An Uncomplicated Delivery in a Patient with Covid-19 in the United States.
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ABSTRACT:
SUBMITTER: Iqbal SN
PROVIDER: S-EPMC7153431 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Publications
An Uncomplicated Delivery in a Patient with Covid-19 in the United States.
Iqbal Sara N SN Overcash Rachael R Mokhtari Neggin N Saeed Haleema H Gold Stacey S Auguste Tamika T Mirza Muhammad-Usman MU Ruiz Maria-Elena ME Chahine Joeffrey J JJ Waga Masashi M Wortmann Glenn G
The New England journal of medicine 20200401 16
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Project description:ImportanceIn-hospital mortality rates from COVID-19 are high but appear to be decreasing for selected locations in the United States. It is not known whether this is because of changes in the characteristics of patients being admitted.ObjectiveTo describe changing in-hospital mortality rates over time after accounting for individual patient characteristics.Design, setting, and participantsThis was a retrospective cohort study of 20 736 adults with a diagnosis of COVID-19 who were included in the US American Heart Association COVID-19 Cardiovascular Disease Registry and admitted to 107 acute care hospitals in 31 states from March through November 2020. A multiple mixed-effects logistic regression was then used to estimate the odds of in-hospital death adjusted for patient age, sex, body mass index, and medical history as well as vital signs, use of supplemental oxygen, presence of pulmonary infiltrates at admission, and hospital site.Main outcomes and measuresIn-hospital death adjusted for exposures for 4 periods in 2020.ResultsThe registry included 20 736 patients hospitalized with COVID-19 from March through November 2020 (9524 women [45.9%]; mean [SD] age, 61.2 [17.9] years); 3271 patients (15.8%) died in the hospital. Mortality rates were 19.1% in March and April, 11.9% in May and June, 11.0% in July and August, and 10.8% in September through November. Compared with March and April, the adjusted odds ratios for in-hospital death were significantly lower in May and June (odds ratio, 0.66; 95% CI, 0.58-0.76; P < .001), July and August (odds ratio, 0.58; 95% CI, 0.49-0.69; P < .001), and September through November (odds ratio, 0.59; 95% CI, 0.47-0.73).Conclusions and relevanceIn this cohort study, high rates of in-hospital COVID-19 mortality among registry patients in March and April 2020 decreased by more than one-third by June and remained near that rate through November. This difference in mortality rates between the months of March and April and later months persisted even after adjusting for age, sex, medical history, and COVID-19 disease severity and did not appear to be associated with changes in the characteristics of patients being admitted.
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Project description:Objectives:The paper highlights US health policy and technology responses to the COVID-19 pandemic from January 1, 2020 - August 9, 2020. Methods:A review of primary data sources in the US was conducted. The data were summarized to describe national and state-level trends in the spread of COVID-19 and in policy and technology solutions. Results:COVID-19 cases and deaths initially peaked in late March and April, but after a brief reduction in June cases and deaths began rising again July and continued to climb into early August. The US policy response is best characterized by its federalist, decentralized nature. The national government has led in terms of economic and fiscal response, increasing funding for scientific research into testing, treatment, and vaccines, and in creating more favorable regulations for the use of telemedicine. State governments have been responsible for many of the containment, testing, and treatment responses, often with little federal government support. Policies that favor economic re-opening are often followed by increases in state-level case numbers, which are then followed by stricter containment measures, such as mask wearing or pausing re-opening plans. Conclusions:While all US states have begun to "re-open" economic activities, this trend appears to be largely driven by social tensions and economic motivations than an ability to effectively test and surveil populations.
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2022-06-03 | GSE184150 | GEO
Project description:BackgroundThe surges of Coronavirus Disease 2019 (COVID-19) appeared to follow a repeating pattern of COVID-19 outbreaks regardless of social distancing, mask mandates, and vaccination campaigns.ObjectivesThis study aimed to investigate the seasonality of COVID-19 incidence in the United States of America (USA), and to delineate the dominant frequencies of the periodic patterns of the disease.MethodsWe characterized periodicity in COVID-19 incidences over the first three full seasonal years (March 2020 to March 2023) of the COVID-19 pandemic in the USA. We utilized a spectral analysis approach to find the naturally occurring dominant frequencies of oscillation in the incidence data using a Fast Fourier Transform (FFT) algorithm.ResultsOur study revealed four dominant peaks in the periodogram: the two most dominant peaks show a period of oscillation of 366 days and 146.4 days, while two smaller peaks indicate periods of 183 days and 122 days. The period of 366 days indicates that there is a single COVID-19 outbreak that occurs approximately once every year, which correlates with the dominant outbreak in the early/mid-winter months. The period of 146.4 days indicates approximately 3 peaks per year and matches well with each of the 3 annual outbreaks per year.ConclusionOur study revealed the predictable seasonality of COVID-19 outbreaks, which will guide public health preventative efforts to control future outbreaks. However, the methods used in this study cannot predict the amplitudes of the incidences in each outbreak: a multifactorial problem that involves complex environmental, social, and viral strain variables.
| S-EPMC10728821 | biostudies-literature
Project description:We use natality microdata covering the universe of US. births for 2015 to 2021 and California births from 2015 through February 2023 to examine childbearing responses to the COVID-19 pandemic. We find that 60% of the 2020 decline in US fertility rates was driven by sharp reductions in births to foreign-born mothers although births to this group comprised only 22% of all US births in 2019. This decline started in January 2020. In contrast, the COVID-19 recession resulted in an overall "baby bump" among US-born mothers, which marked the first reversal in declining fertility rates since the Great Recession. Births to US-born mothers fell by 31,000 in 2020 relative to a prepandemic trend but increased by 71,000 in 2021. The data for California suggest that US births remained elevated through February 2023. The baby bump was most pronounced for first births and women under age 25, suggesting that the pandemic led some women to start families earlier. Above age 25, the baby bump was most pronounced for women aged 30 to 34 and women with a college education. The 2021 to 2022 baby bump is especially remarkable given the large declines in fertility rates that would have been projected by standard statistical models.
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Project description:BackgroundShortly after the 2020 US election, initial evidence on first-generation COVID-19 vaccines showed 70-95% efficacy and minimal risks. Yet, many US adults expressed reluctance.AimsThe aim of this study was to compare persons willing and unwilling to be vaccinated against COVID-19 and to estimate the effects of vaccination attributes on uptake: proof of vaccination, vaccination setting, effectiveness, duration of immunity, and risk of severe side effects.MethodBetween 9 and 11 November 2020, 1153 US adults completed a discrete choice experiment (DCE) on Phase 2 of the CDC Vaccination Program (August 2021). Each of its eight choice tasks had three vaccination alternatives and "no vaccination for 6 months." An opt-out inflated logit model was estimated to test for respondent differences and attribute effects.ResultsRespondent demographics were unrelated to one's willingness to be vaccinated (p value 0.533), but those with less education were more likely to be unwilling (p < 0.001). Among those willing, uptake ranged from 61.70 to 97.75%, depending on the vaccination attributes. Effectiveness and safety had the largest effects. Offering proof of vaccination and a choice of setting increased uptake as much as increasing immunity from 3 to 6 months.ConclusionsTo maximize uptake, the CDC Program should standardize proof of vaccination and offer a choice of setting, instead of a one-size-fits-all approach. If the first-generation vaccines are efficacious, widely available, and free, overall predicted uptake is 68.81% by the end of Phase 2 (August 2021), which is well below the 75-90% needed for herd immunity. Further health preference research is necessary to uncover and address unwillingness and reluctance to vaccinate against COVID-19.
| S-EPMC8008018 | biostudies-literature