, Vélez JD. Universal Screening for SARS-CoV-2 in Obstetric Care: Clinical Characteristics and Maternofetal Outcomes in a Latin American High-Complexity Unit. J Patient Exp 2023; 10:23743735231213764. [PMID: 38026062 PMCID: PMC10655671 DOI: 10.1177/23743735231213764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
The asymptomatic population's role in COVID-19 transmission poses challenges for control efforts. Pregnant women are susceptible to severe manifestations, increasing maternal and perinatal morbidity and mortality. This study describes the clinical characteristics, maternal and fetal outcomes, and our experience in universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening of pregnant women admitted to a high-complexity obstetric unit in Latin America. Of 568 pregnant women tested for SARS-CoV-2, 23 obtained a positive result. Among these patients, 17% had symptoms at admission, and 0.2% reported an epidemiological link. Pregnant women with positive were associated with an increased risk of eclampsia (16.7% vs 4.9%, P = .014) and acute respiratory distress (16.7% vs 4.9%, P = .014). In this group, 4 patients developed maternal near misses, and no maternal deaths were noted. Two early perinatal deaths occurred in the positive SARS-CoV-2 test group (2, 9.5% vs 17, 4.1%, P = .235). The high prevalence of asymptomatic pregnant women with SARS-CoV-2 and the adverse outcomes for those infected during pregnancy highlights the importance of universal screening upon hospital admission. This approach streamlines risk management, and enhances service structure, resource allocation, care pathways, patient management, follow-up, and overall outcomes.
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Affiliation(s)
- María Fernanda Escobar Vidarte
- Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
- Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Valle del Cauca, Colombia
| | - Maria Paula Echavarria
- Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
- Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Valle del Cauca, Colombia
| | - Javier Andrés Carvajal
- Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
- Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Valle del Cauca, Colombia
| | - Ludwig Luis Albornoz
- Department of Pathology, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Evelyn E. Peña-Zarate
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Laura Libreros
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Daniela Nasner
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Juan Diego Vélez
- Department of Infectious Disease, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
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10
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Lang S, Silveira L, Smith C, Abuogi L, DeCamp LR. Variation over Time in Child and Neighborhood Characteristics Associated with COVID-19. Health Equity 2023; 7:676-684. [PMID: 37908402 PMCID: PMC10615088 DOI: 10.1089/heq.2022.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction To examine the associations between child and neighborhood characteristics and incidence of COVID-19 infection during the first 19 months of the pandemic. Study Design We utilized individual electronic health record data and corresponding census tract characteristics for pediatric SARS-CoV-2 cases (age <18 years) from March 23, 2020 to September 30, 2021 with molecular tests resulted at a children's health system in Colorado. We compared associations between individual SARS-CoV-2 cases and census tract SARS-CoV-2 positivity rates over three time periods (TP1: March-September 2020; TP2: October 2020-March 2021; TP3: April-September 2021) using multinomial logistic regression for individual associations and negative binomial regression for census tract associations. Results We included 7498 pediatric SARS-CoV-2 cases and data from 711 corresponding census tracts. Spanish preferred health care language was associated with SARS-CoV-2 positivity for TP1 (odds ratio [OR] 4.9, 95% confidence interval [CI] 3.7-6.5) and TP2 (OR 2.01, 95% CI 1.6-2.6) compared with TP3. Other non-English preferred health care language was associated with SARS-CoV-2 positivity in TP1 (OR 2.4, 95% CI 1.4-4.2). Increasing percentage internationally born in a census tract was associated with SARS-CoV-2 positivity for TP1 (multivariable incident rate ratio [IRR]=1.040, p<0.0001), TP2 (multivariable IRR=1.028, p<0.0001), and in all TP combined (multivariable IRR=1.024, p<0.0001). Discussion Our study is notable for the identification of COVID-19 disparities among children in immigrant families and communities, particularly early in the pandemic. Addressing disparities for immigrant communities requires targeted investments in public health infrastructure.
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Affiliation(s)
- Sean Lang
- Department of Pediatrics, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
- Children's Hospital Immunodeficiency Program (CHiP), Children's Hospital Colorado, Aurora, Colorado, USA
| | - Lori Silveira
- Department of Pediatrics, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Christiana Smith
- Department of Pediatrics, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
- Children's Hospital Immunodeficiency Program (CHiP), Children's Hospital Colorado, Aurora, Colorado, USA
| | - Lisa Abuogi
- Department of Pediatrics, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
- Children's Hospital Immunodeficiency Program (CHiP), Children's Hospital Colorado, Aurora, Colorado, USA
| | - Lisa Ross DeCamp
- Department of Pediatrics, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), Aurora, Colorado, USA
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Yu Z, Liu X. Spatial variations of the third and fourth COVID-19 waves in Hong Kong: A comparative study using built environment and socio-demographic characteristics. ENVIRONMENT AND PLANNING. B, URBAN ANALYTICS AND CITY SCIENCE 2023; 50:1144-1160. [PMID: 38603206 PMCID: PMC9168414 DOI: 10.1177/23998083221107019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Since the first confirmed case was reported in January 2020, Hong Kong has experienced multiple waves of COVID-19 outbreaks. Recent literature has explored the spatial patterns of disease incidence and their relationships with the built environment and demographic characteristics. Nonetheless, few studies aim at the comparative patterns of different epidemic waves occurring in the same spatial context. This study analyses spatial patterns of the third and fourth COVID-19 epidemic waves and then evaluates the spatial relationship between case incidence and built environment and socio-demographic characteristics. By collecting local-related cases, this study incorporates a two-fold analytical strategy: (1) Using rank-size distribution and log-odd ratio to depict the spatial pattern of COVID-19 incidence rates; (2) through global and local regression models, investigating incidence's associations with the urban built environment and socio-demographic characteristics. The results reveal that the two different epidemic waves have far distinct spatial tendencies to their infection risk factors, reflecting location-specific associations with the built environments and socio-demographics. Collectively, we discover that the third and fourth COVID-19 waves are likely associated with residential context and urban activities, respectively. Practical implications are discussed that would be of interest to policymakers and health professionals.
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Affiliation(s)
- Zidong Yu
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Xintao Liu
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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12
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Titus AR, Mezuk B, Hirschtick JL, McKane P, Elliott MR, Fleischer NL. Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02453-9. [PMID: 36917277 PMCID: PMC10013232 DOI: 10.1007/s00127-023-02453-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE The COVID-19 pandemic has had wide-ranging impacts on mental health, however, less is known about predictors of mental health outcomes among adults who have experienced a COVID-19 diagnosis. We examined the intersection of demographic, economic, and illness-related predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in the U.S. state of Michigan early in the pandemic. METHODS Data were from a population-based survey of Michigan adults who experienced a COVID-19 diagnosis prior to August 1, 2020 (N = 1087). We used weighted prevalence estimates and multinomial logistic regression to examine associations between mental health outcomes (depressive symptoms, anxiety symptoms, and comorbid depressive/anxiety symptoms) and demographic characteristics, pandemic-associated changes in accessing basic needs (accessing food/clean water and paying important bills), self-reported COVID-19 symptom severity, and symptom duration. RESULTS Relative risks for experiencing poor mental health outcomes varied by sex, age, race/ethnicity, and income. In adjusted models, experiencing a change in accessing basic needs associated with the pandemic was associated with higher relative risks for anxiety and comorbid anxiety/depressive symptoms. Worse COVID-19 symptom severity was associated with a higher burden of comorbid depressive/anxiety symptoms. "Long COVID" (symptom duration greater than 60 days) was associated with all outcomes. CONCLUSION Adults diagnosed with COVID-19 may face overlapping risk factors for poor mental health outcomes, including pandemic-associated disruptions to household and economic wellbeing, as well as factors related to COVID-19 symptom severity and duration. An integrated approach to treating depressive/anxiety symptoms among COVID-19 survivors is warranted.
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Affiliation(s)
- Andrea R Titus
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA.
| | - Briana Mezuk
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jana L Hirschtick
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Patricia McKane
- Lifecourse Epidemiology and Genomics Division, Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Michael R Elliott
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA.,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Nancy L Fleischer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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13
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Lax ES, Novak SA, Webster GD. Maternal Functioning and Psychological Distress During the COVID-19 Pandemic. J Womens Health (Larchmt) 2023; 32:138-149. [PMID: 36178475 DOI: 10.1089/jwh.2021.0588] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Our objective was to understand maternal functioning and psychological distress among mothers of young children in the United States during April/May 2020, early in the coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: Participants were 862 moms of children aged 0-3 years old who completed an online survey. We examined maternal functioning (maternal competency and self-care subscales from the Barkin Index of Maternal Functioning) and psychological distress (depression, anxiety, and stress subscales of the DASS-21), and then examined interaction effects of COVID-19 impact and socioeconomic status (SES; represented by income and education). Results: Mothers' reports of higher maternal functioning correlated with lower psychological distress and both sets of factors varied substantially by SES and COVID-19 Impact. Higher COVID-19 Impact was associated with lower functioning and greater distress. Higher income and education were associated with better maternal self-care, but not maternal competency. Although we expected high SES to buffer mothers from a higher impact of COVID-19, we found that mothers with high SES reported a lower level of maternal competence and more stress than low-SES mothers. Interactions between COVID-19 impact and SES predicting maternal functioning and psychological distress revealed that when COVID-19 impact was low, high SES was associated with high functioning scores and less distress. Conclusions: This work challenges the assumptions that a stressful event will be uniformly experienced by mothers of young children as well as the stress-buffering role of higher SES. This study highlights the importance of considering SES when characterizing maternal functioning and psychological distress during times of high stress. Further research is needed to examine the processes contributing to these discrepancies.
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Affiliation(s)
- Elizabeth S Lax
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Sarah A Novak
- Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Gregory D Webster
- Department of Psychology, University of Florida, Gainesville, Florida, USA
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Dioun S, Chen L, Hillyer G, Tatonetti NP, May BL, Melamed A, Wright JD. Association between neighborhood socioeconomic status, built environment and SARS-CoV-2 infection among cancer patients treated at a Tertiary Cancer Center in New York City. Cancer Rep (Hoboken) 2023; 6:e1714. [PMID: 36307215 PMCID: PMC9874553 DOI: 10.1002/cnr2.1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 08/03/2022] [Accepted: 08/17/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Racial and ethnic minority groups experience a disproportionate burden of SARS-CoV-2 illness and studies suggest that cancer patients are at a particular risk for severe SARS-CoV-2 infection. AIMS The objective of this study was examine the association between neighborhood characteristics and SARS-CoV-2 infection among patients with cancer. METHODS AND RESULTS We performed a cross-sectional study of New York City residents receiving treatment for cancer at a tertiary cancer center. Patients were linked by their address to data from the US Census Bureau's American Community Survey and to real estate tax data from New York's Department of City Planning. Models were used to both to estimate odds ratios (ORs) per unit increase and to predict probabilities (and 95% CI) of SARS-CoV2 infection. We identified 2350 New York City residents with cancer receiving treatment. Overall, 214 (9.1%) were infected with SARS-CoV-2. In adjusted models, the percentage of Hispanic/Latino population (aOR = 1.01; 95% CI, 1.005-1.02), unemployment rate (aOR = 1.10; 95% CI, 1.05-1.16), poverty rates (aOR = 1.02; 95% CI, 1.0002-1.03), rate of >1 person per room (aOR = 1.04; 95% CI, 1.01-1.07), average household size (aOR = 1.79; 95% CI, 1.23-2.59) and population density (aOR = 1.86; 95% CI, 1.27-2.72) were associated with SARS-CoV-2 infection. CONCLUSION Among cancer patients in New York City receiving anti-cancer therapy, SARS-CoV-2 infection was associated with neighborhood- and building-level markers of larger household membership, household crowding, and low socioeconomic status. NOVELTY AND IMPACT We performed a cross-sectional analysis of residents of New York City receiving treatment for cancer in which we linked subjects to census and real estate date. This linkage is a novel way to examine the neighborhood characteristics that influence SARS-COV-2 infection. We found that among patients receiving anti-cancer therapy, SARS-CoV-2 infection was associated with building and neighborhood-level markers of household crowding, larger household membership, and low socioeconomic status. With ongoing surges of SARS-CoV-2 infections, these data may help in the development of interventions to decrease the morbidity and mortality associated with SARS-CoV-2 among cancer patients.
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Affiliation(s)
- Shayan Dioun
- Columbia Universtiy College of Physicians and SurgeonsNew YorkNew YorkUSA
- New York Presbyterian HospitalNew YorkNew YorkUSA
| | - Ling Chen
- Columbia Universtiy College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Grace Hillyer
- Mailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA
- Herbert Irving Comprehensive Cancer CenterNew YorkNew YorkUSA
| | - Nicholas P. Tatonetti
- Columbia Universtiy College of Physicians and SurgeonsNew YorkNew YorkUSA
- Herbert Irving Comprehensive Cancer CenterNew YorkNew YorkUSA
| | - Benjamin L. May
- Columbia Universtiy College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Alexander Melamed
- Columbia Universtiy College of Physicians and SurgeonsNew YorkNew YorkUSA
- New York Presbyterian HospitalNew YorkNew YorkUSA
- Herbert Irving Comprehensive Cancer CenterNew YorkNew YorkUSA
| | - Jason D. Wright
- Columbia Universtiy College of Physicians and SurgeonsNew YorkNew YorkUSA
- New York Presbyterian HospitalNew YorkNew YorkUSA
- Herbert Irving Comprehensive Cancer CenterNew YorkNew YorkUSA
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15
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Grünebaum A, Dudenhausen J, Chervenak FA. Covid and pregnancy in the United States - an update as of August 2022. J Perinat Med 2023; 51:34-38. [PMID: 36117400 DOI: 10.1515/jpm-2022-0361] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/07/2022] [Indexed: 01/17/2023]
Abstract
COVID-19 is caused by the 2019 novel coronavirus (2019-nCoV). The first cases of COVID-19 were identified in December 2019, and the first United States (US) case was identified on January 20th, 2020. Since then, COVID-19 has spread throughout the world and was declared a pandemic by the WHO on March 11, 2020. As of July 2022, about 90 million persons have been infected with COVID-19 in the US, and there have been over 1 million deaths There have been 224,587 pregnant patients infected with COVID-19, and 34,527 were hospitalized. Pregnancy increases the risk of severe disease associated with COVID-19 and vaccinated patients are significantly less likely to develop severe disease. Adverse pregnancy and neonatal outcomes are more common among women infected with SARS-CoV-2 during pregnancy, especially among those with severe disease, and vaccination also protects the newborn infant. The intrauterine transmission of SARS-CoV-2 appears to be rare. COVID-19 vaccinations and booster shots in pregnancy are safe. In addition, the available data suggest that vaccination during pregnancy is associated with the transmission of SARS-CoV-2 antibodies to the fetus. The vaccination of lactating women is associated with high levels of SARS-CoV-2 antibodies in the breast milk. It is important that with future pandemics the concept of vaccine recommendations in pregnancy should be made early on to prevent maternal, fetal, and neonatal morbidity and mortality. Physicians and other healthcare professionals should strongly recommend COVID-19 vaccination to patients who are pregnant, planning to become pregnant, and to those who are breastfeeding.
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Affiliation(s)
- Amos Grünebaum
- Department of Obstetrics and Gynecology Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, USA
| | - Joachim Dudenhausen
- Department of Obstetrics, Charité - University Medicine Berlin, Berlin, Germany
| | - Frank A Chervenak
- Department of Obstetrics and Gynecology Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, New York, USA
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Khan MM, Odoi A, Odoi EW. Geographic disparities in COVID-19 testing and outcomes in Florida. BMC Public Health 2023; 23:79. [PMID: 36631768 PMCID: PMC9832260 DOI: 10.1186/s12889-022-14450-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 10/25/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Understanding geographic disparities in Coronavirus Disease 2019 (COVID-19) testing and outcomes at the local level during the early stages of the pandemic can guide policies, inform allocation of control and prevention resources, and provide valuable baseline data to evaluate the effectiveness of interventions for mitigating health, economic and social impacts. Therefore, the objective of this study was to identify geographic disparities in COVID-19 testing, incidence, hospitalizations, and deaths during the first five months of the pandemic in Florida. METHODS: Florida county-level COVID-19 data for the time period March-July 2020 were used to compute various COVID-19 metrics including testing rates, positivity rates, incidence risks, percent of hospitalized cases, hospitalization risks, case-fatality rates, and mortality risks. High or low risk clusters were identified using either Kulldorff's circular spatial scan statistics or Tango's flexible spatial scan statistics and their locations were visually displayed using QGIS. RESULTS Visual examination of spatial patterns showed high estimates of all COVID-19 metrics for Southern Florida. Similar to the spatial patterns, high-risk clusters for testing and positivity rates and all COVID-19 outcomes (i.e. hospitalizations and deaths) were concentrated in Southern Florida. The distributions of these metrics in the other parts of Florida were more heterogeneous. For instance, testing rates for parts of Northwest Florida were well below the state median (11,697 tests/100,000 persons) but they were above the state median for North Central Florida. The incidence risks for Northwest Florida were equal to or above the state median incidence risk (878 cases/100,000 persons), but the converse was true for parts of North Central Florida. Consequently, a cluster of high testing rates was identified in North Central Florida, while a cluster of low testing rate and 1-3 clusters of high incidence risks, percent of hospitalized cases, hospitalization risks, and case fatality rates were identified in Northwest Florida. Central Florida had low-rate clusters of testing and positivity rates but it had a high-risk cluster of percent of hospitalized cases. CONCLUSIONS Substantial disparities in the spatial distribution of COVID-19 outcomes and testing and positivity rates exist in Florida, with Southern Florida counties generally having higher testing and positivity rates and more severe outcomes (i.e. hospitalizations and deaths) compared to Northern Florida. These findings provide valuable baseline data that is useful for assessing the effectiveness of preventive interventions, such as vaccinations, in various geographic locations in the state. Future studies will need to assess changes in spatial patterns over time at lower geographical scales and determinants of any identified patterns.
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Affiliation(s)
- Md Marufuzzaman Khan
- Department of Public Health, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN, USA
| | - Agricola Odoi
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Evah W Odoi
- Department of Public Health, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN, USA.
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Dimopoulou D, Kyritsi M, Dadouli K, Vergadi E, Tsiligianni E, Papadimitriou E, Mavridi A, Giannakopoulos S, Tsiourvopoulou G, Palyvou M, Angeli E, Brikos N, Eleftheriou I, Spoulou V, Michos A, Gkentzi D, Siomou E, Papaevangelou V, Grivea I, Syrogiannopoulos G, Galanakis E, Hadjichristodoulou C, Tsolia M. Seroprevalence of anti-SARS-CoV-2 antibodies among children and their parents in Greece. Eur J Pediatr 2023; 182:439-449. [PMID: 36383284 PMCID: PMC9666986 DOI: 10.1007/s00431-022-04681-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022]
Abstract
UNLABELLED School closures were enforced as measures to restrain the COVID-19 pandemic, based on the assumption that young children may play a key role in SARS-CoV-2 spread. This study aims to determine the prevalence of SARS-CoV-2 IgG antibodies in children and corresponding parents, in order to improve surveillance and estimate the prevalence of asymptomatic or subclinical COVID-19 cases. A prospective multicenter study was conducted between March and June 2021 in Greece. Children admitted to the hospital or examined in outpatient clinics for reasons other than COVID-19 and their parents were tested for anti-Spike SARS-CoV-2 IgG in serum. A questionnaire about clinical and demographic data was completed. The study included 823 participants: 427 children and 396 corresponding parents. The overall seroprevalence was 16.4% in parents and 13.8% in children. Among families with ≥ 1 seropositive child or parent, the combination of a seropositive parent and a corresponding seronegative child was 29.6%, a seronegative parent and a corresponding seropositive child was 24.7%, and a seropositive child with a corresponding seropositive parent was 45.7%. Age, level of education, and school or work attendance were not significantly associated with increased seropositivity. On the contrary, ethnic minority of Roma, close contact with known COVID-19 case, previous symptoms consistent with COVID-19, and mass gatherings were risk factors for seropositivity. CONCLUSION The spread of SARS-CoV-2 during a period of lockdown in Greece was low in children and comparable to adults most likely due to intrafamilial transmission. Accordingly, it is unlikely that children have boosted virus transmission. WHAT IS KNOWN • In the earliest months of the pandemic, it was demonstrated that children had significantly lower seroprevalence rates than the older age groups, due to the fact that children had decreased exposure to the virus, because of early public health interventions, such as school and day care closure. • Later, further studies reported that children have similar incidence rate of SARS-CoV-2 infection compared to adults in households and community settings. WHAT IS NEW • In this seroprevalence study, the spread of SARS-CoV-2 infection during a period of lockdown in Greece with the predominance of the Alpha-variant was particularly low in children and comparable to adults, most likely due to intrafamilial transmission. • These study findings will be useful for decisions regarding non-pharmaceutical interventions during the pandemic, and especially, to guide in designing and implementing appropriate containment measures for schools and social gatherings.
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Affiliation(s)
- Dimitra Dimopoulou
- Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, Second Department of Paediatrics, Thivon and Leivadias Str, 11526, Athens, Greece.
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Eleni Vergadi
- School of Medicine, Department of Paediatrics, University of Crete, University General Hospital of Heraklion, Heraklion, Greece
| | | | - Eleni Papadimitriou
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Artemis Mavridi
- Third Department of Paediatrics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Maria Palyvou
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Evangelia Angeli
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Nikitas Brikos
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Irini Eleftheriou
- Second Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens, Second Department of Paediatrics, Thivon and Leivadias Str, 11526 Athens, Greece
| | - Vassiliki Spoulou
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Michos
- First Department of Paediatrics, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Despoina Gkentzi
- Medical School, Department of Paediatrics, University of Patras, Patras, Greece
| | - Ekaterini Siomou
- Department of Pediatrics, University Hospital of Ioannina, Ioannina, Greece
| | - Vassiliki Papaevangelou
- Third Department of Paediatrics, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Grivea
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - George Syrogiannopoulos
- School of Health Sciences, Faculty of Medicine, Department of Paediatrics, University General Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Emmanouil Galanakis
- School of Medicine, Department of Paediatrics, University of Crete, University General Hospital of Heraklion, Heraklion, Greece
| | | | - Maria Tsolia
- Second Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens, Second Department of Paediatrics, Thivon and Leivadias Str, 11526 Athens, Greece
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Effects of housing environments on COVID-19 transmission and mental health revealed by COVID-19 Participant Experience data from the All of Us Research Program in the USA: a case-control study. BMJ Open 2022. [PMID: 36535714 DOI: 10.1101/2022.04.05.22273358v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES To examine the association between housing types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the large-scale individual-level All of Us Research Program COVID-19 Participant Experience (COPE) survey data. We hypothesise that housing types with a shared component are associated with elevated COVID-19 infection and subsequent mental health conditions. DESIGN A retrospective case-control study. SETTING Secondary analysis of online surveys conducted in the USA. PARTICIPANTS 62 664 participant responses to COPE from May to July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure is the self-reported COVID-19 status, and the secondary outcome measures are anxiety or stress. Both measures were applied for matched cases and controls of the same race, sex, age group and survey version. RESULTS A multiple logistic regression analysis revealed that housing types with a shared component are significantly associated with COVID-19 infection (OR=1.19, 95% CI 1.1 to 1.3; p=2×10-4), anxiety (OR=1.26, 95% CI 1.1 to 1.4; p=1.1×10-6) and stress (OR=1.29, 95% CI 1.2 to 1.4; p=4.3×10-10) as compared with free-standing houses, after adjusting for confounding factors. Further, frequent optional shopping or outing trips, another indicator of the built environment, are also associated with COVID-19 infection (OR=1.36, 95% CI 1.1 to 1.8; p=0.02), but not associated with elevated mental health conditions. Confounding factors are controlled in the analysis such as ethnicity, age, social distancing behaviour and house occupancy. CONCLUSION Our study demonstrates that houses with a shared component tend to have an increased risk of COVID-19 transmission, which consequently leads to high levels of anxiety and stress for their dwellers. The study also suggests the necessity to improve the quality of the built environment such as residential housing and its surroundings through planning, design and management, ensuring a more resilient society that can cope with future pandemics.
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Luo W, Baldwin E, Jiang AY, Li S, Yang B, Li H. Effects of housing environments on COVID-19 transmission and mental health revealed by COVID-19 Participant Experience data from the All of Us Research Program in the USA: a case-control study. BMJ Open 2022; 12:e063714. [PMID: 36535714 PMCID: PMC9764101 DOI: 10.1136/bmjopen-2022-063714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To examine the association between housing types and COVID-19 infection (or mental health) during the early stages of the pandemic by using the large-scale individual-level All of Us Research Program COVID-19 Participant Experience (COPE) survey data. We hypothesise that housing types with a shared component are associated with elevated COVID-19 infection and subsequent mental health conditions. DESIGN A retrospective case-control study. SETTING Secondary analysis of online surveys conducted in the USA. PARTICIPANTS 62 664 participant responses to COPE from May to July 2020. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measure is the self-reported COVID-19 status, and the secondary outcome measures are anxiety or stress. Both measures were applied for matched cases and controls of the same race, sex, age group and survey version. RESULTS A multiple logistic regression analysis revealed that housing types with a shared component are significantly associated with COVID-19 infection (OR=1.19, 95% CI 1.1 to 1.3; p=2×10-4), anxiety (OR=1.26, 95% CI 1.1 to 1.4; p=1.1×10-6) and stress (OR=1.29, 95% CI 1.2 to 1.4; p=4.3×10-10) as compared with free-standing houses, after adjusting for confounding factors. Further, frequent optional shopping or outing trips, another indicator of the built environment, are also associated with COVID-19 infection (OR=1.36, 95% CI 1.1 to 1.8; p=0.02), but not associated with elevated mental health conditions. Confounding factors are controlled in the analysis such as ethnicity, age, social distancing behaviour and house occupancy. CONCLUSION Our study demonstrates that houses with a shared component tend to have an increased risk of COVID-19 transmission, which consequently leads to high levels of anxiety and stress for their dwellers. The study also suggests the necessity to improve the quality of the built environment such as residential housing and its surroundings through planning, design and management, ensuring a more resilient society that can cope with future pandemics.
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Affiliation(s)
- Wenting Luo
- Biosystems Engineering, The University of Arizona, Tucson, Arizona, USA
- Mathematics, The University of Arizona, Tucson, Arizona, USA
| | - Edwin Baldwin
- Biosystems Engineering, The University of Arizona, Tucson, Arizona, USA
| | - Anna Yi Jiang
- Biomedical Engineering, The University of Arizona, Tucson, Arizona, USA
| | - Shujuan Li
- School of Landscape Architecture and Planning, The University of Arizona, Tucson, Arizona, USA
| | - Bo Yang
- School of Landscape Architecture and Planning, The University of Arizona, Tucson, Arizona, USA
| | - Haiquan Li
- Biosystems Engineering, The University of Arizona, Tucson, Arizona, USA
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Tong H, Li M, Kang J. Relationships between building attributes and COVID-19 infection in London. BUILDING AND ENVIRONMENT 2022; 225:109581. [PMID: 36124292 PMCID: PMC9472810 DOI: 10.1016/j.buildenv.2022.109581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
In the UK, all domestic COVID-19 restrictions have been removed since they were introduced in March 2020. After illustrating the spatial-temporal variations in COVID-19 infection rates across London, this study then particularly aimed to examine the relationships of COVID-19 infection rates with building attributes, including building density, type, age, and use, since previous studies have shown that the built environment plays an important role in public health. Multisource data from national health services and the London Geomni map were processed with GIS techniques and statistically analysed. From March 2020 to April 2022, the infection rate of COVID-19 in London was 3,159.28 cases per 10,000 people. The spatial distribution across London was uneven, with a range from 1,837.88 to 4,391.79 per 10,000 people. During this period, it was revealed that building attributes played a significant role in COVID-19 infection. It was noted that higher building density areas had lower COVID-19 infection rates in London. Moreover, a higher percentage of historic or flat buildings tended to lead to a decrease in infection rates. In terms of building use, the rate of COVID-19 infection tended to be lower in public buildings and higher in residential buildings. Variations in the infection rate were more sensitive to building type; in particular, the percentage of residents living in flats contributed the most to variations in COVID-19 infection rates, with a value of 2.3%. This study is expected to provide support for policy and practice towards pandemic-resilient architectural design.
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Affiliation(s)
- Huan Tong
- School of Architecture, Harbin Institute of Technology, Shenzhen, Shenzhen, China
- Institute for Environmental Design and Engineering, The Bartlett, University College London, London, United Kingdom
| | - Mingxiao Li
- School of Architecture and Urban Planning, Shenzhen University, Shenzhen, China
| | - Jian Kang
- Institute for Environmental Design and Engineering, The Bartlett, University College London, London, United Kingdom
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21
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Patel BM, Khanna D, Khanna S, Hapshy V, Khanna P, Kahar P, Parmar MS. Effects of COVID-19 on Pregnant Women and Newborns: A Review. Cureus 2022; 14:e30555. [DOI: 10.7759/cureus.30555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022] Open
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22
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Indriyani W, Yudhistira MH, Sastiono P, Hartono D. The relationship between the built environment and respiratory health: Evidence from a longitudinal study in Indonesia. SSM Popul Health 2022; 19:101193. [PMID: 36105559 PMCID: PMC9464964 DOI: 10.1016/j.ssmph.2022.101193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/20/2022] [Accepted: 07/29/2022] [Indexed: 11/26/2022] Open
Abstract
Multiple studies have discussed the relationship between the built environment and non-infectious diseases, but research involving infectious diseases and the built environment is scarce. How the built environment is associated with infectious diseases varies across areas, and previous literature produces mixed results. This study investigated the relationship between the built environment and infectious diseases in Indonesia, which has different settings compared to developed countries. We combined the longitudinal panel data, Indonesian Family Life Survey (IFLS), and land cover data to examine the relationship between the built environment and the likelihood of contracting respiratory infectious diseases. We focused on the sprawl index to measure the built environment. The study confirmed that a sprawling neighbourhood is linked to lower respiratory infection symptoms by employing a fixed effect method. The association is more evident in urban areas and for females. The results also suggested that the linkage works through housing quality, such as housing crowdedness and ventilation, and neighbourhood conditions like neighbourhood transportation modes and air pollution levels. Thus, our results underlined the need to consider the health consequences of the densification policy and determine the direction of landscape planning and policy.
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Affiliation(s)
- Witri Indriyani
- Research Cluster on Urban and Transportation Economics, Faculty of Economics and Business, Universitas Indonesia, Indonesia
- Research Cluster on Energy Modeling and Regional Economic Analysis (RCEMREA), Faculty of Economics and Business, Universitas Indonesia, Indonesia
| | - Muhammad Halley Yudhistira
- Research Cluster on Urban and Transportation Economics, Faculty of Economics and Business, Universitas Indonesia, Indonesia
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Indonesia
| | - Prani Sastiono
- Research Cluster on Urban and Transportation Economics, Faculty of Economics and Business, Universitas Indonesia, Indonesia
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Indonesia
| | - Djoni Hartono
- Research Cluster on Energy Modeling and Regional Economic Analysis (RCEMREA), Faculty of Economics and Business, Universitas Indonesia, Indonesia
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23
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Nelson KN, Siegler AJ, Sullivan PS, Bradley H, Hall E, Luisi N, Hipp-Ramsey P, Sanchez T, Shioda K, Lopman BA. Nationally representative social contact patterns among U.S. adults, August 2020-April 2021. Epidemics 2022; 40:100605. [PMID: 35810698 PMCID: PMC9242729 DOI: 10.1016/j.epidem.2022.100605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 06/14/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
The response to the COVID-19 pandemic in the U.S prompted abrupt and dramatic changes to social contact patterns. Monitoring changing social behavior is essential to provide reliable input data for mechanistic models of infectious disease, which have been increasingly used to support public health policy to mitigate the impacts of the pandemic. While some studies have reported on changing contact patterns throughout the pandemic, few have reported differences in contact patterns among key demographic groups and none have reported nationally representative estimates. We conducted a national probability survey of US households and collected information on social contact patterns during two time periods: August-December 2020 (before widespread vaccine availability) and March-April 2021 (during national vaccine rollout). Overall, contact rates in Spring 2021 were similar to those in Fall 2020, with most contacts reported at work. Persons identifying as non-White, non-Black, non-Asian, and non-Hispanic reported high numbers of contacts relative to other racial and ethnic groups. Contact rates were highest in those reporting occupations in retail, hospitality and food service, and transportation. Those testing positive for SARS-CoV-2 antibodies reported a higher number of daily contacts than those who were seronegative. Our findings provide evidence for differences in social behavior among demographic groups, highlighting the profound disparities that have become the hallmark of the COVID-19 pandemic.
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Affiliation(s)
- Kristin N Nelson
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA.
| | - Aaron J Siegler
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Heather Bradley
- Department of Population Health Sciences, Georgia State University School of Public Health, USA
| | - Eric Hall
- School of Public Health, Oregon Health & Science University, USA
| | - Nicole Luisi
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Palmer Hipp-Ramsey
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA
| | - Kayoko Shioda
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, USA
| | - Benjamin A Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, USA
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24
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Pan J, Bardhan R. Evaluating the risk of accessing green spaces in COVID-19 pandemic: A model for public urban green spaces (PUGS) in London. URBAN FORESTRY & URBAN GREENING 2022; 74:127648. [PMID: 35721365 PMCID: PMC9195353 DOI: 10.1016/j.ufug.2022.127648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 05/07/2023]
Abstract
The pandemic caused by SARS-CoV-2 (COVID-19) at the beginning of 2020 has restricted the human population indoor with some allowance for recreation in green spaces for social interaction and daily exercise. Understanding and measuring the risk of COVID-19 infection during public urban green spaces (PUGS) visits is essential to reduce the spread of the virus and improve well-being. This study builds a data-fused risk assessment model to evaluate the risk of visiting the PUGS in London. Three parameters are used for risk evaluation: the number of new cases at the middle-layer super output area (MSOA) level, the accessibility of each public green space and the Indices of Multiple Deprivation at the lower-layer super output area (LSOA) level. The model assesses 1357 PUGS and identifies the risk in three levels, high, medium and low, according to the results of a two-step clustering analysis. The spatial variability of risk across the city is demonstrated in the evaluation. The evaluation of risk can provide a better metric to the decision-making at both the individual level, on deciding which green space to visit, and the borough level, on how to implement restricting measures on green space access.
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Affiliation(s)
- Jiayu Pan
- The Martin Centre for Architecture, Department of Architecture, University of Cambridge, Cambridge CB2 1PX, UK
| | - Ronita Bardhan
- The Martin Centre for Architecture, Department of Architecture, University of Cambridge, Cambridge CB2 1PX, UK
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25
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Zhang X, Sun Z, Ashcroft T, Dozier M, Ostrishko K, Krishan P, McSwiggan E, Keller M, Douglas M. Compact cities and the Covid-19 pandemic: Systematic review of the associations between transmission of Covid-19 or other respiratory viruses and population density or other features of neighbourhood design. Health Place 2022; 76:102827. [PMID: 35642837 PMCID: PMC9119959 DOI: 10.1016/j.healthplace.2022.102827] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 04/06/2022] [Accepted: 05/15/2022] [Indexed: 01/13/2023]
Abstract
Living in compact neighbourhoods that are walkable, well connected, with accessible green space can benefit physical and mental health. However, the pandemic raises concern up to what extent features of compact neighbourhood design affect transmission of viral respiratory infections. We conducted a systematic review to identify, appraise and synthesise evidence reporting associations between transmission of respiratory viruses, including Covid-19, and dwelling or population density or other features of neighbourhood design. Twenty-one studies met our inclusion criteria. These studies used different measures of neighbourhood design, contributing to inconsistent findings. Whereas no convincing conclusion can be drawn here, the outcome of this review indicates that robust, global evidence is warranted to inform future policies and legislation concerned with compact neighbourhood design and transmission of respiratory and viral infection.
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Affiliation(s)
- Xiaomeng Zhang
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Ziwen Sun
- School of Design and Art, Beijing Institute of Technology, Beijing, China.
| | | | - Marshall Dozier
- Information Services, The University of Edinburgh, Edinburgh, UK
| | | | - Prerna Krishan
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Markéta Keller
- Usher Institute, The University of Edinburgh, Edinburgh, UK
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Prophylactic Architecture: Formulating the Concept of Pandemic-Resilient Homes. BUILDINGS 2022. [DOI: 10.3390/buildings12070927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The lockdown instituted during the COVID-19 pandemic has drawn the world’s attention to the importance of homes as integrated structures for practicing all aspects of life. The home has been transformed from a mere place to live into a complete piece of infrastructure accommodating all activities of life, including study, work, shopping, exercise, entertainment, and even telehealth. Although quarantines were necessary to protect against viral infection, we have faced social and psychological challenges due to the failure of the current home design to accommodate the new lockdown lifestyle during the pandemic. Thus, this study aims to set a foundation for the development and design of resilient homes in a post-quarantine world by establishing a comprehensive framework for quarantine-resilient homes. The framework was established on the basis of the relevant literature and proposals from architects and experts. It brings a perspective to the future requirements of homes so as to provide architects, stakeholders, and policymakers with the appropriate knowledge to mitigate the impact of lockdowns on mental health and well-being in residential buildings by focusing on the physical and architectural environment.
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27
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Chen L, Liu X, Hu T, Bao S, Ye X, Ma N, Zhou X. Measurement of contagion spatial spread probability in public places: A case study on COVID-19. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2022; 143:102700. [PMID: 35418716 PMCID: PMC8986488 DOI: 10.1016/j.apgeog.2022.102700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 03/28/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
The scale and scope of the COVID-19 epidemic have highlighted the need for timely control of viral transmission. This paper proposed a new spatial probability model of epidemic infection using an improved Wasserstein distance algorithm and Monte Carlo simulation. This method identifies the public places in which COVID-19 spreads and grows easily. The Wasserstein Distance algorithm is used to calculate the distribution similarity between COVID-19 cases and the public places. Further, we used hypothesis tests and Monte Carlo simulation to estimate the spatial spread probability of COVID-19 in different public places. We used Snow's data to test the stability and accuracy of this measurement. This verification proved that our method is reliable and robust. We applied our method to the detailed geographic data of COVID-19 cases and public places in Wuhan. We found that, rather than financial service institutions and markets, public buildings such as restaurants and hospitals in Wuhan are 95 percent more likely to be the public places of COVID-19 spread.
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Affiliation(s)
- Lu Chen
- School of Management and Economics, Southeast University, Nanjing, 211189, China
| | - Xiuyan Liu
- School of Management and Economics, Southeast University, Nanjing, 211189, China
- National School of Development and Policy, Southeast University, Nanjing, 211189, China
| | - Tao Hu
- Department of Geography, Oklahoma State University, Stillwater, OK, 74075, USA
| | - Shuming Bao
- Center for Geographic Analysis, Harvard University, Cambridge, MA, 02138, USA
- Geo-computation Center for Social Science, Wuhan University, Hubei, 430079, China
| | - Xinyue Ye
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, 77840, USA
| | - Ning Ma
- School of Law, Southeast University, Nanjing, 211189, China
| | - Xiaoxue Zhou
- Jiangsu Institute of Industrial Development, Nanjing University of Finance and Economics, Nanjing, 210023, China
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Neighborhood Characteristics and Racial Disparities in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Seropositivity in Pregnancy. Obstet Gynecol 2022; 139:1018-1026. [PMID: 35675599 DOI: 10.1097/aog.0000000000004791] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 03/03/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To quantify the extent to which neighborhood characteristics contribute to racial and ethnic disparities in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity in pregnancy. METHODS This cohort study included pregnant patients who presented for childbirth at two hospitals in Philadelphia, Pennsylvania from April 13 to December 31, 2020. Seropositivity for SARS-CoV-2 was determined by measuring immunoglobulin G and immunoglobulin M antibodies by enzyme-linked immunosorbent assay in discarded maternal serum samples obtained for clinical purposes. Race and ethnicity were self-reported and abstracted from medical records. Patients' residential addresses were geocoded to obtain three Census tract variables: community deprivation, racial segregation (Index of Concentration at the Extremes), and crowding. Multivariable mixed effects logistic regression models and causal mediation analyses were used to quantify the extent to which neighborhood variables may explain racial and ethnic disparities in seropositivity. RESULTS Among 5,991 pregnant patients, 562 (9.4%) were seropositive for SARS-CoV-2. Higher seropositivity rates were observed among Hispanic (19.3%, 104/538) and Black (14.0%, 373/2,658) patients, compared with Asian (3.2%, 13/406) patients, White (2.7%, 57/2,133) patients, and patients of another race or ethnicity (5.9%, 15/256) (P<.001). In adjusted models, per SD increase, deprivation (adjusted odds ratio [aOR] 1.16, 95% CI 1.02-1.32) and crowding (aOR 1.15, 95% CI 1.05-1.26) were associated with seropositivity, but segregation was not (aOR 0.90, 95% CI 0.78-1.04). Mediation analyses revealed that crowded housing may explain 6.7% (95% CI 2.0-14.7%) of the Hispanic-White disparity and that neighborhood deprivation may explain 10.2% (95% CI 0.5-21.1%) of the Black-White disparity. CONCLUSION Neighborhood deprivation and crowding were associated with SARS-CoV-2 seropositivity in pregnancy in the prevaccination era and may partially explain high rates of SARS-CoV-2 seropositivity among Black and Hispanic patients. Investing in structural neighborhood improvements may reduce inequities in viral transmission.
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Simon E, Gouyon J, Cottenet J, Bechraoui‐Quantin S, Rozenberg P, Mariet A, Quantin C. Impact of SARS-CoV-2 infection on risk of prematurity, birthweight and obstetric complications: A multivariate analysis from a nationwide, population-based retrospective cohort study. BJOG 2022; 129:1084-1094. [PMID: 35253329 PMCID: PMC9111136 DOI: 10.1111/1471-0528.17135] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the impact of maternal coronavirus disease 2019 (COVID-19) on prematurity, birthweight and obstetric complications. DESIGN Nationwide, population-based retrospective cohort study. SETTING National Programme de Médicalisation des Systèmes d'Information database in France. POPULATION All single births from March to December 2020: 510 387 deliveries, including 2927 (0.6%) with confirmed COVID-19 in the mother and/or the newborn. METHODS The group with COVID-19 was compared with the group without COVID-19 using the chi-square test or Fisher's exact test, and the Student's t test or Mann-Whitney U test. Logistic regressions were used to study the effect of COVID-19 on the risk of prematurity or macrosomia (birthweight ≥4500 g). MAIN OUTCOME MEASURES Prematurity less than 37, less than 28, 28-31, or 32-36 weeks of gestation; birthweight; obstetric complications. RESULTS In singleton pregnancies, COVID-19 was associated with obstetric complications such as hypertension (2.8% versus 2.0%, p < 0.01), pre-eclampsia (3.6% versus 2.0%, p < 0.01), diabetes (18.8% versus 14.4%, p < 0.01) and caesarean delivery (26.8% versus 19.7%, p < 0.01). Among pregnant women with COVID-19, there was more prematurity between 28 and 31 weeks of gestation (1.3% versus 0.6%, p < 0.01) and between 32 and 36 weeks of gestation (7.7% versus 4.3%, p < 0.01), and more macrosomia (1.0% versus 0.7%, p = 0.04), but there was no difference in small-for-gestational-age newborns (6.3% versus 8.7%, p = 0.15). Logistic regression analysis for prematurity showed an adjusted odds ratio (aOR) of 1.77 (95% CI 1.55-2.01) for COVID-19. For macrosomia, COVID-19 resulted in non-significant aOR of 1.38 (95% CI 0.95-2.00). CONCLUSIONS COVID-19 is a risk factor for prematurity, even after adjustment for other risk factors. TWEETABLE ABSTRACT The risk of prematurity is twice as high in women with COVID-19 after adjustment for factors usually associated with prematurity.
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Affiliation(s)
- Emmanuel Simon
- Gynaecology, Obstetrics, and Fetal MedicineUniversity HospitalDijonFrance
| | - Jean‐Bernard Gouyon
- Centre d'Etudes Périnatales Océan Indien (EA 7388)Centre Hospitalier Universitaire Sud RéunionLa RéunionSaint PierreFrance
| | - Jonathan Cottenet
- Biostatistics and Bioinformatics (DIM)University HospitalDijonFrance
| | | | - Patrick Rozenberg
- Department of Obstetrics and Gynaecology, Hôpital Intercommunal de PoissyUniversité Versailles Saint‐QuentinPoissyFrance
| | - Anne‐Sophie Mariet
- Biostatistics and Bioinformatics (DIM)University HospitalDijonFrance
- Inserm, CIC 1432DijonFrance
- Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials UnitDijon University HospitalDijonFrance
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM)University HospitalDijonFrance
- Inserm, CIC 1432DijonFrance
- Clinical Investigation Centre, Clinical Epidemiology/Clinical Trials UnitDijon University HospitalDijonFrance
- High‐Dimensional Biostatistics for Drug Safety and GenomicsUniversité Paris‐Saclay, UVSQ, Univ. Paris‐Sud, Inserm, CESPVillejuifFrance
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The association between maternal characteristics and SARS-CoV-2 in pregnancy: a population-based registry study in Sweden and Norway. Sci Rep 2022; 12:8355. [PMID: 35589871 PMCID: PMC9120467 DOI: 10.1038/s41598-022-12395-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/10/2022] [Indexed: 01/08/2023] Open
Abstract
The objectives of the current study were to identify risk factors for SARS-CoV-2 positivity, and to address how different testing strategies, choice of comparison group, and population background characteristics may influence observed associations. National registries data for 107,627 pregnant women in Sweden and 81,195 in Norway, were used to identify risk factors for SARS-CoV-2, separately for women under non-universal testing (testing by indication) and universal testing (testing of all pregnant women in contact with a delivery ward). We also investigated underlying characteristics associated with testing for SARS-CoV-2. Overall, 2.1% of pregnant women in Sweden and 1.1% in Norway were test-positive during the pandemic’s first 18 months. We show that the choice of test strategy for SARS-CoV-2 provided different associations with risk factors for the disease; for instance, women who were overweight, obese or had gestational diabetes had increased odds of being test-positive under non-universal testing, but not under universal testing. Nevertheless, a consistent pattern of association between being born in the Middle East and Africa and test-positivity was found independent of test strategy and in both countries. These women were also less likely to get tested. Our results are useful to consider for surveillance and clinical recommendations for pregnant women during the current and future pandemics.
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Unruh LH, Dharmapuri S, Xia Y, Soyemi K. Health disparities and COVID-19: A retrospective study examining individual and community factors causing disproportionate COVID-19 outcomes in Cook County, Illinois. PLoS One 2022; 17:e0268317. [PMID: 35576226 PMCID: PMC9109922 DOI: 10.1371/journal.pone.0268317] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 04/27/2022] [Indexed: 12/29/2022] Open
Abstract
Early data from the COVID-19 pandemic suggests that the disease has had a disproportionate impact on communities of color with higher infection and mortality rates within those communities. This study used demographic data from the 2018 US census estimates, mortality data from the Cook County Medical Examiner’s office, and testing results from the Illinois Department of Public Health to perform bivariate and multivariate regression analyses to explore the role race plays in COVID-19 outcomes at the individual and community levels. We used the ZCTA Social Deprivation Index (SDI), a measure of ZCTA area level deprivation based on seven demographic characteristics to quantify the socio-economic variation in health outcomes and levels of disadvantage across ZCTAs. Principal findings showed that: 1) while Black individuals make up 22% of Cook County’s population, they account for 28% of the county’s COVID-19 related deaths; 2) the average age of death from COVID-19 is seven years younger for Non-White compared with White decedents; 3) residents of Minority ZCTA areas were 1.02 times as likely to test positive for COVID-19, (Incidence Rate Ratio (IRR) 1.02, [95% CI 0.95, 1.10]); 1.77 times as likely to die (IRR 1.77, [95% CI 1.17, 2.66]); and were 1.15 times as likely to be tested (IRR 1.15, [95% CI 0.99, 1.33]). There are notable differences in COVID-19 related outcomes between racial and ethnic groups at individual and community levels. This study illustrates the health disparities and underlying systemic inequalities experienced by communities of color.
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Affiliation(s)
- Larissa H. Unruh
- Department of Emergency Medicine, John H. Stroger Jr. Hospital of Cook County Health, Chicago, Illinois, United States of America
| | - Sadhana Dharmapuri
- Cermak Health Services, Cook County Juvenile Temporary Detention Center, Chicago, Illinois, United States of America
- Department of Pediatrics, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States of America
| | - Yinglin Xia
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, United States of America
| | - Kenneth Soyemi
- Cermak Health Services, Cook County Juvenile Temporary Detention Center, Chicago, Illinois, United States of America
- Department of Pediatrics, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States of America
- * E-mail:
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Weaver AK, Head JR, Gould CF, Carlton EJ, Remais JV. Environmental Factors Influencing COVID-19 Incidence and Severity. Annu Rev Public Health 2022; 43:271-291. [PMID: 34982587 PMCID: PMC10044492 DOI: 10.1146/annurev-publhealth-052120-101420] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Emerging evidence supports a link between environmental factors-including air pollution and chemical exposures, climate, and the built environment-and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and coronavirus disease 2019 (COVID-19) susceptibility and severity. Climate, air pollution, and the built environment have long been recognized to influence viral respiratory infections, and studies have established similar associations with COVID-19 outcomes. More limited evidence links chemical exposures to COVID-19. Environmental factors were found to influence COVID-19 through four major interlinking mechanisms: increased risk of preexisting conditions associated with disease severity; immune system impairment; viral survival and transport; and behaviors that increase viral exposure. Both data and methodologic issues complicate the investigation of these relationships, including reliance on coarse COVID-19 surveillance data; gaps in mechanistic studies; and the predominance of ecological designs. We evaluate the strength of evidence for environment-COVID-19 relationships and discuss environmental actions that might simultaneously address the COVID-19 pandemic, environmental determinants of health, and health disparities.
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Affiliation(s)
- Amanda K Weaver
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA; ,
| | - Jennifer R Head
- Department of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, USA;
| | - Carlos F Gould
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA;
- Department of Earth System Science, Stanford University, Stanford, California, USA
| | - Elizabeth J Carlton
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz, Aurora, Colorado, USA;
| | - Justin V Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California, USA; ,
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Nelson KN, Siegler AJ, Sullivan PS, Bradley H, Hall E, Luisi N, Hipp-Ramsey P, Sanchez T, Shioda K, Lopman BA. Nationally Representative Social Contact Patterns among U.S. adults, August 2020-April 2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2021.09.22.21263904. [PMID: 35378746 PMCID: PMC8978954 DOI: 10.1101/2021.09.22.21263904] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The response to the COVID-19 pandemic in the U.S prompted abrupt and dramatic changes to social contact patterns. Monitoring changing social behavior is essential to provide reliable input data for mechanistic models of infectious disease, which have been increasingly used to support public health policy to mitigate the impacts of the pandemic. While some studies have reported on changing contact patterns throughout the pandemic., few have reported on differences in contact patterns among key demographic groups and none have reported nationally representative estimates. We conducted a national probability survey of US households and collected information on social contact patterns during two time periods: August-December 2020 (before widespread vaccine availability) and March-April 2021 (during national vaccine rollout). Overall, contact rates in Spring 2021 were similar to those in Fall 2020, with most contacts reported at work. Persons identifying as non-White, non-Black, non-Asian, and non-Hispanic reported high numbers of contacts relative to other racial and ethnic groups. Contact rates were highest in those reporting occupations in retail, hospitality and food service, and transportation. Those testing positive for SARS-CoV-2 antibodies reported a higher number of daily contacts than those who were seronegative. Our findings provide evidence for differences in social behavior among demographic groups, highlighting the profound disparities that have become the hallmark of the COVID-19 pandemic.
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Affiliation(s)
- Kristin N Nelson
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Aaron J Siegler
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Patrick S Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Heather Bradley
- Department of Population Health Sciences, Georgia State University School of Public Health
| | - Eric Hall
- School of Public Health, Oregon Health & Science University
| | - Nicole Luisi
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | | | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Kayoko Shioda
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University
| | - Benjamin A Lopman
- Department of Epidemiology, Rollins School of Public Health, Emory University
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Ghosh AK, Venkatraman S, Reshetnyak E, Rajan M, An A, Chae JK, Unruh MA, Abramson D, DiMaggio C, Hupert N. Association between city-wide lockdown and COVID-19 hospitalization rates in multigenerational households in New York City. PLoS One 2022; 17:e0266127. [PMID: 35353857 PMCID: PMC8967012 DOI: 10.1371/journal.pone.0266127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background
City-wide lockdowns and school closures have demonstrably impacted COVID-19 transmission. However, simulation studies have suggested an increased risk of COVID-19 related morbidity for older individuals inoculated by house-bound children. This study examines whether the March 2020 lockdown in New York City (NYC) was associated with higher COVID-19 hospitalization rates in neighborhoods with larger proportions of multigenerational households.
Methods
We obtained daily age-segmented COVID-19 hospitalization counts in each of 166 ZIP code tabulation areas (ZCTAs) in NYC. Using Bayesian Poisson regression models that account for spatiotemporal dependencies between ZCTAs, as well as socioeconomic risk factors, we conducted a difference-in-differences study amongst ZCTA-level hospitalization rates from February 23 to May 2, 2020. We compared ZCTAs in the lowest quartile of multigenerational housing to other quartiles before and after the lockdown.
Findings
Among individuals over 55 years, the lockdown was associated with higher COVID-19 hospitalization rates in ZCTAs with more multigenerational households. The greatest difference occurred three weeks after lockdown: Q2 vs. Q1: 54% increase (95% Bayesian credible intervals: 22–96%); Q3 vs. Q1: 48% (17–89%); Q4 vs. Q1: 66% (30–211%). After accounting for pandemic-related population shifts, a significant difference was observed only in Q4 ZCTAs: 37% (7–76%).
Interpretation
By increasing house-bound mixing across older and younger age groups, city-wide lockdown mandates imposed during the growth of COVID-19 cases may have inadvertently, but transiently, contributed to increased transmission in multigenerational households.
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Affiliation(s)
- Arnab K. Ghosh
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
- * E-mail:
| | - Sara Venkatraman
- Department of Statistics and Data Science, Cornell University, Ithaca, New York, United States of America
| | - Evgeniya Reshetnyak
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
| | - Mangala Rajan
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
| | - Anjile An
- Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
| | - John K. Chae
- Department of Medicine, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
| | - Mark A. Unruh
- Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
| | - David Abramson
- School of Global Public Health, New York University, New York, New York, United States of America
| | - Charles DiMaggio
- Department of Surgery, New York University School of Medicine, New York, New York, United States of America
| | - Nathaniel Hupert
- Department of Population Health Sciences, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
- Cornell Center for Disease and Disaster Preparedness, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
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Emeruwa UN, Gyamfi-Bannerman C, Miller RS. Health Care Disparities in the COVID-19 Pandemic in the United States: A Focus on Obstetrics. Clin Obstet Gynecol 2022; 65:123-133. [PMID: 35045035 PMCID: PMC8767922 DOI: 10.1097/grf.0000000000000665] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The influence of social determinants of health on disease dynamics and outcomes has become increasingly clear, making them a prime target of investigation and mitigation efforts. The obstetric population is uniquely positioned to provide insight into the health inequities exacerbated by the coronavirus disease 2019 pandemic given their susceptibility to infectious disease morbidity and frequent interactions with the health care system, which provide opportunities for ascertainment of disease incidence and severity. This review summarizes the data on disparities identified in the US obstetric population during the coronavirus disease 2019 pandemic as they relate to race and ethnicity, built environment, insurance status, language, and immigration status.
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Affiliation(s)
- Ukachi N. Emeruwa
- Division of Maternal- Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York
| | - Cynthia Gyamfi-Bannerman
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego School of Medicine, UC San Diego Health, La Jolla, California
| | - Russell S. Miller
- Division of Maternal- Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York
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Ríos V, Denova-Gutiérrez E, Barquera S. Association between living in municipalities with high crowding conditions and poverty and mortality from COVID-19 in Mexico. PLoS One 2022; 17:e0264137. [PMID: 35192660 PMCID: PMC8863291 DOI: 10.1371/journal.pone.0264137] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/03/2022] [Indexed: 12/15/2022] Open
Abstract
Background The World Health Organization stated a pandemic by severe acute respiratory syndrome coronavirus SARS-Cov2 (COVID-19) on March, 2020 with devastating implications for populations, healthcare systems, and economies globally. Objective The present study explores the association between patients living in municipalities with crowding conditions and poverty and mortality from COVID-19 in Mexico; specifically evaluating the socioeconomic characteristics of the municipality in which the patients reside and some individual characteristics. Methods In the present study, we examined public information collected from the National Epidemiological Surveillance System informing all persons tested for SARS-CoV-2 and published by the Ministry of Health. The present analysis was restricted to those with the date of registration to October 12, 2021. The association between the main exposures (overcrowded conditions and poverty) and the outcomes of interest (death by COVID-19) was explored using Cox proportional hazard regression models, including frailty penalties to accommodate multilevel data and random effects for the municipality of case occurrence. Results A total of 9619917 subjects were included in the Epidemiological Surveillance System for viral respiratory disease platform. Of those for which results were available, 6141403 were negative for COVID-19 and 3478514 were positive for COVID-19; with a total of 273216 deaths in those who tested positive. Among those positive to COVID-19 mean age was 46.9. Patients living in municipalities with high rates of crowding conditions increased the risk of dying from COVID-19 by 8% (95% CI: 1.03, 1.14). Individuals living in municipalities with indigenous background was associated with an increased risk of dying from COVID-19 (HR = 1.10; 95% CI: 1.04, 1.17). Individuals living in municipalities with illiteracy (HR = 1.09; 95% CI: 1.03, 1.11), poverty (HR = 1.17; 95% CI: 1.14, 1.19), food insecurity (HR = 1.094; 95% CI 1.02, 1.06), limited access to social security (HR = 1.10; 95% CI: 1.08, 1.13) and health services (HR = 1.06; 95% CI: 1.04, 1.08) had a higher risk of mortality from COVID-19. Conclusion Our data suggest that patients living in municipalities with higher rates of crowding conditions and higher rates of poverty had elevated risk of mortality from COVID-19. In Mexico, the COVID-19 pandemic is a systemic crisis linked to human development since we have seen that it affects less developed and more vulnerable municipalities. Policies to reduce vulnerabilities and develop strategies to deal with health crises like the current one needs to be considered.
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Affiliation(s)
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- * E-mail:
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Abstract
As of November, 2021 there have been more than 250 million coronavirus disease-2019 (COVID-19) cases worldwide and more than 5 million deaths. Obstetric patients have been a population of interest given that they may be at risk of more severe infection and adverse pregnancy outcomes. The purpose of this review is to assess current epidemiology and outcomes research related to COVID-19 for the obstetric population. This review covers the epidemiology of COVID-19, symptomatology, transmission, and current knowledge gaps related to outcomes for the obstetric population.
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Jamieson DJ, Rasmussen SA. An update on COVID-19 and pregnancy. Am J Obstet Gynecol 2022; 226:177-186. [PMID: 34534497 PMCID: PMC8438995 DOI: 10.1016/j.ajog.2021.08.054] [Citation(s) in RCA: 209] [Impact Index Per Article: 104.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 12/22/2022]
Abstract
Physiological, mechanical, and immunologic alterations in pregnancy could potentially affect the susceptibility to and the severity of COVID-19 during pregnancy. Owing to the lack of comparable incidence data and the challenges with disentangling differences in the susceptibility from different exposure risks, the data are insufficient to determine whether pregnancy increases the susceptibility to SARS-CoV-2 infection. The data support pregnancy as a risk factor for severe disease associated with COVID-19; some of the best evidence comes from the United States Centers for Disease Control and Prevention COVID-19 surveillance system, which reported that pregnant persons were more likely to be admitted to an intensive care unit, require invasive ventilation, require extracorporeal membrane oxygenation, and die than nonpregnant women of reproductive age. Although the intrauterine transmission of SARS-CoV-2 has been documented, it appears to be rare. It is possibly related to low levels of SARS-CoV-2 viremia and the decreased coexpression of angiotensin-converting enzyme 2 and transmembrane serine protease 2 needed for SARS-CoV-2 entry into cells in the placenta. Evidence is accumulating that SARS-CoV-2 infection during pregnancy is associated with a number of adverse pregnancy outcomes including preeclampsia, preterm birth, and stillbirth, especially among pregnant persons with severe COVID-19 disease. In addition to the direct impact of COVID-19 on pregnancy outcomes, there is evidence that the pandemic and its effects on healthcare systems have had adverse effects such as increased stillbirths and maternal deaths on the pregnancy outcomes. These trends may represent widening disparities and an alarming reversal of recent improvements in maternal and infant health. All the 3 COVID-19 vaccines currently available in the United States can be administered to pregnant or lactating persons, with no preference for the vaccine type. Although the safety data in pregnancy are rapidly accumulating and no safety signals in pregnancy have been detected, additional information about the birth outcomes, particularly among persons vaccinated earlier in pregnancy, are needed.
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Affiliation(s)
- Denise J Jamieson
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA.
| | - Sonja A Rasmussen
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL; Department of Obstetrics and Gynecology, University of Florida College of Medicine, Gainesville, FL; Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL
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Wang Y, Tsai TC, Duncan D, Ji J. Association of city-level walkability, accessibility to biking and public transportation and socio-economic features with COVID-19 infection in Massachusetts, USA: An ecological study. GEOSPATIAL HEALTH 2022; 17. [PMID: 35147011 DOI: 10.4081/gh.2022.1017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/16/2021] [Indexed: 06/14/2023]
Abstract
With people restricted to their residences, neighbourhood characteristics may affect behaviour and risk of coronavirus disease 2019 (COVID-19) infection. We aimed to analyse whether neighbourhoods with higher walkability, public transit, biking services and higher socio-economic status were associated with lower COVID-19 infection during the peak of the COVID-19 pandemic in Massachusetts. We used Walk Score®, Bike Score®, and Transit Score® indices to assess the walkability and transportation of 72 cities in Massachusetts, USA based on availability of data and collected the total COVID-19 case numbers of each city up to 10 April 2021. We used univariate and multivariate linear models to analyse the effects of these scores on COVID-19 cases per 100,000 in each city, adjusting for demographic covariates and all covariates, respectively. In the 72 cities studied, the average Walk Score, Transit Score and Bike Score was 48.7, 36.5 and 44.1, respectively, with a total of 426,182 COVID-19 cases. Higher Walk Score, Transit Score, and Bike Score rankings were negatively associated with COVID-19 cases per 100,000 persons (<0.05). Cities with a higher proportion of Hispanic population and a lower median household income were associated with more COVID-19 cases per 100,000 (P<0.05). Higher Walk Score, Transit Score and Bike Score were shown to be protective against COVID-19 transmission, while socio-demographic factors were associated with COVID-19 infection. Understanding the complex relationship of how the structure of the urban environment may constrain commuting patterns for residents and essential workers during COVID-19 would offer potential insights on future pandemic preparedness and response.
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Affiliation(s)
- Yucheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing.
| | - Thomas C Tsai
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA.
| | - Dustin Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
| | - John Ji
- Vanke School of Public Health, Tsinghua University, Beijing.
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Sheng J, Malani A, Goel A, Botla P. JUE insights: Does mobility explain why slums were hit harder by COVID-19 in Mumbai, India? JOURNAL OF URBAN ECONOMICS 2022; 127:103357. [PMID: 35250114 PMCID: PMC8886515 DOI: 10.1016/j.jue.2021.103357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/18/2021] [Indexed: 06/14/2023]
Abstract
SARS-CoV-2 has had a greater burden, as measured by rate of infection, in poorer communities within cities. For example, 55% of Mumbai slums residents had antibodies to COVID-19, 3.2 times the seroprevalence in non-slum areas of the city according to a sero-survey done in July 2020. One explanation is that government suppression was less severe in poorer communities, either because the poor were more likely to be exempt or unable to comply. Another explanation is that effective suppression itself accelerated the epidemic in poor neighborhoods because households are more crowded and residents share toilet and water facilities. We show there is little evidence for the first hypothesis in the context of Mumbai. Using location data from smart phones, we find that slum residents had nominally but not significantly (economically or statistically) higher mobility than non-slums prior to the sero-survey. We also find little evidence that mobility in non-slums was lower than in slums during lockdown, a subset of the period before the survey.
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Ishimaru T, Mine Y, Odgerel CO, Miyake F, Kubo T, Ikaga T, Fujino Y. Prospective cohort study of bedroom heating and risk of common cold in children. Pediatr Int 2022; 64:e14755. [PMID: 33899990 DOI: 10.1111/ped.14755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/23/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In countries with mild winter climates and inadequate heating, the relationship between housing conditions and health outcomes in winter have not been well studied. The purpose of the present study was to evaluate the relationship between heater type and temperature factors in the bedroom and incidence of the common cold among children in Japan. METHODS In this prospective cohort study, we distributed baseline questionnaires and temperature loggers in December 2019 and administered follow-up questionnaires in March 2020. We recruited children under the age of 15 years. We performed Poisson regression analysis and logistic regression analysis. RESULTS Of 297 participants, air conditioners were the most prevalent (n = 105, 35%), followed by gas or kerosene heaters (n = 50, 17%), and floor heaters (n = 31, 10%). Air-conditioners were associated with higher incidence of all events related to the common cold, especially having a fever (adjusted incidence rate ratio (aIRR) = 1.84, 95% confidence interval (CI): 1.41-2.40). Gas or kerosene and floor heaters showed a lower incidence rate of some events related to the common cold, such as school or nursery school absence (aIRR = 0.55, 95% CI: 0.37-0.82 and aIRR = 0.39, 95% CI: 0.23-0.67, respectively). Bedroom temperature did not show a positive association, but children who always felt cold showed a higher incidence of some events related to the common cold. CONCLUSIONS Our findings imply that the heating approach and modal thermal comfort, such as location of heating appliances, humidity, airflow, and radiant heat, may be more important for the onset of common cold in children than bedroom temperature itself.
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Affiliation(s)
- Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yuko Mine
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chimed-Ochir Odgerel
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | - Fuyu Miyake
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | - Toshiharu Ikaga
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Wheeler PH, Patten CA, Wi CI, Bublitz JT, Ryu E, Ristagno EH, Juhn YJ. Role of geographic risk factors and social determinants of health in COVID-19 epidemiology: Longitudinal geospatial analysis in a midwest rural region. J Clin Transl Sci 2021; 6:e51. [PMID: 35651962 PMCID: PMC9108006 DOI: 10.1017/cts.2021.885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/21/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Studies examining the role of geographic factors in coronavirus disease-2019 (COVID-19) epidemiology among rural populations are lacking. Methods Our study is a population-based longitudinal study based on rural residents in four southeast Minnesota counties from March through October 2020. We used a kernel density estimation approach to identify hotspots for COVID-19 cases. Temporal trends of cases and testing were examined by generating a series of hotspot maps during the study period. Household/individual-level socioeconomic status (SES) was measured using the HOUSES index and examined for association between identified hotspots and SES. Results During the study period, 24,243 of 90,975 residents (26.6%) were tested for COVID-19 at least once; 1498 (6.2%) of these tested positive. Compared to other rural residents, hotspot residents were overall younger (median age: 40.5 vs 43.2), more likely to be minorities (10.7% vs 9.7%), and of higher SES (lowest HOUSES [SES] quadrant: 14.6% vs 18.7%). Hotspots accounted for 30.1% of cases (14.5% of population) for rural cities and 60.8% of cases (27.1% of population) for townships. Lower SES and minority households were primarily affected early in the pandemic and higher SES and non-minority households affected later. Conclusion In rural areas of these four counties in Minnesota, geographic factors (hotspots) play a significant role in the overall burden of COVID-19 with associated racial/ethnic and SES disparities, of which pattern differed by the timing of the pandemic (earlier in pandemic vs later). The study results could more precisely guide community outreach efforts (e.g., public health education, testing/tracing, and vaccine roll out) to those residing in hotspots.
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Affiliation(s)
- Philip H. Wheeler
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Christi A. Patten
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joshua T. Bublitz
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Euijung Ryu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Young J. Juhn
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Dai CL, Kornilov SA, Roper RT, Cohen-Cline H, Jade K, Smith B, Heath JR, Diaz G, Goldman JD, Magis AT, Hadlock JJ. Characteristics and Factors Associated With Coronavirus Disease 2019 Infection, Hospitalization, and Mortality Across Race and Ethnicity. Clin Infect Dis 2021; 73:2193-2204. [PMID: 33608710 PMCID: PMC7929051 DOI: 10.1093/cid/ciab154] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Data on the characteristics of coronavirus disease 2019 (COVID-19) patients disaggregated by race/ethnicity remains limited. We evaluated the sociodemographic and clinical characteristics of patients across racial/ethnic groups and assessed their associations with COVID-19 outcomes. METHODS This retrospective cohort study examined 629 953 patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a large health system spanning California, Oregon, and Washington between March 1 and December 31, 2020. Sociodemographic and clinical characteristics were obtained from electronic health records. Odds of SARS-CoV-2 infection, COVID-19 hospitalization, and in-hospital death were assessed with multivariate logistic regression. RESULTS A total of 570 298 patients with known race/ethnicity were tested for SARS-CoV-2, of whom 27.8% were non-White minorities: 54 645 individuals tested positive, with minorities representing 50.1%. Hispanics represented 34.3% of infections but only 13.4% of tests. Although generally younger than White patients, Hispanics had higher rates of diabetes but fewer other comorbidities. A total of 8536 patients were hospitalized and 1246 died, of whom 56.1% and 54.4% were non-White, respectively. Racial/ethnic distributions of outcomes across the health system tracked with state-level statistics. Increased odds of testing positive and hospitalization were associated with all minority races/ethnicities. Hispanic patients also exhibited increased morbidity, and Hispanic race/ethnicity was associated with in-hospital mortality (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.14-1.70). CONCLUSION Major healthcare disparities were evident, especially among Hispanics who tested positive at a higher rate, required excess hospitalization and mechanical ventilation, and had higher odds of in-hospital mortality despite younger age. Targeted, culturally responsive interventions and equitable vaccine development and distribution are needed to address the increased risk of poorer COVID-19 outcomes among minority populations.
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Affiliation(s)
| | | | - Ryan T Roper
- Institute for Systems Biology, Seattle, Washington, USA
| | - Hannah Cohen-Cline
- Providence Center for Outcomes Research and Education, Providence Health System, Renton, Washington, USA
| | - Kathleen Jade
- Institute for Systems Biology, Seattle, Washington, USA
| | - Brett Smith
- Institute for Systems Biology, Seattle, Washington, USA
| | - James R Heath
- Institute for Systems Biology, Seattle, Washington, USA
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - George Diaz
- Providence Regional Medical Center, Everett, Washington, USA
| | - Jason D Goldman
- Swedish Center for Research and Innovation, Swedish Medical Center, Seattle, Washington, USA
- Division of Allergy & Infectious Diseases, University of Washington, Seattle, Washington, USA
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Larcade R, DeShea L, Lang GA, Caballero MT, Ferretti A, Beasley WH, Tipple TE, Vain N, Prudent L, Lang ML, Polack F, Ofman G. Maternal-fetal immunologic response to SARS-CoV-2 infection in a symptomatic vulnerable population: A prospective cohort. J Infect Dis 2021; 225:800-809. [PMID: 34865064 DOI: 10.1093/infdis/jiab591] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND COVID-19 disproportionally affects pregnant women and their newborn, yet little is known about the variables that modulate the maternal-fetal immune response to infection. METHODS We prospectively studied socioeconomic, biologic and clinical factors affecting humoral immunity in 87 unvaccinated pregnant women admitted to hospital in the Buenos Aires metropolitan area for symptoms consistent with COVID-19 disease. RESULTS The number of days between symptom onset and childbirth predicted maternal and newborn virus Spike protein Receptor Binding Domain (RBD)-specific IgG. These findings suggest newborns may benefit less when mothers deliver soon after COVID-19 infection. Similarly, a longer time between symptom onset and birth predicted higher in utero transfer of maternal IgG and its concentration in cord blood. Older gestational ages at birth were associated with lower maternal IgG: cord blood IgG ratios. Eighty seven percent of women with confirmed SARS-CoV-2 infection developed RBD-specific IgA responses in breast milk within 96 h of childbirth. IgA was not significantly associated with time from infection but correlated with maternal serum IgG and placental transfer. CONCLUSIONS These results demonstrate the combined role of biologic, clinical and socioeconomic variables associated with maternal SARS-CoV-2 RBD-specific antibodies and supports early vaccination strategies for COVID-19 in socioeconomically vulnerable pregnant women.
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Affiliation(s)
| | - Lise DeShea
- The University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, USA
| | - Gillian A Lang
- The University of Oklahoma Health Sciences Center, Oklahoma City, USA, Department of Microbiology and Immunology, Oklahoma City; USA
| | - Mauricio T Caballero
- Fundación INFANT, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | | | - William H Beasley
- The University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, USA
| | - Trent E Tipple
- The University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, USA
| | | | | | - Mark L Lang
- The University of Oklahoma Health Sciences Center, Oklahoma City, USA, Department of Microbiology and Immunology, Oklahoma City; USA
| | | | - Gaston Ofman
- The University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, USA.,Fundación INFANT, Buenos Aires, Argentina
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Kashem SB, Baker DM, González SR, Lee CA. Exploring the nexus between social vulnerability, built environment, and the prevalence of COVID-19: A case study of Chicago. SUSTAINABLE CITIES AND SOCIETY 2021; 75:103261. [PMID: 34580620 PMCID: PMC8459204 DOI: 10.1016/j.scs.2021.103261] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/31/2021] [Accepted: 08/10/2021] [Indexed: 05/18/2023]
Abstract
COVID-19 has significantly and unevenly impacted the United States, disproportionately affecting socially vulnerable communities. While epidemiologists and public health officials have suggested social distancing and shelter-in-place orders to halt the spread of this virus, the ability to comply with these guidelines is dependent on neighborhood, household, and individual characteristics related to social vulnerability. We use structural equation modeling and multiple data sources, including anonymized mobile phone location data from SafeGraph, to examine the effects of different social vulnerability and built environment factors on COVID-19 prevalence over two overlapping time periods (March to May and March to November of 2020). We use Chicago, Illinois as a case study and find that zip codes with low educational attainment consistently experienced higher case rates over both periods. Though population density was not significantly related to the prevalence in any period, movement of people made a significant contribution only during the longer time period. This finding highlights the significance of analyzing different timeframes for understanding social vulnerability. Our results suggest social vulnerability played an influential role in COVID-19 prevalence, highlighting the needs to address socioeconomic barriers to pandemic recovery and future pandemic response.
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Affiliation(s)
- Shakil Bin Kashem
- Department of Landscape Architecture and Regional & Community Planning, Kansas State University, 3002 Seaton Hall, 920 N 17th St., Manhattan, KS 66506, USA
| | - Dwayne M Baker
- Urban Studies Department, Queens College, CUNY, 65-30 Kissena Blvd., Queens, NY 11367-1597, USA
| | - Silvia R González
- UCLA Luskin Center for Innovation, The University of California, Los Angeles, 3323 Public Affairs Building, Box 951656, Los Angeles, CA 90095-1656, USA
| | - C Aujean Lee
- Regional and City Planning, The University of Oklahoma, 830 Van Vleet Oval, Norman, OK 73019, USA
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46
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Xu Q, Samanapally H, Nathala P, Salunkhe V, Furmanek S, Cahill MN, McGuffin T, Mohammad T, Marsili B, Petrey J, Carrico R, Ramirez J, Akca O, Clifford SP, Pahwa S, Roser L, Kong M, Huang J. Outcomes and Risk Factors for Cardiovascular Events in Hospitalized COVID-19 Patients. J Cardiothorac Vasc Anesth 2021; 35:3581-3593. [PMID: 33867235 PMCID: PMC7997853 DOI: 10.1053/j.jvca.2021.03.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To analyze outcomes and risk factors of cardiovascular events in a metropolitan coronavirus disease 2019 (COVID-19) database, and to perform a subgroup analysis in African American populations to determine whether outcomes and risk factors are influenced by race. DESIGN Retrospective cohort analysis from March 9, 2020 to June 20, 2020. SETTING Population-based study in Louisville, KY, USA. PARTICIPANTS Seven hundred adult inpatients hospitalized with COVID-19. INTERVENTIONS N/A. MEASUREMENTS AND MAIN RESULTS This cohort consisted of 126 patients (18%) with cardiovascular events and 574 patients without cardiovascular events. Patients with cardiovascular events had a much higher mortality rate than those without cardiovascular events (45.2% v 8.7%, p < 0.001). There was no difference between African American and white patients regarding mortality (43.9% v 46.3%, p = 1) and length of stay for survivors (11 days v 9.5 days, p = 0.301). Multiple logistics regression analysis suggested that male, race, lower SaO2/FIO2, higher serum potassium, lower serum albumin, and number of cardiovascular comorbidities were highly associated with the occurrence of cardiovascular events in COVID-19 patients. Lower serum albumin and neoplastic and/or immune-compromised diseases were highly associated with cardiovascular events for African American COVID-19 patients. SaO2/FIO2 ratio and cardiovascular comorbidity count were significantly associated with cardiovascular events in white patients. CONCLUSIONS Cardiovascular events were prevalent and associated with worse outcomes in hospitalized patients with COVID-19. Outcomes of cardiovascular events in African American and white COVID-19 patients were similar after propensity score matching analysis. There were common and unique risk factors for cardiovascular events in African American COVID-19 patients when compared with white patients.
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Affiliation(s)
- Qian Xu
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY
| | - Harideep Samanapally
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY
| | - Pavani Nathala
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY
| | - Vidyulata Salunkhe
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY
| | - Stephen Furmanek
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY
| | - Meredith N Cahill
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY; School of Medicine, University of Louisville, Louisville, KY
| | | | - Tahboub Mohammad
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY
| | - Bradford Marsili
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY
| | - Jessica Petrey
- Kornhauser Health Sciences Library, University of Louisville, Louisville, KY
| | - Ruth Carrico
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY
| | - Julio Ramirez
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY
| | - Ozan Akca
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY
| | - Sean P Clifford
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY
| | - Siddharth Pahwa
- Department of Cardiovascular & Thoracic Surgery, University of Louisville, Louisville, KY
| | - Lynn Roser
- School of Nursing, University of Louisville, Louisville, KY
| | - Maiying Kong
- Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY
| | - Jiapeng Huang
- Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY; Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY; Department of Cardiovascular & Thoracic Surgery, University of Louisville, Louisville, KY; Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY.
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47
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Boelig RC, Aagaard KM, Debbink MP, Shamshirsaz AA. Society for Maternal-Fetal Medicine Special Statement: COVID-19 research in pregnancy: progress and potential. Am J Obstet Gynecol 2021; 225:B19-B31. [PMID: 34481778 PMCID: PMC8413099 DOI: 10.1016/j.ajog.2021.08.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The COVID-19 global pandemic has broad implications for obstetrical care and perinatal outcomes. As we approach the 2-year mark into an unprecedented international pandemic, this review presents the progress and opportunities for research related to COVID-19 and pregnancy. Research is the basis for evidence-based clinical guidelines, and we aim to provide the structure and guidance for framing COVID-19-related obstetrical research. This structure will pertain not only to this pandemic but future ones as well.
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Affiliation(s)
- Research Committee
- Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
| | | | - Rupsa C. Boelig
- Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
| | - Kjersti M. Aagaard
- Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
| | - Michelle P. Debbink
- Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
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Feehan AK, Denstel KD, Katzmarzyk PT, Velasco C, Burton JH, Price-Haywood EG, Seoane L. Community versus individual risk of SARS-CoV-2 infection in two municipalities of Louisiana, USA: An assessment of Area Deprivation Index (ADI) paired with seroprevalence data over time. PLoS One 2021; 16:e0260164. [PMID: 34847149 PMCID: PMC8631658 DOI: 10.1371/journal.pone.0260164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/03/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Determine whether an individual is at greater risk of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) infection because of their community or their individual risk factors. STUDY DESIGN AND SETTING 4,752 records from two large prevalence studies in New Orleans and Baton Rouge, Louisiana were used to assess whether zip code tabulation areas (ZCTA)-level area deprivation index (ADI) or individual factors accounted for risk of infection. Logistic regression models assessed associations of individual-level demographic and socioeconomic factors and the zip code-level ADI with SARS-CoV-2 infection. RESULTS In the unadjusted model, there were increased odds of infection among participants residing in high versus low ADI (both cities) and high versus mid-level ADI (Baton Rouge only) zip codes. When individual-level covariates were included, the odds of infection remained higher only among Baton Rouge participants who resided in high versus mid-level ADI ZCTAs. Several individual factors contributed to infection risk. After adjustment for ADI, race and age (Baton Rouge) and race, marital status, household size, and comorbidities (New Orleans) were significant. CONCLUSIONS While higher ADI was associated with higher risk of SARS-CoV-2 infection, individual-level participant characteristics accounted for a significant proportion of this association. Additionally, stage of the pandemic may affect individual risk factors for infection.
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Affiliation(s)
- Amy K. Feehan
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Ochsner Clinical School, The University of Queensland, New Orleans, LA, United States of America
| | - Kara D. Denstel
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States of America
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States of America
| | - Cruz Velasco
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Center for Outcomes and Health Services Research, New Orleans, LA, United States of America
| | - Jeffrey H. Burton
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Center for Outcomes and Health Services Research, New Orleans, LA, United States of America
| | - Eboni G. Price-Haywood
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Ochsner Clinical School, The University of Queensland, New Orleans, LA, United States of America
- Center for Outcomes and Health Services Research, New Orleans, LA, United States of America
| | - Leonardo Seoane
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Ochsner Clinical School, The University of Queensland, New Orleans, LA, United States of America
- Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, United States of America
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Gonzalez CJ, Aristega Almeida B, Corpuz GS, Mora HA, Aladesuru O, Shapiro MF, Sterling MR. Challenges with social distancing during the COVID-19 pandemic among Hispanics in New York City: a qualitative study. BMC Public Health 2021; 21:1946. [PMID: 34702228 PMCID: PMC8547302 DOI: 10.1186/s12889-021-11939-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hispanics in the United States are disproportionately affected by the novel coronavirus (COVID-19). While social distancing and quarantining are effective methods to reduce its spread, Hispanics, who are more likely to be essential workers and live in multigenerational homes than non-Hispanics, may face challenges that limit their ability to carry out these preventative efforts. We elicited the experiences of Hispanic adults with social distancing and self-quarantining during the COVID-19 pandemic in New York. METHODS In this qualitative study, Hispanic adults receiving care at a federally qualified community health center in East Harlem, New York, were recruited for remote one-on-one semi-structured interviews from 5/15/2020 to 11/17/2020. Interviews were conducted by a bilingual interviewer in Spanish or English, using a semi-structured topic guide informed by the Health Belief Model. Audio-recordings were professionally transcribed. We used thematic analysis to iteratively code the data. Each transcript was independently coded by two research team members, then reconciled by a third. Major themes and subthemes were identified. RESULTS Among 20 participants, four major themes emerged; Hispanics were: (1) fearful of contracting and transmitting COVID-19, (2) engaging in practices to reduce transmission of COVID-19, (3) experiencing barriers to social distancing and quarantining, and (4) facing an enduring psychological and physical toll from COVID-19. CONCLUSIONS Despite understanding the risks for contracting COVID-19 and taking appropriate precautions, Hispanics faced numerous challenges to social distancing and quarantining, such as living in crowded, multi-generational households, working as essential workers, and providing unpaid care to family members. Such challenges took a toll on their physical, emotional, and financial well-being. Our findings suggest that a tailored approach to public health messaging and interventions for pandemic planning are warranted among members of this community. Further research is needed to understand and mitigate the long term physical and psychological consequences of the pandemic among Hispanics.
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Affiliation(s)
- Christopher J Gonzalez
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA.
| | - Bryan Aristega Almeida
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - George S Corpuz
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - Hector A Mora
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - Oluwatobi Aladesuru
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - Martin F Shapiro
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
| | - Madeline R Sterling
- Department of Medicine, Weill Cornell Medical College, Cornell University, 525 E 68th St., New York, NY, 10065, USA
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50
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Lee K, Hyun K, Mitchell J, Saha T, Oran Gibson N, Krejci C. Exploring Factors Enhancing Resilience Among Marginalized Older Adults During the COVID-19 Pandemic. J Appl Gerontol 2021; 41:610-618. [PMID: 34608810 PMCID: PMC8685756 DOI: 10.1177/07334648211048749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Marginalized older adults are highly vulnerable to COVID-19 due to social isolation and physical and functional limitations. Despite these stressors, they appear to be resilient by leveraging individual, community, and societal resources. This study conducted in-depth interviews with marginalized older adults to understand how COVID-19 affected their mobility and daily lives. We also identified different levels of protective factors affecting their resiliency to pandemic stressors. COVID-19 influenced not only the physical health but also the mental health of older adults. However, they overcame adversity by using technology to continue daily activities, exchanging informal support with family and neighbors, relying on formal support from community organizations, and keeping themselves physically active in their neighborhoods. Our findings suggest a holistic approach to enhance the resilience of older adults during an unprecedented event.
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Affiliation(s)
- Kathy Lee
- School of Social Work, 423694University of Texas at Arlington, Arlington, TX, USA
| | - Kate Hyun
- Department of Civil Engineering, 12329University of Texas at Arlington, Arlington, TX, USA
| | - Jaci Mitchell
- School of Social Work, 423694University of Texas at Arlington, Arlington, TX, USA
| | - Troyee Saha
- Department of Civil Engineering, 12329University of Texas at Arlington, Arlington, TX, USA
| | - Nilufer Oran Gibson
- Department of Industrial, Manufacturing, and Systems Engineering, 12329University of Texas at Arlington, Arlington, TX, USA
| | - Caroline Krejci
- Department of Industrial, Manufacturing, and Systems Engineering, 12329University of Texas at Arlington, Arlington, TX, USA
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