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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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Kwekha-Rashid AS, Abduljabbar HN, Alhayani B. Coronavirus disease (COVID-19) cases analysis using machine-learning applications. APPLIED NANOSCIENCE 2023; 13:2013-2025. [PMID: 34036034 PMCID: PMC8138510 DOI: 10.1007/s13204-021-01868-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/04/2021] [Indexed: 12/23/2022]
Abstract
Today world thinks about coronavirus disease that which means all even this pandemic disease is not unique. The purpose of this study is to detect the role of machine-learning applications and algorithms in investigating and various purposes that deals with COVID-19. Review of the studies that had been published during 2020 and were related to this topic by seeking in Science Direct, Springer, Hindawi, and MDPI using COVID-19, machine learning, supervised learning, and unsupervised learning as keywords. The total articles obtained were 16,306 overall but after limitation; only 14 researches of these articles were included in this study. Our findings show that machine learning can produce an important role in COVID-19 investigations, prediction, and discrimination. In conclusion, machine learning can be involved in the health provider programs and plans to assess and triage the COVID-19 cases. Supervised learning showed better results than other Unsupervised learning algorithms by having 92.9% testing accuracy. In the future recurrent supervised learning can be utilized for superior accuracy.
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Affiliation(s)
- Ameer Sardar Kwekha-Rashid
- Business Information Technology, College of Administration and Economics, University of Sulaimani, Sulaimaniya, Iraq
| | - Heamn N. Abduljabbar
- College of Education, Physics Department, Salahaddin University, Shaqlawa, Iraq ,Department of radiology and imagingFaculty of Medicine and Health Sciences, Universiti Putra Malaysia UPM, Seri Kembangan, Malaysia
| | - Bilal Alhayani
- Electronics and Communication Department, Yildiz Technical University, Istanbul, Turkey
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3
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Spoer BR, McCulley E, Lampe TM, Hsieh PY, Chen A, Ofrane R, Rollins H, Thorpe LE, Bilal U, Gourevitch MN. Validation of a neighborhood-level COVID Local Risk Index in 47 large U.S. cities. Health Place 2022; 76:102814. [PMID: 35623163 PMCID: PMC9128556 DOI: 10.1016/j.healthplace.2022.102814] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To present the COVID Local Risk Index (CLRI), a measure of city- and neighborhood-level risk for SARS COV-2 infection and poor outcomes, and validate it using sub-city SARS COV-2 outcome data from 47 large U.S. cities. METHODS Cross-sectional validation analysis of CLRI against SARS COV-2 incidence, percent positivity, hospitalization, and mortality. CLRI scores were validated against ZCTA-level SARS COV-2 outcome data gathered in 2020-2021 from public databases or through data use agreements using a negative binomial model. RESULTS CLRI was associated with each SARS COV-2 outcome in pooled analysis. In city-level models, CLRI was positively associated with positivity in 11/14 cities for which data were available, hospitalization in 6/6 cities, mortality in 13/14 cities, and incidence in 33/47 cities. CONCLUSIONS CLRI is a valid tool for assessing sub-city risk of SARS COV-2 infection and illness severity. Stronger associations with positivity, hospitalization and mortality may reflect differential testing access, greater weight on components associated with poor outcomes than transmission, omitted variable bias, or other reasons. City stakeholders can use the CLRI, publicly available on the City Health Dashboard (www.cityhealthdashboard.com), to guide SARS COV-2 resource allocation.
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Affiliation(s)
- Ben R Spoer
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
| | - Edwin McCulley
- Department of Epidemiology and Biostatistics, Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Taylor M Lampe
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Pei Yang Hsieh
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Alexander Chen
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Rebecca Ofrane
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Heather Rollins
- Department of Epidemiology and Biostatistics, Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Lorna E Thorpe
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Usama Bilal
- Department of Epidemiology and Biostatistics, Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Marc N Gourevitch
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA
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4
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Saunders-Hastings P, Zhou CK, Hobbi S, Wong HL, Lloyd P, Boyd E, Alawar N, Clarke TC, Beers J, Burrell T, Shoaibi A. Characterization of test positivity among patients with coronavirus disease 2019 (COVID-19) in three electronic health records databases, February-November 2020. BMC Public Health 2022; 22:1217. [PMID: 35717174 PMCID: PMC9206507 DOI: 10.1186/s12889-022-13635-6] [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] [Received: 02/15/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background Monitoring COVID-19 testing volumes and test positivity is an integral part of the response to the pandemic. We described the characteristics of individuals who were tested and tested positive for SARS-CoV-2 during the pre-vaccine phase of the pandemic in the United States (U.S.). Methods This descriptive study analyzed three U.S. electronic health record (EHR) databases (Explorys, Academic Health System, and OneFlorida) between February and November 2020, identifying patients who received an interpretable nucleic acid amplification test (NAAT) result. Test-level data were used to characterize the settings in which tests were administered. Patient-level data were used to calculate test positivity rates and characterize the demographics, comorbidities, and hospitalization rates of COVID-19-positive patients. Results Over 40% of tests were conducted in outpatient care settings, with a median time between test order and result of 0–1 day for most settings. Patients tested were mostly female (55.6–57.7%), 18–44 years of age (33.9–41.2%), and Caucasian (44.0–66.7%). The overall test positivity rate was 13.0% in Explorys, 8.0% in Academic Health System, and 8.9% in OneFlorida. The proportion of patients hospitalized within 14 days of a positive COVID-19 NAAT result was 24.2–33.1% across databases, with patients over 75 years demonstrating the highest hospitalization rates (46.7–69.7% of positive tests). Conclusions This analysis of COVID-19 testing volume and positivity patterns across three large EHR databases provides insight into the characteristics of COVID-19-tested, COVID-19-test-positive, and hospitalized COVID-19-test-positive patients during the early phase of the pandemic in the U.S. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13635-6.
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Affiliation(s)
| | - Cindy Ke Zhou
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | | | - Hui-Lee Wong
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Patricia Lloyd
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Eva Boyd
- Gevity Consulting Inc., part of Accenture, Ottawa, ON, Canada
| | | | - Tainya C Clarke
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | | | | | - Azadeh Shoaibi
- Center for Biologics Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
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5
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da Silva Torres MK, Lopes FT, de Lima ACR, Lima CNC, Dos Santos Brito WR, Dos Santos BC, de Sousa RS, Gomes JLC, Botelho BJS, Correa ACA, Machado LFA, Feitosa RNM, Lima SS, Vallinoto IMVC, Vallinoto ACR. Seroprevalence and risk factors for COVID-19 in the metropolis of the Brazilian Amazon. Sci Rep 2022; 12:8571. [PMID: 35595782 PMCID: PMC9122246 DOI: 10.1038/s41598-022-12629-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 04/27/2022] [Indexed: 12/04/2022] Open
Abstract
The devastating effect of health system overload was observed after cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) peaked in April 2020 in Belém, a capital metropolis in the Brazilian Amazon. Our results showed a high seroprevalence (39.24%) of anti-SARS-CoV-2 IgG antibodies among the population of the capital of the state of Pará after the first wave of the pandemic. Old age, mixed race, a high school education level, low income and contact with infected individuals are risk factors and may be driving seropositivity and exposure to SARS-CoV-2 in this population. This study is one of the first to provide important information to understand the socioeconomic inequalities, behavioral characteristics and viral transmission dynamics associated with the risk of SARS-CoV-2 infection in the capital of the state of Pará, northern Brazil.
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Affiliation(s)
- Maria Karoliny da Silva Torres
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Felipe Teixeira Lopes
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Aline Cecy Rocha de Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Carlos Neandro Cordeiro Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Wandrey Roberto Dos Santos Brito
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Bernardo Cintra Dos Santos
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil
| | - Renata Santos de Sousa
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil
| | - Jayanne Lilian Carvalho Gomes
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil
| | - Bruno José Sarmento Botelho
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil
| | - Ana Carolina Alves Correa
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil
| | - Luiz Fernando A Machado
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Rosimar Neris Martins Feitosa
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Sandra Souza Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Izaura Maria Vieira Cayres Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil.,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil
| | - Antonio Carlos R Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará (Universidade Federal Do Pará-UFPA), Belém, Pará, Brazil. .,Graduate Program in Biology of Infectious and Parasitic Agents, Belém, Brazil.
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Williamson CG, Tran Z, Rudasill S, Hadaya J, Verma A, Bridges AW, Satou G, Biniwale RM, Benharash P. Race-based disparities in access to surgical palliation for hypoplastic left heart syndrome. Surgery 2022; 172:500-505. [PMID: 35450745 DOI: 10.1016/j.surg.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/15/2022] [Accepted: 03/06/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Racial disparities in outcomes have been shown to persist in many operative specialties, including the management of congenital heart disease. Using a demographic-adjusted methodology, we examined whether patient race influenced access to high-performing centers for the operative management of hypoplastic left heart syndrome. METHODS The 2005-2017 National Inpatient Sample was queried to identify all pediatric (≤5 years) hospitalizations with an operation for hypoplastic left heart syndrome. A racial disparity index was generated for each hospital and defined as the proportion of White patients receiving operative management for hypoplastic left heart syndrome divided by the proportion of White patients admitted for respiratory failure. This methodology quantified hospital-level racial variation while adjusting for the local racial makeup of each center. RESULTS Of the 17,275 patients who met inclusion criteria, 64.1% were managed at high-volume centers. Patients at high-volume centers had a similar distribution of operative type, age, and burden of comorbidities. The mean racial disparity index steadily grew from 1.06 at the lowest volume decile of operative volume to 1.51 at the highest, indicating an increasing proportion of White patients as volume increased. Using risk-adjusted analysis, each decile increase in hospital volume was associated with a 14% relative reduction in odds of mortality and a 0.06 increase in predicted racial disparity index. Increasing volume was further associated with reduced odds of non-home discharge but did not alter resource utilization. CONCLUSION We demonstrate that high-volume centers disproportionally serve White patients and have superior clinical outcomes compared to low-volume centers. This study highlights the critical importance of equitable access to expert care for high-risk conditions such as hypoplastic left heart syndrome.
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Affiliation(s)
- Catherine G Williamson
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Zachary Tran
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Sarah Rudasill
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Joseph Hadaya
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Arjun Verma
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Alexander W Bridges
- Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Gary Satou
- Division of Pediatric Cardiology, Mattel Children's Hospital, University of California, Los Angeles, CA
| | - Reshma M Biniwale
- Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA; Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA.
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7
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Mondal S, Chaipitakporn C, Kumar V, Wangler B, Gurajala S, Dhaniyala S, Sur S. COVID-19 in New York state: Effects of demographics and air quality on infection and fatality. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:150536. [PMID: 34628294 PMCID: PMC8461036 DOI: 10.1016/j.scitotenv.2021.150536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/28/2021] [Accepted: 09/19/2021] [Indexed: 05/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has had a global impact that has been unevenly distributed among and even within countries. Multiple demographic and environmental factors have been associated with the risk of COVID-19 spread and fatality, including age, gender, ethnicity, poverty, and air quality among others. However, specific contributions of these factors are yet to be understood. Here, we attempted to explain the variability in infection, death, and fatality rates by understanding the contributions of a few selected factors. We compared the incidence of COVID-19 in New York State (NYS) counties during the first wave of infection and analyzed how different demographic and environmental variables associate with the variation observed across the counties. We observed that infection and death rates, two important COVID-19 metrics, to be highly correlated with both being highest in counties located near New York City, considered as one of the epicenters of the infection in the US. In contrast, disease fatality was found to be highest in a different set of counties despite registering a low infection rate. To investigate this apparent discrepancy, we divided the counties into three clusters based on COVID-19 infection, death, or fatality, and compared the differences in the demographic and environmental variables such as ethnicity, age, population density, poverty, temperature, and air quality in each of these clusters. Furthermore, a regression model built on this data reveals PM2.5 and distance from the epicenter are significant risk factors for infection, while disease fatality has a strong association with age and PM2.5. Our results demonstrate that for the NYS, demographic components distinctly associate with specific aspects of COVID-19 burden and also highlight the detrimental impact of poor air quality. These results could help design and direct location-specific control and mitigation strategies.
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Affiliation(s)
- Sumona Mondal
- Department of Mathematics, Clarkson University, Potsdam, NY, USA
| | | | - Vijay Kumar
- Department of Mathematics, Clarkson University, Potsdam, NY, USA
| | - Bridget Wangler
- David D. Reh School of Business, Clarkson University, Potsdam, NY, USA
| | | | - Suresh Dhaniyala
- Department of Mechanical and Aeronautical Engineering, Clarkson University, Potsdam, NY, USA
| | - Shantanu Sur
- Department of Biology, Clarkson University, Potsdam, NY, USA.
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8
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Bailey DN, Sanfilippo F. Communication during a global pandemic: The utility of a professional society listserv and journal. Acad Pathol 2022; 9:100043. [PMID: 35937187 PMCID: PMC9339247 DOI: 10.1016/j.acpath.2022.100043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- David N. Bailey
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
- Corresponding author. Department of Pathology, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0612, USA.
| | - Fred Sanfilippo
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
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9
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Magesh S, John D, Li WT, Li Y, Mattingly-app A, Jain S, Chang EY, Ongkeko WM. Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic-Review and Meta-analysis. JAMA Netw Open 2021; 4:e2134147. [PMID: 34762110 PMCID: PMC8586903 DOI: 10.1001/jamanetworkopen.2021.34147] [Citation(s) in RCA: 376] [Impact Index Per Article: 125.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
IMPORTANCE COVID-19 has disproportionately affected racial and ethnic minority groups, and race and ethnicity have been associated with disease severity. However, the association of socioeconomic determinants with racial disparities in COVID-19 outcomes remains unclear. OBJECTIVE To evaluate the association of race and ethnicity with COVID-19 outcomes and to examine the association between race, ethnicity, COVID-19 outcomes, and socioeconomic determinants. DATA SOURCES A systematic search of PubMed, medRxiv, bioRxiv, Embase, and the World Health Organization COVID-19 databases was performed for studies published from January 1, 2020, to January 6, 2021. STUDY SELECTION Studies that reported data on associations between race and ethnicity and COVID-19 positivity, disease severity, and socioeconomic status were included and screened by 2 independent reviewers. Studies that did not have a satisfactory quality score were excluded. Overall, less than 1% (0.47%) of initially identified studies met selection criteria. DATA EXTRACTION AND SYNTHESIS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Associations were assessed using adjusted and unadjusted risk ratios (RRs) and odds ratios (ORs), combined prevalence, and metaregression. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES The main measures were RRs, ORs, and combined prevalence values. RESULTS A total of 4 318 929 patients from 68 studies were included in this meta-analysis. Overall, 370 933 patients (8.6%) were African American, 9082 (0.2%) were American Indian or Alaska Native, 101 793 (2.4%) were Asian American, 851 392 identified as Hispanic/Latino (19.7%), 7417 (0.2%) were Pacific Islander, 1 037 996 (24.0%) were White, and 269 040 (6.2%) identified as multiracial and another race or ethnicity. In age- and sex-adjusted analyses, African American individuals (RR, 3.54; 95% CI, 1.38-9.07; P = .008) and Hispanic individuals (RR, 4.68; 95% CI, 1.28-17.20; P = .02) were the most likely to test positive for COVID-19. Asian American individuals had the highest risk of intensive care unit admission (RR, 1.93; 95% CI, 1.60-2.34, P < .001). The area deprivation index was positively correlated with mortality rates in Asian American and Hispanic individuals (P < .001). Decreased access to clinical care was positively correlated with COVID-19 positivity in Hispanic individuals (P < .001) and African American individuals (P < .001). CONCLUSIONS AND RELEVANCE In this study, members of racial and ethnic minority groups had higher risks of COVID-19 positivity and disease severity. Furthermore, socioeconomic determinants were strongly associated with COVID-19 outcomes in racial and ethnic minority populations.
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Affiliation(s)
- Shruti Magesh
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California, San Diego
- Research Service, VA San Diego Healthcare System, San Diego, California
| | - Daniel John
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California, San Diego
- Research Service, VA San Diego Healthcare System, San Diego, California
| | - Wei Tse Li
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California, San Diego
- Research Service, VA San Diego Healthcare System, San Diego, California
| | - Yuxiang Li
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California, San Diego
- Research Service, VA San Diego Healthcare System, San Diego, California
| | - Aidan Mattingly-app
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California, San Diego
- Research Service, VA San Diego Healthcare System, San Diego, California
| | - Sharad Jain
- The University of California Davis School of Medicine, Sacramento
| | - Eric Y. Chang
- Department of Radiology, University of California, San Diego
- Radiology Service, VA San Diego Healthcare System, San Diego, California
| | - Weg M. Ongkeko
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California, San Diego
- Research Service, VA San Diego Healthcare System, San Diego, California
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10
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Ahlstrand E, Cajander S, Cajander P, Ingberg E, Löf E, Wegener M, Lidén M. Visual scoring of chest CT at hospital admission predicts hospitalization time and intensive care admission in Covid-19. Infect Dis (Lond) 2021; 53:622-632. [PMID: 33848219 PMCID: PMC8054497 DOI: 10.1080/23744235.2021.1910727] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Chest CT is prognostic in Covid-19 but there is a lack of consensus on how to report the CT findings. A chest CT scoring system, ÖCoS, was implemented in clinical routine on 1 April 2020, in Örebro Region, Sweden. The ÖCoS-severity score measures the extent of lung involvement. The objective of the study was to evaluate the ÖCoS scores as predictors of the clinical course of Covid-19. Methods Population based study including data from all hospitalized patients with Covid-19 in Örebro Region during March to July 2020. We evaluated the correlations between CT scores at the time of admission to hospital and intensive care in relation to hospital and intensive care length of stay (LoS), intensive care admission and death. C-reactive protein and lymphocyte count were included as covariates in multivariate regression analyses. Results In 381 included patients, the ÖCoS-severity score at admission closely correlated to hospital length of stay, and intensive care admission or death. At admission to intensive care, the ÖCoS-severity score correlated with intensive care length of stay. The ÖCoS-severity score was superior to basic inflammatory biomarkers in predicting clinical outcomes. Conclusion Chest CT visual scoring at admission to hospital predicted the clinical course of Covid-19 pneumonia.
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Affiliation(s)
- Erik Ahlstrand
- Faculty of Medicine and Health, Department of Medicine, Örebro University, Örebro, Sweden
| | - Sara Cajander
- Faculty of Medicine and Health, Department of Infectious Diseases, Örebro University, Örebro, Sweden
| | - Per Cajander
- Faculty of Medicine and Health, Department of Anesthesiology and Intensive Care, Örebro University, Örebro, Sweden
| | - Edvin Ingberg
- Faculty of Medicine and Health, Department of Infectious Diseases, Örebro University, Örebro, Sweden
| | - Erika Löf
- Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden
| | - Matthias Wegener
- Department of Radiology, Örebro University Hospital, Örebro, Sweden
| | - Mats Lidén
- Faculty of Medicine and Health, Department of Radiology, Örebro University, Örebro, Sweden
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11
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Khan AH, Tirth V, Fawzy M, Mahmoud AED, Khan NA, Ahmed S, Ali SS, Akram M, Hameed L, Islam S, Das G, Roy S, Dehghani MH. COVID-19 transmission, vulnerability, persistence and nanotherapy: a review. ENVIRONMENTAL CHEMISTRY LETTERS 2021; 19:2773-2787. [PMID: 33846683 PMCID: PMC8026094 DOI: 10.1007/s10311-021-01229-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/16/2021] [Indexed: 05/09/2023]
Abstract
End 2019, the zoonotic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), named COVID-19 for coronavirus disease 2019, is the third adaptation of a contagious virus following the severe acute respiratory syndrome coronavirus in 2002, SARS-CoV, and the Middle East respiratory syndrome virus in 2012, MERS-CoV. COVID-19 is highly infectious and virulent compared to previous outbreaks. We review sources, contagious routes, preventive measures, pandemic, outbreak, epidemiology of SARS-CoV, MERS-CoV and SARS-CoV-2 from 2002 to 2020 using a Medline search. We discuss the chronology of the three coronaviruses, the vulnerability of healthcare workers, coronaviruses on surface and in wastewater, diagnostics and cures, and measures to prevent spreading.
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Affiliation(s)
- Afzal Husain Khan
- Civil Engineering Department, Jazan University, Jazan, 114 Saudi Arabia
| | - Vineet Tirth
- Department of Mechanical Engineering, King Khalid University, Abha, 61413 Saudi Arabia
| | - Manal Fawzy
- Environmental Sciences Department, Faculty of Science, Alexandria University, Alexandria, 21511 Egypt
| | - Alaa El Din Mahmoud
- Environmental Sciences Department, Faculty of Science, Alexandria University, Alexandria, 21511 Egypt
| | - Nadeem A. Khan
- Civil Engineering Department, Jamia Millia Islamia (A Central University), New Delhi, 110025 India
| | - Sirajuddin Ahmed
- Civil Engineering Department, Jamia Millia Islamia (A Central University), New Delhi, 110025 India
| | - Syed Sadat Ali
- Department of Physiology, Faculty of Medicine, Jazan University, Jazan, 114 Saudi Arabia
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University, Faisalabad, Pakistan
| | - Leena Hameed
- Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan
| | - Saiful Islam
- Civil Engineering Department, College of Engineering, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Gotam Das
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, 61413 Saudi Arabia
| | - Sharmili Roy
- Division of Oncology, School of Medicine, Stanford University, Stanford, CA 94305 USA
| | - Mohammad Hadi Dehghani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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12
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Mackey K, Ayers CK, Kondo KK, Saha S, Advani SM, Young S, Spencer H, Rusek M, Anderson J, Veazie S, Smith M, Kansagara D. Racial and Ethnic Disparities in COVID-19-Related Infections, Hospitalizations, and Deaths : A Systematic Review. Ann Intern Med 2021; 174:362-373. [PMID: 33253040 PMCID: PMC7772883 DOI: 10.7326/m20-6306] [Citation(s) in RCA: 670] [Impact Index Per Article: 223.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Data suggest that the effects of coronavirus disease 2019 (COVID-19) differ among U.S. racial/ethnic groups. PURPOSE To evaluate racial/ethnic disparities in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and COVID-19 outcomes, factors contributing to disparities, and interventions to reduce them. DATA SOURCES English-language articles in MEDLINE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus, searched from inception through 31 August 2020. Gray literature sources were searched through 2 November 2020. STUDY SELECTION Observational studies examining SARS-CoV-2 infections, hospitalizations, or deaths by race/ethnicity in U.S. settings. DATA EXTRACTION Single-reviewer abstraction confirmed by a second reviewer; independent dual-reviewer assessment of quality and strength of evidence. DATA SYNTHESIS 37 mostly fair-quality cohort and cross-sectional studies, 15 mostly good-quality ecological studies, and data from the Centers for Disease Control and Prevention and APM Research Lab were included. African American/Black and Hispanic populations experience disproportionately higher rates of SARS-CoV-2 infection, hospitalization, and COVID-19-related mortality compared with non-Hispanic White populations, but not higher case-fatality rates (mostly reported as in-hospital mortality) (moderate- to high-strength evidence). Asian populations experience similar outcomes to non-Hispanic White populations (low-strength evidence). Outcomes for other racial/ethnic groups have been insufficiently studied. Health care access and exposure factors may underlie the observed disparities more than susceptibility due to comorbid conditions (low-strength evidence). LIMITATIONS Selection bias, missing race/ethnicity data, and incomplete outcome assessments in cohort and cross-sectional studies must be considered. In addition, adjustment for key demographic covariates was lacking in ecological studies. CONCLUSION African American/Black and Hispanic populations experience disproportionately higher rates of SARS-CoV-2 infection and COVID-19-related mortality but similar rates of case fatality. Differences in health care access and exposure risk may be driving higher infection and mortality rates. PRIMARY FUNDING SOURCE Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development. (PROSPERO: CRD42020187078).
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Affiliation(s)
- Katherine Mackey
- VA Evidence Synthesis Program, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (K.M., K.K.K., S.S., D.K.)
| | - Chelsea K Ayers
- VA Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon (C.K.A., S.Y., J.A., S.V.)
| | - Karli K Kondo
- VA Evidence Synthesis Program, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (K.M., K.K.K., S.S., D.K.)
| | - Somnath Saha
- VA Evidence Synthesis Program, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (K.M., K.K.K., S.S., D.K.)
| | - Shailesh M Advani
- Social Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland (S.M.A.)
| | - Sarah Young
- VA Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon (C.K.A., S.Y., J.A., S.V.)
| | - Hunter Spencer
- Oregon Health & Science University, Portland, Oregon (H.S., M.R.)
| | - Max Rusek
- Oregon Health & Science University, Portland, Oregon (H.S., M.R.)
| | - Johanna Anderson
- VA Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon (C.K.A., S.Y., J.A., S.V.)
| | - Stephanie Veazie
- VA Evidence Synthesis Program, VA Portland Health Care System, Portland, Oregon (C.K.A., S.Y., J.A., S.V.)
| | - Mia Smith
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon (M.S.)
| | - Devan Kansagara
- VA Evidence Synthesis Program, VA Portland Health Care System and Oregon Health & Science University, Portland, Oregon (K.M., K.K.K., S.S., D.K.)
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13
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Larsen CG, Bub CD, Schaffler BC, Walden T, Intravia JM. The impact of confirmed coronavirus disease 2019 (COVID-19) infection on ambulatory procedures and associated delays in care for asymptomatic patients. Surgery 2021; 169:1340-1345. [PMID: 33593601 PMCID: PMC7817437 DOI: 10.1016/j.surg.2021.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/18/2020] [Accepted: 01/08/2021] [Indexed: 12/25/2022]
Abstract
Background Since the reopening of ambulatory centers, minimal data has been reported regarding positive tests among patients undergoing ambulatory procedures, associated delays in care, and outcomes of patients previously positive for coronavirus disease 2019. Methods A retrospective observational case series of ambulatory procedures was performed. Records since the reopening of ambulatory centers in New York were searched for patients with positive coronavirus disease 2019 nasal swab results who underwent ambulatory procedures. Chart reviews were conducted to determine coronavirus disease history and hospitalizations, demographic information, procedure details, and 30-day admissions. Results A total of 3,762 patients underwent ambulatory procedures. Of those, 53 were previously diagnosed with coronavirus disease 2019 but recovered and tested negative at preprocedural testing. Of the 3,709 asymptomatic patients, 37 (1.00%) tested positive during preprocedural testing; 21 patients had their procedures delayed on average 28.6 days until testing negative, while 16 had their procedures performed before testing negative owing to the time sensitivity of the procedure. There were no major complications or 30-day admissions in any of these asymptomatic patients. Three patients tested positive for coronavirus disease after having an ambulatory procedure. Conclusion Positive tests in asymptomatic patients led to procedure delays of 28.6 days. No patients who underwent ambulatory procedures after a positive coronavirus disease 2019 test had any coronavirus disease-related complications, regardless of whether or not the procedure was delayed until testing negative. Three patients tested positive for coronavirus disease 2019 after having an ambulatory procedure; however, at an average of 19.7 days after, these cases were likely community acquired making the rate of nosocomial infection negligible.
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Affiliation(s)
- Christopher G Larsen
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
| | - Christine D Bub
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Benjamin C Schaffler
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Timothy Walden
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Jessica M Intravia
- Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
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14
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Kaul KL. One Year Later: What Have We Learned From COVID-19? Lessons and Accomplishments in Academic Pathology Departments. Acad Pathol 2021; 8:23742895211021979. [PMID: 34124347 PMCID: PMC8175832 DOI: 10.1177/23742895211021979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/17/2021] [Accepted: 04/10/2021] [Indexed: 01/28/2023] Open
Affiliation(s)
- Karen L. Kaul
- Department of Pathology, NorthShore University HealthSystem, Evanston, IL, USA
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15
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Crawford JM, Aguero-Rosenfeld ME, Aifantis I, Cadoff EM, Cangiarella JF, Cordon-Cardo C, Cushing M, Firpo-Betancourt A, Fox AS, Furuya Y, Hacking S, Jhang J, Leonard DGB, Libien J, Loda M, Mendu DR, Mulligan MJ, Nasr MR, Pecora ND, Pessin MS, Prystowsky MB, Ramanathan LV, Rauch KR, Riddell S, Roach K, Roth KA, Shroyer KR, Smoller BR, Spitalnik SL, Spitzer ED, Tomaszewski JE, Waltman S, Willis L, Sumer-King Z. The New York State SARS-CoV-2 Testing Consortium: Regional Communication in Response to the COVID-19 Pandemic. Acad Pathol 2021; 8:23742895211006818. [PMID: 34013020 PMCID: PMC8107494 DOI: 10.1177/23742895211006818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/28/2021] [Accepted: 03/11/2021] [Indexed: 01/22/2023] Open
Abstract
The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, created an unprecedented need for comprehensive laboratory testing of populations, in order to meet the needs of medical practice and to guide the management and functioning of our society. With the greater New York metropolitan area as an epicenter of this pandemic beginning in March 2020, a consortium of laboratory leaders from the assembled New York academic medical institutions was formed to help identify and solve the challenges of deploying testing. This report brings forward the experience of this consortium, based on the real-world challenges which we encountered in testing patients and in supporting the recovery effort to reestablish the health care workplace. In coordination with the Greater New York Hospital Association and with the public health laboratory of New York State, this consortium communicated with state leadership to help inform public decision-making addressing the crisis. Through the length of the pandemic, the consortium has been a critical mechanism for sharing experience and best practices in dealing with issues including the following: instrument platforms, sample sources, test performance, pre- and post-analytical issues, supply chain, institutional testing capacity, pooled testing, biospecimen science, and research. The consortium also has been a mechanism for staying abreast of state and municipal policies and initiatives, and their impact on institutional and laboratory operations. The experience of this consortium may be of value to current and future laboratory professionals and policy-makers alike, in dealing with major events that impact regional laboratory services.
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Affiliation(s)
- James M. Crawford
- Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | | | - Ioannis Aifantis
- Department of Pathology, New York University Grossman School of Medicine, New York, NY, USA
| | - Evan M. Cadoff
- Department of Pathology, Montefiore Medical Center, Bronx, NY, USA
| | - Joan F. Cangiarella
- Department of Pathology, New York University Grossman School of Medicine, New York, NY, USA
| | - Carlos Cordon-Cardo
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA
| | - Melissa Cushing
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Aldolfo Firpo-Betancourt
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA
| | - Amy S. Fox
- Department of Pathology, Montefiore Medical Center, Bronx, NY, USA
| | - Yoko Furuya
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Sean Hacking
- Department of Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Jeffrey Jhang
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA
| | - Debra G. B. Leonard
- Department of Pathology and Laboratory Medicine, Robert Larner MD College of Medicine, University of Vermont, Burlington, VT, USA
| | - Jenny Libien
- Department of Pathology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Massimo Loda
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Damadora Rao Mendu
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA
| | - Mark J. Mulligan
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Michel R. Nasr
- Department of Pathology, Upstate Medical University, Syracuse, NY, USA
| | - Nicole D. Pecora
- Department of Pathology and Laboratory Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Melissa S. Pessin
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Lakshmi V. Ramanathan
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Scott Riddell
- Department of Pathology, Upstate Medical University, Syracuse, NY, USA
| | - Karen Roach
- Hospital Association of New York, Renssaeler, NY, USA
| | - Kevin A. Roth
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Kenneth R. Shroyer
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Bruce R. Smoller
- Department of Pathology and Laboratory Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | - Steven L. Spitalnik
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Eric D. Spitzer
- Department of Pathology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - John E. Tomaszewski
- Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, in partnership with Kaleida Health Laboratories, Buffalo, NY, USA
| | - Susan Waltman
- Greater New York Hospital Association, New York, NY, USA
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16
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Estimating the predictive value of negative severe acute respiratory coronavirus virus 2 (SARS-CoV-2) results: A prospective study. Infect Control Hosp Epidemiol 2020; 42:1257-1259. [PMID: 33298203 PMCID: PMC7783084 DOI: 10.1017/ice.2020.1362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We performed a prospective study of 501 patients, regardless of symptoms, admitted to the hospital, to estimate the predictive value of a negative nasopharyngeal swab for severe acute respiratory coronavirus virus 2 (SARS-CoV-2). At a positivity rate of 10.2%, the estimated negative predictive value (NPV) was 97.2% and the NPV rose as prevalence decreased during the study.
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17
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K. C. M, Oral E, Straif-Bourgeois S, Rung AL, Peters ES. The effect of area deprivation on COVID-19 risk in Louisiana. PLoS One 2020; 15:e0243028. [PMID: 33270701 PMCID: PMC7714106 DOI: 10.1371/journal.pone.0243028] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/14/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Louisiana in the summer of 2020 had the highest per capita case count for COVID-19 in the United States and COVID-19 deaths disproportionately affects the African American population. Neighborhood deprivation has been observed to be associated with poorer health outcomes. The purpose of this study was to examine the relationship between neighborhood deprivation and COVID-19 in Louisiana. METHODS The Area Deprivation Index (ADI) was calculated and used to classify neighborhood deprivation at the census tract level. A total of 17 US census variables were used to calculate the ADI for each of the 1148 census tracts in Louisiana. The data were extracted from the American Community Survey (ACS) 2018. The neighborhoods were categorized into quintiles as well as low and high deprivation. The publicly available COVID-19 cumulative case counts by census tract were obtained from the Louisiana Department of Health website on July 31, 2020. Descriptive and Poisson regression analyses were performed. RESULTS Neighborhoods in Louisiana were substantially different with respect to deprivation. The ADI ranged from 136.00 for the most deprived neighborhood and -33.87 in the least deprived neighborhood. We observed that individuals residing in the most deprived neighborhoods had almost a 40% higher risk of COVID-19 compared to those residing in the least deprived neighborhoods. CONCLUSION While the majority of previous studies were focused on very limited socio-environmental factors such as crowding and income, this study used a composite area-based deprivation index to examine the role of neighborhood environment on COVID-19. We observed a positive relationship between neighborhood deprivation and COVID-19 risk in Louisiana. The study findings can be utilized to promote public health preventions measures besides social distancing, wearing a mask while in public and frequent handwashing in vulnerable neighborhoods with greater deprivation.
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Affiliation(s)
- Madhav K. C.
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, United States of America
| | - Evrim Oral
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, United States of America
| | - Susanne Straif-Bourgeois
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, United States of America
| | - Ariane L. Rung
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, United States of America
| | - Edward S. Peters
- Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, United States of America
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18
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Richmond HL, Tome J, Rochani H, Fung ICH, Shah GH, Schwind JS. The Use of Penalized Regression Analysis to Identify County-Level Demographic and Socioeconomic Variables Predictive of Increased COVID-19 Cumulative Case Rates in the State of Georgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8036. [PMID: 33142755 PMCID: PMC7663274 DOI: 10.3390/ijerph17218036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/22/2020] [Accepted: 10/25/2020] [Indexed: 02/07/2023]
Abstract
Systemic inequity concerning the social determinants of health has been known to affect morbidity and mortality for decades. Significant attention has focused on the individual-level demographic and co-morbid factors associated with rates and mortality of COVID-19. However, less attention has been given to the county-level social determinants of health that are the main drivers of health inequities. To identify the degree to which social determinants of health predict COVID-19 cumulative case rates at the county-level in Georgia, we performed a sequential, cross-sectional ecologic analysis using a diverse set of socioeconomic and demographic variables. Lasso regression was used to identify variables from collinear groups. Twelve variables correlated to cumulative case rates (for cases reported by 1 August 2020) with an adjusted r squared of 0.4525. As time progressed in the pandemic, correlation of demographic and socioeconomic factors to cumulative case rates increased, as did number of variables selected. Findings indicate the social determinants of health and demographic factors continue to predict case rates of COVID-19 at the county-level as the pandemic evolves. This research contributes to the growing body of evidence that health disparities continue to widen, disproportionality affecting vulnerable populations.
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Affiliation(s)
- Holly L. Richmond
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Joana Tome
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Haresh Rochani
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Isaac Chun-Hai Fung
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
| | - Gulzar H. Shah
- Jiann-Ping Hsu College of Public Health, Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA 30458, USA;
| | - Jessica S. Schwind
- Jiann-Ping Hsu College of Public Health, Department of Biostatistics, Epidemiology & Environmental Health Sciences, Georgia Southern University, Statesboro, GA 30458, USA; (H.L.R.); (J.T.); (H.R.); (I.C.-H.F.)
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19
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Sinard JH. An Analysis of the Effect of the COVID-19 Pandemic on Case Volumes in an Academic Subspecialty-Based Anatomic Pathology Practice. Acad Pathol 2020; 7:2374289520959788. [PMID: 33088911 PMCID: PMC7545513 DOI: 10.1177/2374289520959788] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/18/2020] [Accepted: 08/22/2020] [Indexed: 01/19/2023] Open
Abstract
The recent COVID pandemic has had a major effect on anatomic pathology specimen volumes across the country. The effect of this pandemic on a subspecialty academic practice is presented. We used a data-driven approach to monitor the changing workloads in a granular fashion and dynamically adjust the scheduling of faculty and histology staff accordingly to minimize the number of people present on-site. At the peak of the pandemic locally, the main hospital in our health system had 450 COVID-positive inpatients. The surgical pathology specimen volume dropped to 13% of the pre-pandemic levels, and this occurred about 2 weeks before the peak of the inpatient census; cytology specimens (the majority of which are outreach gynecological) dropped to approximately 5% of the pre-pandemic volume, 4 weeks before the peak inpatient census. All of the surgical subspecialty services showed a significant decrease in volume, with hematopathology being the least affected (dropped to 30% of the pre-pandemic level). The genitourinary surgical subspecialty service (predominantly prostate and bladder biopsies) was the most affected (dropped to 1% of the pre-pandemic level) but was fastest to return as clinical operations began to return to normal. The only specimen type which showed a significant increase in turnaround time during the pandemic was our gynecologic cytology specimens and that occurred as the specimen volume returned. This was due to stay-at-home directives for the cytotechnologists and the fact that some of them were retasked to participate in our SARS-CoV-2 testing.
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Affiliation(s)
- John H Sinard
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
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