Dataset Information

Reduction in risk of death among patients admitted with COVID-19 between first and second epidemic waves in New York City.

ABSTRACT: Many regions have experienced successive epidemic waves of COVID-19 since the emergence of SARS-CoV-2 with heterogeneous differences in mortality. Elucidating factors differentially associated with mortality between epidemic waves may inform clinical and public health strategies. We examined clinical and demographic data among patients admitted with COVID-19 during the first (March-June 2020) and second (December 2020-March 2021) epidemic waves at an academic medical center in New York City. Hospitalized patients (N=4631) had lower mortality during the second wave (14%) than the first (23%). Patients in the second wave had a lower 30-day mortality (Hazard Ratio (HR) 0.52, 95% CI 0.44, 0.61) than those in the first wave. The mortality decrease persisted after adjusting for confounders except for the volume of COVID-19 admissions (HR 0.88, 95% CI 0.70, 1.11), a measure of health system strain. Several demographic and clinical patient factors were associated with an increased risk of mortality independent of wave.

Article summary

Using clinical and demographic data from COVID-19 hospitalizations at a tertiary New York City medical center, we show that a reduction in mortality during the second epidemic wave was associated with decreased strain on healthcare resources.

SUBMITTER: Bowen A

PROVIDER: S-EPMC8978950 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Reduction in risk of death among patients admitted with COVID-19 between first and second epidemic waves in New York City.

Bowen Anthony A Zucker Jason J Shen Yanhan Y Huang Simian S Yan Qiheng Q Annavajhala Medini K MK Uhlemann Anne-Catrin AC Kuhn Louise L Sobieszczyk Magdalena M Castor Delivette D

medRxiv : the preprint server for health sciences 20220330

Many regions have experienced successive epidemic waves of COVID-19 since the emergence of SARS-CoV-2 with heterogeneous differences in mortality. Elucidating factors differentially associated with mortality between epidemic waves may inform clinical and public health strategies. We examined clinical and demographic data among patients admitted with COVID-19 during the first (March-June 2020) and second (December 2020-March 2021) epidemic waves at an academic medical center in New York City. Hos ...[more]

PMID: 35378759

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Project description:The five boroughs of New York City (NYC) were early epicenters of the Covid-19 pandemic in the United States, with over 380,000 cases by May 31. High caseloads were also seen in nearby counties in New Jersey (NJ), Connecticut (CT) and New York (NY). The pandemic started in the area in March with an exponential rise in the number of daily cases, peaked in early April, briefly declined, and then, showed clear signs of a second peak in several counties. We will show that despite control measures such as lockdown and restriction of movement during the exponential rise in daily cases, there was a significant net migration of households from NYC boroughs to the neighboring counties in NJ, CT and NY State. We propose that the second peak in daily cases in these counties around NYC was due, in part, to the movement of people from NYC boroughs to these counties. We estimate the movement of people using "Change of Address" (CoA) data from the US Postal Service, provided under the "Freedom of Information Act" of 1967. To identify the timing of the second peak and the number of cases in it, we use a previously proposed SIR model, which accurately describes the early stages of the coronavirus pandemic in European countries. Subtracting the model fits from the data identified, we establish the timing and the number of cases, N CS , in the second peak. We then related the number of cases in the second peak to the county population density, P, and the excess Change of Address, E CoA, into each county using the simple model which fits the data very well with α = 0.68, β = 0.31 (R 2 = 0.74, p = 1.3e-8). We also find that the time between the first and second peaks was proportional to the distance of the county seat from NY Penn Station, suggesting that this migration of households and disease was a directed flow and not a diffusion process. Our analysis provides a simple method to use change of address data to track the spread of an infectious agent, such as SARS-Cov-2, due to migrations away from epicenters during the initial stages of a pandemic.

Dataset Information

Reduction in risk of death among patients admitted with COVID-19 between first and second epidemic waves in New York City.

Article summary

Publications

Reduction in risk of death among patients admitted with COVID-19 between first and second epidemic waves in New York City.

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