1
|
Faust JS, Meyerowitz-Katz G. Is Paxlovid Still Worth It? Clin Infect Dis 2024:ciae106. [PMID: 38412357 DOI: 10.1093/cid/ciae106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
- Jeremy Samuel Faust
- Brigham and Women's Hospital Department of Emergency Medicine, Mass General Brigham Division of Health Services Research, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
2
|
Renton B, Du C, Chen AJ, Li SX, Lin Z, Krumholz HM, Faust JS. State-Level Excess Mortality and Potential Deaths Averted in US Adults During the Delta and Omicron Waves of COVID-19. J Gen Intern Med 2024; 39:142-146. [PMID: 37620716 PMCID: PMC10817860 DOI: 10.1007/s11606-023-08374-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Affiliation(s)
| | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | | | - Shu-Xia Li
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Zhenqiu Lin
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
3
|
Faust JS, Kumar A, Shah J, Khadke S, Dani SS, Ganatra S, Sax PE. Oral Nirmatrelvir and Ritonavir for Coronavirus Disease 2019 in Vaccinated, Nonhospitalized Adults Aged 18-50 Years. Clin Infect Dis 2023; 77:1257-1264. [PMID: 37387690 DOI: 10.1093/cid/ciad400] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/30/2023] [Accepted: 06/26/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The effects of nirmatrelvir/ritonavir (NMV/r [Paxlovid]) on coronavirus disease 2019 (COVID-19) outcomes in younger vaccinated adults are unclear. The objective of this study was to assess if NMV/r use in vaccinated adults aged ≤50 years is associated with improved outcomes and to identify beneficial and nonbeneficial subgroups. METHODS In this cohort study, we generated 2 propensity-matched cohorts of 2547 patients from an 86 119-person cohort assembled from the TriNetX database. Patients in 1 cohort received NMV/r, and patients in the matched control cohort did not. The main outcome was composite of all-cause emergency department visits, hospitalization, and mortality. RESULTS The composite outcome was detected in 4.9% of the NMV/r cohort and 7.0% of the non-NMV/r cohort (odds ratio, 0.683 [95% confidence interval, .540-.864]; P = .001), indicating a 30% relative risk reduction. The number needed to treat (NNT) for the primary outcome was 47. Subgroup analyses found significant associations for patients with cancer (NNT = 45), cardiovascular disease (NNT = 30), and both conditions (NNT = 16). No benefit was found for patients with only chronic lower respiratory disorders (asthma/chronic obstructive pulmonary disease [COPD]) or without serious comorbidities. Thirty-two percent of NMV/r prescriptions in the overall database were for 18- to 50-year-olds. CONCLUSIONS NMV/r use in vaccinated adults aged 18-50 years, especially with serious comorbidities, was associated with reduced all-cause hospital visits, hospitalization, and mortality in the first 30 days of COVID-19 illness. However, NMV/r in patients without significant comorbidities or with only asthma/COPD had no association of benefit. Therefore, identifying high-risk patients should be a priority and overprescription should be avoided.
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Division of Health Policy and Public Health, Department of Emergency Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ashish Kumar
- Department of Medicine, Cleveland Clinic Akron General, Akron, Ohio, USA
| | - Jui Shah
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Vermont, USA
| | - Sumanth Khadke
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Vermont, USA
| | - Sourbha S Dani
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Vermont, USA
| | - Sarju Ganatra
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, Vermont, USA
| | - Paul E Sax
- Division of Infectious Disease, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Chemaitelly H, Faust JS, Krumholz HM, Ayoub HH, Tang P, Coyle P, Yassine HM, Al Thani AA, Al-Khatib HA, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, Latif AN, Shaik RM, Abdul-Rahim HF, Nasrallah GK, Al-Kuwari MG, Butt AA, Al-Romaihi HE, Al-Thani MH, Al-Khal A, Bertollini R, Abu-Raddad LJ. Short- and longer-term all-cause mortality among SARS-CoV-2- infected individuals and the pull-forward phenomenon in Qatar: a national cohort study. Int J Infect Dis 2023; 136:81-90. [PMID: 37717648 DOI: 10.1016/j.ijid.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVES We assessed short-, medium-, and long-term all-cause mortality risks after a primary SARS-CoV-2 infection. METHODS A national, matched, retrospective cohort study was conducted in Qatar to assess risk of all-cause mortality in the national SARS-CoV-2 primary infection cohort compared with the national infection-naïve cohort. Associations were estimated using Cox proportional-hazards regression models. Analyses were stratified by vaccination status and clinical vulnerability status. RESULTS Among unvaccinated persons, within 90 days after primary infection, the adjusted hazard ratio (aHR) comparing mortality incidence in the primary-infection cohort with the infection-naïve cohort was 1.19 (95% confidence interval 1.02-1.39). aHR was 1.34 (1.11-1.63) in persons more clinically vulnerable to severe COVID-19 and 0.94 (0.72-1.24) in those less clinically vulnerable. Beyond 90 days after primary infection, aHR was 0.50 (0.37-0.68); aHR was 0.41 (0.28-0.58) at 3-7 months and 0.76 (0.46-1.26) at ≥8 months. The aHR was 0.37 (0.25-0.54) in more clinically vulnerable persons and 0.77 (0.48-1.24) in less clinically vulnerable persons. Among vaccinated persons, mortality incidence was comparable in the primary-infection versus infection-naïve cohorts, regardless of clinical vulnerability status. CONCLUSIONS COVID-19 mortality was primarily driven by an accelerated onset of death among individuals who were already vulnerable to all-cause mortality, but vaccination prevented these accelerated deaths.
Collapse
Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| | - Houssein H Ayoub
- Mathematics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Patrick Tang
- Department of Pathology, Sidra Medicine, Doha, Qatar
| | - Peter Coyle
- Hamad Medical Corporation, Doha, Qatar; Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK
| | - Hadi M Yassine
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asmaa A Al Thani
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hebah A Al-Khatib
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | | | | | | | | | | | | | - Hanan F Abdul-Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Gheyath K Nasrallah
- Biomedical Research Center, QU Health, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Adeel A Butt
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Hamad Medical Corporation, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | | | | | | | | | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar.
| |
Collapse
|
5
|
Affiliation(s)
- Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| |
Collapse
|
6
|
Caraballo C, Massey DS, Ndumele CD, Haywood T, Kaleem S, King T, Liu Y, Lu Y, Nunez-Smith M, Taylor HA, Watson KE, Herrin J, Yancy CW, Faust JS, Krumholz HM. Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020. JAMA 2023; 329:1662-1670. [PMID: 37191702 PMCID: PMC10189563 DOI: 10.1001/jama.2023.7022] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/11/2023] [Indexed: 05/17/2023]
Abstract
Importance Amid efforts in the US to promote health equity, there is a need to assess recent progress in reducing excess deaths and years of potential life lost among the Black population compared with the White population. Objective To evaluate trends in excess mortality and years of potential life lost among the Black population compared with the White population. Design, setting, and participants Serial cross-sectional study using US national data from the Centers for Disease Control and Prevention from 1999 through 2020. We included data from non-Hispanic White and non-Hispanic Black populations across all age groups. Exposures Race as documented in the death certificates. Main outcomes and measures Excess age-adjusted all-cause mortality, cause-specific mortality, age-specific mortality, and years of potential life lost rates (per 100 000 individuals) among the Black population compared with the White population. Results From 1999 to 2011, the age-adjusted excess mortality rate declined from 404 to 211 excess deaths per 100 000 individuals among Black males (P for trend <.001). However, the rate plateaued from 2011 through 2019 (P for trend = .98) and increased in 2020 to 395-rates not seen since 2000. Among Black females, the rate declined from 224 excess deaths per 100 000 individuals in 1999 to 87 in 2015 (P for trend <.001). There was no significant change between 2016 and 2019 (P for trend = .71) and in 2020 rates increased to 192-levels not seen since 2005. The trends in rates of excess years of potential life lost followed a similar pattern. From 1999 to 2020, the disproportionately higher mortality rates in Black males and females resulted in 997 623 and 628 464 excess deaths, respectively, representing a loss of more than 80 million years of life. Heart disease had the highest excess mortality rates, and the excess years of potential life lost rates were largest among infants and middle-aged adults. Conclusions and relevance Over a recent 22-year period, the Black population in the US experienced more than 1.63 million excess deaths and more than 80 million excess years of life lost when compared with the White population. After a period of progress in reducing disparities, improvements stalled, and differences between the Black population and the White population worsened in 2020.
Collapse
Affiliation(s)
- César Caraballo
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Daisy S. Massey
- University of Massachusetts T.H. Chan School of Medicine, Worcester
| | - Chima D. Ndumele
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
| | | | - Shayaan Kaleem
- Department of Human Biology, University of Toronto, Toronto, Ontario, Canada
| | | | - Yuntian Liu
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Herman A. Taylor
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, Georgia
| | - Karol E. Watson
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Clyde W. Yancy
- Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Deputy Editor, JAMA Cardiology
| | | | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
| |
Collapse
|
7
|
Weiner SG, Qato DM, Faust JS, Clear B. Pharmacy Availability of Buprenorphine for Opioid Use Disorder Treatment in the US. JAMA Netw Open 2023; 6:e2316089. [PMID: 37234009 DOI: 10.1001/jamanetworkopen.2023.16089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Affiliation(s)
| | - Dima M Qato
- Program on Medicines and Public Health, USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles
| | - Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | | |
Collapse
|
8
|
Faust JS, Rasmussen SA, Jamieson DJ. Pregnancy should be a condition eligible for additional doses of COVID-19 messenger RNA vaccines. Am J Obstet Gynecol MFM 2023; 5:100801. [PMID: 36371035 PMCID: PMC9645060 DOI: 10.1016/j.ajogmf.2022.100801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/28/2022] [Accepted: 11/05/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Jeremy Samuel Faust
- Emergency Division of Health Policy and Public Health, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Dr Faust).
| | - Sonja A Rasmussen
- Department of Genetic Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD (Dr Rasmussen)
| | - Denise J Jamieson
- and Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA (Dr Jamieson)
| |
Collapse
|
9
|
Faust JS, Renton B, Du C. Massachusetts Data on Excess Mortality During the Delta and Omicron Waves of COVID-19. JAMA 2022; 328:1977-1978. [PMID: 36378211 DOI: 10.1001/jama.2022.16726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Benjamin Renton
- Ariadne Labs, Brigham and Women's Hospital, Boston, Massachusetts
| | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
10
|
Faust JS, Renton B, Chen AJ, Du C, Liang C, Li SX, Lin Z, Krumholz HM. Uncoupling of all-cause excess mortality from COVID-19 cases in a highly vaccinated state. Lancet Infect Dis 2022; 22:1419-1420. [PMID: 36007530 PMCID: PMC9395168 DOI: 10.1016/s1473-3099(22)00547-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 07/26/2022] [Accepted: 08/03/2022] [Indexed: 01/12/2023]
Affiliation(s)
| | | | | | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Chenxue Liang
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Shu-Xia Li
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Zhenqiu Lin
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
11
|
Abstract
This modeling study estimates the excess deaths attributable to COVID-19 disease in Massachusetts during the Delta (June to December 2021) and Omicron (December 2021 to February 2022) waves.
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| | - Chenxue Liang
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| | | | - Benjamin Renton
- Ariadne Labs, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
12
|
Faust JS, Chen AJ, Nguemeni Tiako MJ, Du C, Li SX, Krumholz HM, Barnett ML. Leading Causes of Death Among Adults Aged 25 to 44 Years by Race and Ethnicity in Texas During the COVID-19 Pandemic, March to December 2020. JAMA Intern Med 2022; 182:87-90. [PMID: 34807250 PMCID: PMC8609460 DOI: 10.1001/jamainternmed.2021.6734] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This cohort study examines mortality data from Texas, a racially and ethnically diverse state, to better understand excess mortality among adults aged 25 to 44 years during early months of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Max Jordan Nguemeni Tiako
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| | - Shu-Xia Li
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, Connecticut
| | - Michael L Barnett
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
13
|
Faust JS, Krumholz HM, Du C, Mayes KD, Lin Z, Gilman C, Walensky RP. All-Cause Excess Mortality and COVID-19-Related Mortality Among US Adults Aged 25-44 Years, March-July 2020. JAMA 2021; 325:785-787. [PMID: 33325994 PMCID: PMC7745134 DOI: 10.1001/jama.2020.24243] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study compares all-cause excess mortality and COVID-19–related mortality during the early pandemic period (March-July 2020) with unintentional drug overdoses, the usual leading cause of death in young adults, during the same period in 2018 among adults aged 25 to 44 years.
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Harlan M. Krumholz
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut
| | | | - Zhenqiu Lin
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut
| | - Cleavon Gilman
- Emergency Medicine Department, Yuma Regional Medical Center, Yuma, Arizona
| | | |
Collapse
|
14
|
Abstract
This cohort study evaluates the association between the coronavirus disease 2019 (COVID-19) stay-at-home orders and suicide deaths in Massachusetts.
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Division of Health Policy and Public Health, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sejal B. Shah
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
| | - Shu-Xia Li
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
| | - Zhenqiu Lin
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, Connecticut
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut
| |
Collapse
|
15
|
Faust JS. Toward a Better Case Fatality Estimate for Severe Acute Respiratory Syndrome Coronavirus 2 During the Early Phase of the United States Outbreak. Clin Infect Dis 2020; 71:2952-2954. [PMID: 32472126 PMCID: PMC7314142 DOI: 10.1093/cid/ciaa639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Jeremy Samuel Faust
- Division of Health Policy and Public Health, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
16
|
Abstract
This cohort study compares the excess deaths in New York City during the peak of the 1918 H1N1 influenza pandemic with those during the early period of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Brigham and Women's Hospital, Division of Health Policy and Public Health, Department of Emergency Medicine, Harvard Medical School, Boston Massachusetts
| | - Zhenqiu Lin
- Yale New Haven Hospital, Center for Outcomes Research and Evaluation, New Haven, Connecticut
| | - Carlos Del Rio
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Hubert Department of Global Health, Rollins School of Public Health of Emory University, Atlanta, Georgia
| |
Collapse
|
17
|
Affiliation(s)
- Jeremy Samuel Faust
- Harvard Medical School, Brigham and Women's Hospital, Division of Health Policy and Public Health, Department of Emergency Medicine, Boston, Massachusetts
| | - Carlos Del Rio
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia.,Hubert Department of Global Health, Rollins School of Public Health of Emory University, Atlanta, Georgia
| |
Collapse
|
18
|
Affiliation(s)
- Jeremy Samuel Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| |
Collapse
|
19
|
|
20
|
Taylor RA, Singh Gill H, Marcolini EG, Meyers HP, Faust JS, Newman DH. Determination of a Testing Threshold for Lumbar Puncture in the Diagnosis of Subarachnoid Hemorrhage after a Negative Head Computed Tomography: A Decision Analysis. Acad Emerg Med 2016; 23:1119-1127. [PMID: 27378053 DOI: 10.1111/acem.13042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/05/2016] [Accepted: 06/29/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The objective was to determine the testing threshold for lumbar puncture (LP) in the evaluation of aneurysmal subarachnoid hemorrhage (SAH) after a negative head computed tomography (CT). As a secondary aim we sought to identify clinical variables that have the greatest impact on this threshold. METHODS A decision analytic model was developed to estimate the testing threshold for patients with normal neurologic findings, being evaluated for SAH, after a negative CT of the head. The testing threshold was calculated as the pretest probability of disease where the two strategies (LP or no LP) are balanced in terms of quality-adjusted life-years. Two-way and probabilistic sensitivity analyses (PSAs) were performed. RESULTS For the base-case scenario the testing threshold for performing an LP after negative head CT was 4.3%. Results for the two-way sensitivity analyses demonstrated that the test threshold ranged from 1.9% to 15.6%, dominated by the uncertainty in the probability of death from initial missed SAH. In the PSA the mean testing threshold was 4.3% (95% confidence interval = 1.4% to 9.3%). Other significant variables in the model included probability of aneurysmal versus nonaneurysmal SAH after negative head CT, probability of long-term morbidity from initial missed SAH, and probability of renal failure from contrast-induced nephropathy. CONCLUSIONS Our decision analysis results suggest a testing threshold for LP after negative CT to be approximately 4.3%, with a range of 1.4% to 9.3% on robust PSA. In light of these data, and considering the low probability of aneurysmal SAH after a negative CT, classical teaching and current guidelines addressing testing for SAH should be revisited.
Collapse
Affiliation(s)
| | - Harman Singh Gill
- Departments of Emergency Medicine and Critical Care Cleveland Clinic Cleveland OH
| | - Evie G. Marcolini
- Department of Emergency Medicine Yale University School of Medicine New Haven CT
| | | | - Jeremy Samuel Faust
- Department of Emergency Medicine Icahn School of Medicine at Mount Sinai New York NY
| | - David H. Newman
- Department of Emergency Medicine Icahn School of Medicine at Mount Sinai New York NY
| |
Collapse
|
21
|
Faust JS, Nemes A, Zaurova M. Transient global amnesia: emergency department evaluation and management [digest]. Emerg Med Pract 2016; 18:S1-S2. [PMID: 28745847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Transient global amnesia is a clinically distinct syndrome characterized by the acute inability to form new memories. It can last up to 24 hours. The diagnosis is dependent on eliminating other more serious etiologies including toxic ingestions, acute strokes, complex partial seizures, and central nervous system infections. Transient global amnesia confers no known long-term risks; however, when abnormal signs or symptoms are present, they take precedence and guide the formulation of a differential diagnosis and investigation. In witnessed transient global amnesia with classic features, a minimalist approach is reasonable, avoiding overtesting, inappropriate medication, and medical interventions in favor of observation, ensuring patient safety, and reassuring patients and their families. This review provides a detailed framework for distinguishing transient global amnesia from its dangerous mimics and managing its course in the emergency department. [Points & Pearls is a digest of Emergency Medicine Practice].
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Clinical Instructor, Harvard Medical School; Attending Physician, Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA
| | - Andreea Nemes
- Assistant Professor, Columbia University; Attending Physician, Division of Emergency Medicine, Director of Simulation - Emergency Department, New York Presbyterian Hospital, New York, NY
| | - Milana Zaurova
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
22
|
Faust JS, Nemes A. Transient Global Amnesia: Emergency Department Evaluation And Management. Emerg Med Pract 2016; 18:1-20. [PMID: 27416582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 05/10/2016] [Indexed: 06/06/2023]
Abstract
Transient global amnesia is a clinically distinct syndrome characterized by the acute inability to form new memories. It can last up to 24 hours. The diagnosis is dependent on eliminating other more serious etiologies including toxic ingestions, acute strokes, complex partial seizures, and central nervous system infections. Transient global amnesia confers no known long-term risks; however, when abnormal signs or symptoms are present, they take precedence and guide the formulation of a differential diagnosis and investigation. In witnessed transient global amnesia with classic features, a minimalist approach is reasonable, avoiding overtesting, inappropriate medication, and medical interventions in favor of observation, ensuring patient safety, and reassuring patients and their families. This review provides a detailed framework for distinguishing transient global amnesia from its dangerous mimics and managing its course in the emergency department.
Collapse
Affiliation(s)
- Jeremy Samuel Faust
- Clinical Instructor, Harvard Medical School; Attending Physician, Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA
| | - Andreea Nemes
- Assistant Professor, Columbia University; Attending Physician, Division of Emergency Medicine, Director of Simulation - Emergency Department, New York Presbyterian Hospital, New York, NY
| |
Collapse
|
23
|
|
24
|
Affiliation(s)
- M J Loza
- Kimmel Cancer Institute, Department of Microbiology and Immunology, Thomas Jefferson Medical College, Philadelphia, PA, USA
| | | | | |
Collapse
|