Impact of COVID-19 pandemic on melanoma presentation by facility type and region in the United States.
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ABSTRACT:
SUBMITTER: Kim DY
PROVIDER: S-EPMC9995293 | biostudies-literature | 2023 Jul
REPOSITORIES: biostudies-literature
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Impact of COVID-19 pandemic on melanoma presentation by facility type and region in the United States.
Kim Daniel Y DY Behbahani Sara S Hartman Rebecca I RI
Journal of the American Academy of Dermatology 20230309 1
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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.
| S-EPMC7451131 | biostudies-literature
Project description:ObjectivesTo examine how the COVID-19 pandemic affected driving and health outcomes in older adults.MethodsWe compared Advancing Understanding of Transportation Options (AUTO) study participants enrolled before (December 2019 to March 2020) versus during the pandemic (May 2020 to June 2021). Participants were English-speaking, licensed drivers (≥70 years) who drove weekly and had a primary care provider at a study site and ≥1 medical condition potentially associated with driving cessation. We used baseline self-reported measures on mobility and health.ResultsCompared to those enrolled pre-COVID-19 (n = 61), more participants enrolled during COVID-19 (n = 240) reported driving reductions (26% vs. 70%, p < .001) and more often for personal preference (vs. medical/emotional reasons). While mean social isolation was higher during than pre-COVID-19, self-reported depression, stress, and overall health PROMIS scores did not differ significantly.DiscussionOur findings highlight the resiliency of some older adults and have implications for mitigating the negative effects of driving cessation.
| S-EPMC9378355 | biostudies-literature
Project description:Hospital admissions in the US fell dramatically with the onset of the coronavirus disease 2019 (COVID-19) pandemic. However, little is known about differences in admissions patterns among patient groups or the extent of the rebound. In this study of approximately one million medical admissions from a large, nationally representative hospitalist group, we found that declines in non-COVID-19 admissions from February to April 2020 were generally similar across patient demographic subgroups and exceeded 20 percent for all primary admission diagnoses. By late June/early July 2020, overall non-COVID-19 admissions had rebounded to 16 percent below prepandemic baseline volume (8 percent including COVID-19 admissions). Non-COVID-19 admissions were substantially lower for patients residing in majority-Hispanic neighborhoods (32 percent below baseline) and remained well below baseline for patients with pneumonia (-44 percent), chronic obstructive pulmonary disease/asthma (-40 percent), sepsis (-25 percent), urinary tract infection (-24 percent), and acute ST-elevation myocardial infarction (-22 percent). Health system leaders and public health authorities should focus on efforts to ensure that patients with acute medical illnesses can obtain hospital care as needed during the pandemic to avoid adverse outcomes.
| S-EPMC7769002 | biostudies-literature
Project description:ObjectiveTo evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care.BackgroundWe previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data.MethodsData from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019-February 2020 and March-April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC.ResultsCompared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18-38, p < .001), number of activations leading to angiography (34%, 95% CI: 12-50, p = .005) and number of activations leading to PPCI (20%, 95% CI: 11-27, p < .001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (-0.2 to 44, p = .05).ConclusionsThe COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.
| S-EPMC7436427 | biostudies-literature
Project description:BackgroundThe impact of the coronavirus disease 19 (COVID-19) pandemic on health care workers has been substantial. However, the impact on vascular surgery (VS) trainees has not yet been determined. The goals of our study were to gauge the impact of COVID-19 on VS trainees' personal and professional life and to assess stressors, coping, and support structures involved in these trainees' response to the COVID-19 pandemic.MethodsThis was an anonymous online survey administered in April 12-24, 2020 during the surge phase of the global COVID-19 pandemic. It is a subset analysis of the cross-sectional Society for Vascular Surgery Wellness Committee Pandemic Practice, Anxiety, Coping, and Support Survey. The cohort surveyed was VS trainees, integrated residents and fellows, in the United States of America. Assessment of the personal impact of the pandemic on VS trainees and the coping strategies used by them was based on the validated Generalized Anxiety Disorder 7-item (GAD-7) scale and the validated 28-time Brief Coping Orientation to Problems Experienced inventory.ResultsA total of 145 VS trainees responded to the survey, with a 23% response rate (145/638). Significant changes were made to the clinical responsibilities of VS trainees, with 111 (91%) reporting cancellation of elective procedures, 101 (82%) with call schedule changes, 34 (24%) with duties other than related to VS, and 29 (24%) participation in outpatient care delivery. Over one-third (52/144) reported they had performed a procedure on a patient with confirmed COVID-19; 37 (25.7%) reported they were unaware of the COVID-19 status at the time. The majority continued to work after exposure (29/34, 78%). Major stressors included concerns about professional development, infection risk to family/friends, and impact of care delay on patients. The median score for GAD-7 was 4 (interquartile range 1-8), which corresponds to no or low self-reported anxiety levels. VS trainees employed mostly active coping and rarely avoidant coping mechanisms, and the majority were aware and used social media and online support systems. No significant difference was observed between integrated residents and fellows, or by gender.ConclusionsThe pandemic has had significant impact on VS trainees. Trainees reported significant changes to clinical responsibilities, exposure to COVID-19, and pandemic-related stressors but demonstrated healthy coping mechanisms with low self-reported anxiety levels. The VS community should maintain awareness of the impact of the pandemic on the professional and personal development of surgeons in training. We recommend adaptive evolution in training to accommodate the changing learning environment for trainees.
| S-EPMC7608023 | biostudies-literature
Project description:BackgroundThe pandemic has resulted in an increase of deaths not directly related to COVID-19 infection. We aimed to use a national death dataset to determine the impact of the pandemic on people with liver disease in the U.S, focusing on alcohol-associated liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD).MethodsUsing data from the National Vital Statistic System from the CDC WONDER platform and ICD-10 codes, we identified deaths associated with liver disease. We evaluated observed versus predicted mortality for 2020-2021 based on trends from 2010-2019 with joinpoint and prediction modeling analysis.ResultsAmong 626,090 chronic liver disease-related deaths between 2010 and 2021, Age-standardized mortality rates (ASMR) for ALD dramatically increased between 2010-2019 and 2020-2021 (annual percentage change [APC] 3.5% to 17.6%, P<0.01), leading to a higher observed ASMR (per 100,000 persons) than predicted for 2020 (15.67 vs.13.04) and 2021 (17.42 vs.13.41). ASMR for NAFLD also increased during the pandemic (APC:14.5%), while the rates for hepatitis B and C decreased. Notably, the ASMR rise for ALD was most pronounced in non-Hispanic Whites, Blacks, and Alaska Indians/Native Americans (APC: 11.7%, 10.8%, 18.0%, all P<0.05), with similar but less critical findings for NAFLD while rates were steady for non-Hispanic Asians throughout 2010-2021 (APC: 4.9%). The ASMR rise for ALD was particularly severe for the 25-44 age group (APC: 34.6%, versus 13.7% and 12.6% for 45-64 and ≥65, all P<0.01), which were also all higher than pre-COVID-19 rates (all P<0.01).ConclusionsASMR for ALD and NAFLD increased at an alarming rate during the COVID-19 pandemic with the largest disparities among the young, non-Hispanic White, and Alaska Indian/Native American populations.Lay summaryThe impact of the pandemic on people with liver disease in the U.S remains unclear. This study indicated that age-standardized mortality rates for alcohol associated liver disease and non-alcohol fatty liver disease greatly accelerated during the COVID-19 pandemic with the largest disparities among the young, non-Hispanic White, and Alaska Indian/Native American populations. Increasing awareness about the care importance of chronic liver disease in specific populations must be prioritized.
| S-EPMC9611810 | biostudies-literature
Project description:ObjectiveTo investigate the relationship between vaccination rates and excess mortality during distinct waves of SARS-CoV-2 variant-specific infections, while considering a state's GDP per capita.MethodsWe ranked U.S. states by vaccination rates and GDP and employed the CDC's excess mortality model for regression and odds ratio analysis.ResultsRegression analysis reveals that both vaccination and GDP are significant factors related to mortality when considering the entire U.S. population. Notably, in wealthier states (with GDP above $65,000), excess mortality is primarily driven by slow vaccination rates, while in less affluent states, low GDP plays a major role. Odds ratio analysis demonstrates an almost twofold increase in mortality linked to the Delta and Omicron BA.1 virus variants in states with the slowest vaccination rates compared to those with the fastest (OR 1.8, 95% CI 1.7-1.9, p < 0.01). However, this gap disappeared in the post-Omicron BA.1 period.ConclusionThe interplay between slow vaccination and low GDP per capita drives high mortality.
| S-EPMC10836123 | biostudies-literature
Project description:Shelter-in-place orders and business closures related to COVID-19 changed the hourly profile of electricity demand and created an unprecedented source of uncertainty for the grid. The potential for continued shifts in electricity profiles has implications for electricity sector investment and operating decisions that maintain reserve margins and provide grid reliability. This study reveals that understanding this uncertainty requires an understanding of the underlying drivers at the customer-class scale. This paper utilizes three datasets to compare the impacts of COVID-19 on electricity consumption across a range of spatiotemporal and customer scales. At the utility/customer-class scale, COVID-19-induced shutdowns in the spring of 2020 shifted weekday residential load profiles to resemble weekend profiles from previous years. Total commercial loads declined, but the commercial diurnal load profile was unchanged. With only total loads available at the balancing authority scale, the apparent impact of COVID-19 was smaller during the summer due in part to phased re-opening and spatial variability in re-opening, but there were still clear variations once total loads were broken down zonally. Monthly data at the state scale showed an increase in state-level residential electricity sales, a decrease in commercial sales, and a small net decrease in total sales in most states from April-August 2020. Analyses that focus on total load or a single scale may miss important changes that become apparent when the load is broken down regionally or by customer class.
| S-EPMC9758013 | biostudies-literature
Project description:ObjectivesOur aim was to assess the trend in gynaecologic cancer (GC) mortality in the period from 2010 to 2022 in the United States, with focus on the impact of the pandemic on increased deaths.MethodsGC mortality data were extracted from the Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) platform. We analysed mortality trends and evaluated observed vs. predicted mortality for the period from 2020 to 2022 with joinpoint regression and prediction modelling analyses.ResultsA total of 334,382 deaths among adults aged 25 years and older with gynaecologic cancer were documented from 2010 to 2022. The overall age-standardised mortality rate (ASMR, per 100,000 persons) for ovarian cancer-related death decreased gradually from 7.189 in 2010 to 5.517 in 2019, yielding an APC (annual percentage change) of -2.8%. However, the decrease in ovarian cancer-related mortality slowed down by more than 4-fold during the pandemic. Cervical cancer -related mortality decreased slightly prior to the pandemic and increased during the pandemic with an APC of 0.6%, resulting in excess mortality of 4.92%, 9.73% and 2.03% in 2020, 2021 and 2022, respectively. For uterine corpus cancer, the ASMR increased from 1.905 in 2010 to 2.787 in 2019, and increased sharply to 3.079 in 2021 and 3.211 in 2022. The ASMR rose steadily between 2013 and 2022, yielding an APC of 6.9%.ConclusionsOverall, we found that GC-related mortality increased during the COVID-19 pandemic, and this increase was not specific to age, race, or ethnicity.
| S-EPMC10880335 | biostudies-literature
Project description:ObjectiveTo assess the impact of the COVID-19 pandemic on attitudes toward planned oocyte cryopreservation (OC).DesignCross-sectional study.SettingInternet-based survey questionnaire distributed nationally.PatientsOne thousand women aged 21-45 years, stratified by age ≤35 or >35 years.InterventionsNone.Main outcome measuresChange in the likelihood of considering OC because of the pandemic.ResultsOf the participants who reported that the pandemic altered their likelihood of considering OC (15.2%, n = 152), 52.6% (n = 80) reported an increased and 47.3% (n = 72) reported a decreased likelihood of considering OC. Vaccination status did not affect the likelihood of considering OC. In multivariable analysis, history of COVID-19 infection (odds ratio [OR] 1.57; 95% confidence interval [CI] 1.00-2.45), government-subsidized insurance (OR 1.47; 95% CI 0.97-2.21), loss of health insurance because of the pandemic (OR 2.32; 95% CI 1.15-4.66), working more (OR 2.99; 95% CI 1.62-5.51) or less (OR 2.54; 95% CI 1.65-3.90) because of the pandemic, and relationship status (divorced, separated, or widowed [OR 0.44; 95% CI 0.20-0.99]) were significantly associated with a change in the likelihood of considering OC because of the pandemic. Of those who believed that the COVID-19 pandemic influenced their childbearing plans (28.3%, n = 283), 64.0% (n = 181) deferred childbearing and 29.7% (n = 84) expedited childbearing. The pandemic's economic impact, concerns regarding safety of pregnancy/childbirth, and safety of childrearing were cited as most influential on childbearing (67%, 70%, 58%, respectively) and on the likelihood of considering OC (47%, 45%, and 34%, respectively).ConclusionsThrough its negative impact on financial security and perceived safety, the COVID-19 pandemic has altered the likelihood of considering OC in >15% of reproductive-aged women and reproductive timelines in 30%. Vaccination has not significantly modified these changes.
| S-EPMC9065715 | biostudies-literature