COVID-19 Infection in ESKD: Findings from a Prospective Disease Surveillance Program at Dialysis Facilities in New York City and Long Island.
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ABSTRACT:
SUBMITTER: Weiss S
PROVIDER: S-EPMC7608957 | biostudies-literature | 2020 Nov
REPOSITORIES: biostudies-literature
Publications
COVID-19 Infection in ESKD: Findings from a Prospective Disease Surveillance Program at Dialysis Facilities in New York City and Long Island.
Weiss Steven S Bhat Premila P Del Pilar Fernandez Maria M Bhat J Ganesh JG Coritsidis George N GN
Journal of the American Society of Nephrology : JASN 20201019 11
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Project description:ObjectiveFood insecurity is a serious public health concern that disproportionately impacts minority groups. However, limited research has assessed food insecurity among sexual minorities. The current study investigates whether individuals identifying as lesbian/gay or bisexual (LGB) sexual orientation were more likely to experience food insecurity relative to heterosexual persons.DesignData are from the 2017 and 2018 New York City Community Health Survey. Multinomial logistic regression is used to assess the association between sexual orientation and food insecurity.SettingA sample of adults (18 years and older) who identify as heterosexual, gay/lesbian or bisexual living in New York City in 2017 and 2018.Participants18 610 non-institutionalised adults.ResultsBisexual individuals have significantly higher rates of both mild (relative risk ratio (RRR) = 1·719, 95 % CI 1·148, 2·573) and moderate-to-severe food insecurity (RRR = 1·851, 95 % CI 1·097, 3·122) relative to heterosexual individuals, net of covariates from demographic, household and socio-economic characteristics. Study findings showed no difference in the likelihood of food insecurity between gay/lesbian individuals and heterosexual individuals.ConclusionResults illustrate a complex interplay between sexual orientation and food insecurity among adults living in New York City. Findings suggest that efforts to connect LGB individuals to public assistance programmes such as Supplemental Nutritional Assistance Program, as well as providing information and connections to food assistance through local LGBTQ+ centres, government agencies (i.e., NYC Human Resources Administration) and non-profit organisations (i.e., Food Bank for New York City) may be beneficial approaches to alleviate food insecurity among this population.
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Project description:Background and objectivesLimited existing data on psychiatric illness in ESKD patients suggest these diseases are common and burdensome, but under-recognized in clinical practice.Design, setting, participants, & measurementsWe examined hospitalizations with psychiatric diagnoses using inpatient claims from the first year of ESKD in adult and pediatric Medicare recipients who initiated treatment from 1996 to 2013. We assessed associations between hospitalizations with psychiatric diagnoses and all-cause death after discharge in adult dialysis patients using multivariable-adjusted Cox proportional hazards regression models.ResultsIn the first ESKD year, 72% of elderly adults, 66% of adults and 64% of children had at least one hospitalization. Approximately 2% of adults and 1% of children were hospitalized with a primary psychiatric diagnosis. The most common primary psychiatric diagnoses were depression/affective disorder in adults and children, and organic disorders/dementias in elderly adults. Prevalence of hospitalizations with psychiatric diagnoses increased over time across groups, primarily from secondary diagnoses. 19% of elderly adults, 25% of adults and 15% of children were hospitalized with a secondary psychiatric diagnosis. Hazards ratios of all-cause death were higher in all dialysis adults hospitalized with either primary (1.29; 1.26 to 1.32) or secondary (1.11; 1.10 to 1.12) psychiatric diagnoses than in those hospitalized without psychiatric diagnoses.ConclusionsHospitalizations with psychiatric diagnoses are common in pediatric and adult ESKD patients, and are associated with subsequent higher mortality, compared with hospitalizations without psychiatric diagnoses. The prevalence of hospitalizations with psychiatric diagnoses likely underestimates the burden of mental illness in the population.
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