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Yamaguchi S, Okada A, Ono S, Inoue R, Kurakawa KI, Sunaga S, Yamauchi T, Nangaku M, Kadowaki T. Impact of the COVID-19 pandemic and COVID-19 downgrade on non-COVID-19 respiratory diseases in Japan. Public Health 2025; 243:105719. [PMID: 40233687 DOI: 10.1016/j.puhe.2025.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 03/10/2025] [Accepted: 03/27/2025] [Indexed: 04/17/2025]
Abstract
OBJECTIVES A worldwide decrease in the incidence of respiratory diseases during the coronavirus disease (COVID-19) pandemic has been reported, largely due to non-pharmaceutical interventions (NPIs). However, the impact of lifting NPIs remains unclear. In Japan, NPIs were lifted rather drastically when COVID-19 was downgraded on May 8, 2023. This study aimed to evaluate the impact of the COVID-19 pandemic and its downgrade on non-COVID-19 respiratory diseases using nationwide databases. STUDY DESIGN Retrospective cohort study. METHODS Monthly hospitalisation and prescription rates between January 2017 and October 2023 were collected from the JMDC insurance claims database covering 16,485,812 insured individuals. The monthly mortality rates in Japan were collected from an open data source published by Ministry of Health, Labour and Welfare of Japan. Interrupted time series analyses using seasonal autoregressive integrated moving average models were performed. RESULTS While hospitalisation rates for diseases such as pneumonia, asthma, and aspiration pneumonia decreased during the pandemic, a step increase in hospitalisations for these diseases and prescriptions for anti-asthma drugs was observed following the COVID-19 downgrade. The pandemic impacted all age groups; however, the impact of COVID-19 downgrade was more pronounced in children aged 0-5 years. Although mortality from non-COVID-19 respiratory diseases decreased during the pandemic, no immediate step increase in mortality was observed following the downgrade. CONCLUSIONS Although hospitalisations for pneumonia and prescriptions for anti-asthma drugs increased immediately after downgrading COVID-19, no step increase in mortality was observed presumably because older people were less affected than children.
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Affiliation(s)
- Satoko Yamaguchi
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Reiko Inoue
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kayo Ikeda Kurakawa
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kadowaki
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Toranomon Hospital, Tokyo, Japan.
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Russell JA. Innocent bystanders: effects of the COVID-19 pandemic on non-COVID-19 critical illness outcomes. Thorax 2024; 79:101-103. [PMID: 38050148 DOI: 10.1136/thorax-2023-220431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 12/06/2023]
Affiliation(s)
- James A Russell
- Division of Critical Care Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Beeh KM, Scheithe K, Schmutzler H, Krüger S. Real-World Effectiveness of Fluticasone Furoate/Umeclidinium/Vilanterol Once-Daily Single-Inhaler Triple Therapy for Symptomatic COPD: The ELLITHE Non-Interventional Trial. Int J Chron Obstruct Pulmon Dis 2024; 19:205-216. [PMID: 38249826 PMCID: PMC10800114 DOI: 10.2147/copd.s427770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024] Open
Abstract
Purpose Real-life effectiveness data on once-daily single-inhaler triple therapy (odSITT) with the inhaled corticosteroid fluticasone furoate (FF), the long-acting muscarinic antagonist umeclidinium (UMEC), and the long-acting β2-agonist vilanterol (VI) in patients with chronic obstructive pulmonary disease (COPD) are important to complement evidence from well-controlled randomized clinical trials. Effectiveness of odSITT was quantified by assessing health status and symptoms in usual care. Patients and Methods ELLITHE was a single-country (Germany), multicenter, open-label, non-interventional effectiveness study between 2020 and 2022, evaluating the effect of treatment initiation with FF/UMEC/VI 100/62.5/25 µg once-daily via the ELLIPTA inhaler on improvements in clinical outcomes versus baseline in COPD patients. The primary endpoint was the change in the total COPD Assessment Test (CAT) score between baseline and month 12. Key secondary endpoints included change in CAT score over time, occurrence of exacerbations until month 12, changes in forced expiratory volume in one second (FEV1), inhaler adherence, and safety. Results Nine hundred and six patients were included (age 66.6 years, 55.6% male, mean FEV1 52.6% of predicted, mean CAT 21.5 units, 1.4 exacerbations/year pre-study). About 63.9% of patients were escalated from dual therapies, and 18% were switched from multiple-inhaler triple therapies. Reductions in CAT score at month 12 were statistically significant and above the threshold of clinical importance (-2.6 units; p < 0.0001). CAT score also improved at interim visits. CAT improvements were more pronounced in patients with high baseline scores and better inhaler adherence. Exacerbations during follow-up were rare (0.2 events/year) compared to pre-study (1.4 events/year). FEV1 was improved by 93 mL (p < 0.0001). No new safety effects were observed. Conclusion In usual care, treatment with odSITT resulted in significant and clinically relevant improvements of CAT score and FEV1 in COPD patients, regardless of the occurrence of exacerbations. These findings challenge the current guideline recommendations for SITT only in patients experiencing exacerbations.
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Affiliation(s)
| | - Karl Scheithe
- Department of Biostatistics, GKM Gesellschaft Für Therapieforschung mbH, Munich, Germany
| | | | - Saskia Krüger
- Medical Department, BERLIN-CHEMIE AG, Berlin, Germany
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Balavenkataraman A, Saunders H, Helgeson SA. Trends in outcomes of hospitalizations from acute exacerbations of chronic obstructive pulmonary disease during the COVID-19 pandemic. Lung India 2024; 41:77-79. [PMID: 38160468 PMCID: PMC10883440 DOI: 10.4103/lungindia.lungindia_472_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Affiliation(s)
- Arvind Balavenkataraman
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, USA. E-mail:
| | - Hollie Saunders
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, USA. E-mail:
| | - Scott A. Helgeson
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, Florida, USA. E-mail:
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Ho T, Shahzad A, Jones A, Raghavan N, Loeb M, Johnston N. Examining the effect of the COVID-19 pandemic on community virus prevalence and healthcare utilisation reveals that peaks in asthma, COPD and respiratory tract infection occur with the re-emergence of rhino/enterovirus. Thorax 2023; 78:1248-1253. [PMID: 37423763 PMCID: PMC10715522 DOI: 10.1136/thorax-2022-219957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/30/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Airway disease exacerbations are cyclical related to respiratory virus prevalence. The COVID-19 pandemic has been associated with reduced exacerbations possibly related to public health measures and their impact on non-COVID-19 respiratory viruses. We aimed to investigate the prevalence of non-COVID-19 respiratory viruses during the pandemic compared with prior in Ontario, Canada and healthcare utilisation related to asthma, chronic obstructive pulmonary disease (COPD) and respiratory tract infection. METHODS This is a population-based retrospective analysis of respiratory virus tests, emergency department (ED) visits and hospitalisations between 2015 and 2021 in Ontario. Weekly virus testing data were used to estimate viral prevalence for all non-COVID-19 respiratory viruses. We plotted the %positivity and observed and expected counts of each virus to visualise the impact of the pandemic. We used Poisson and binomial logistic regression models to estimate the change in %positivity, count of positive viral cases and count of healthcare utilisation during the pandemic. RESULTS The prevalence of all non-COVID-19 respiratory viruses decreased dramatically during the pandemic compared with prior. Comparing periods, the incidence rate ratio (IRR) for positive cases corresponded to a >90% reduction for non-COVID-19 respiratory viruses except adenovirus and rhino/enterovirus. Asthma-related ED visits and hospital admissions fell by 57% (IRR 0.43 (95% CI 0.37 to 0.48)) and 61% (IRR 0.39 (95% CI 0.33 to 0.46)). COPD-related ED visits and admissions fell by 63% (IRR 0.37 (95% CI 0.30 to 0.45)) and 45% (IRR 0.55 (95% CI 0.48 to 0.62)). Respiratory tract infection ED visits and admissions fell by 85% (IRR 0.15 (95% CI 0.10 to 0.22)), and 85% (IRR 0.15 (95% CI 0.09 to 0.24)). Rather than the usual peaks in disease condition, during the pandemic, healthcare utilisation peaked in October when rhino/enterovirus peaked. CONCLUSIONS The prevalence of nearly all non-COVID-19 respiratory viruses decreased during the pandemic and was associated with marked reductions in ED visits and hospitalisations. The re-emergence of rhino/enterovirus was associated with increased healthcare utilisation.
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Affiliation(s)
- Terence Ho
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Abdullah Shahzad
- The University of Melbourne Melbourne Medical School, Melbourne, Victoria, Australia
| | - Aaron Jones
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Natya Raghavan
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mark Loeb
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Neil Johnston
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Nieto-Rivera B, Saldaña-Ahuactzi Z, Parra-Ortega I, Flores-Alanis A, Carbajal-Franco E, Cruz-Rangel A, Galaviz-Hernández S, Romero-Navarro B, de la Rosa-Zamboni D, Salazar-García M, Contreras CA, Ortega-Riosvelasco F, López-Martínez I, Barrera-Badillo G, Diaz-Garcia H, Romo-Castillo M, Moreno-Espinosa S, Luna-Pineda VM. Frequency of respiratory virus-associated infection among children and adolescents from a tertiary-care hospital in Mexico City. Sci Rep 2023; 13:19763. [PMID: 37957308 PMCID: PMC10643542 DOI: 10.1038/s41598-023-47035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/08/2023] [Indexed: 11/15/2023] Open
Abstract
Acute respiratory infections (ARIs) are a major cause of morbidity and mortality among children. The causative pathogens show geographic and seasonal variations. We retrospectively evaluated the frequency and seasonality of respiratory pathogens in children and adolescents (age: 0-19 years) with ARIs treated between January 1, 2021, and March 31, 2022, at a single center in Mexico. Out of 2400 patients, 1,603 were diagnosed with SARS-CoV-2 infection and 797 were diagnosed with other common respiratory pathogens (CRPs). Of the 797 patients, 632 were infected with one CRP and 165 with > 2 CRPs. Deaths occurred only in SARS-CoV-2-infected patients. Rhinovirus/Enterovirus, respiratory syncytial virus B, and parainfluenza virus 3 were the most prevalent in cases with single and multiple infections. CRP showed a high frequency between autumn and winter of 2021, with higher incidence of hospitalization compared to COVID-19. The main comorbidities were immunosuppression, cardiovascular disease (CD), and asthma. The frequency of CRPs showed a downward trend throughout the first half of 2021. CRPs increased in single- and co-infection cases between the fourth and fifth waves of COVID-19, probably due to decreased nonpharmaceutical interventions and changes in diagnostic tests. Age, cyanosis (symptom), and immunosuppression (comorbidity) were found to differentiate between SARS-CoV-2 infection and CRP infection.
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Affiliation(s)
- Brenda Nieto-Rivera
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Zeus Saldaña-Ahuactzi
- Centro de Investigación en Biotecnología Aplicada, Instituto Politécnico Nacional, Santa Inés Tecuexcomac, Tepetitla de Lardizábal, Tlaxcala, México
| | - Israel Parra-Ortega
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Alejandro Flores-Alanis
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Ebzadrel Carbajal-Franco
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Armando Cruz-Rangel
- Laboratorio de Bioquímica de Enfermedades Crónicas, Instituto Nacional de Medicina Genómica, Ciudad de México, México
| | | | - Benjamín Romero-Navarro
- Subdirección de Servicios Auxiliares de Diagnóstico, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Daniela de la Rosa-Zamboni
- Subdirección de Atención Integral al Paciente, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Marcela Salazar-García
- Laboratorio de Biología del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Carmen A Contreras
- Facultad de Medicina, Universidad Privada Antenor Orrego, Trujillo, Peru
| | | | - Irma López-Martínez
- Dirección de Diagnóstico y Referencia, Instituto de Diagnóstico y Referencia Epidemiológicos, Ciudad de México, México
| | - Gisela Barrera-Badillo
- Laboratorio de Virus Respiratorios, Instituto de Diagnóstico y Referencia Epidemiológicos, Ciudad de México, México
| | - Hector Diaz-Garcia
- Centro de Investigación en Malformaciones Congénitas, Hospital Infantil de México Federico Gómez, Ciudad de México, México
- Escuela Superior de Enfermería y Obstetricia, Instituto Politécnico Nacional, Ciudad de México, México
| | - Mariana Romo-Castillo
- Laboratorio de Investigación en COVID-19, Laboratorio de Investigación en Inmunología y Proteomica, Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | | | - Victor M Luna-Pineda
- Laboratorio de Investigación en COVID-19, Laboratorio de Investigación en Inmunología y Proteomica, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
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Lee T, Walley KR, Boyd JH, Cawcutt KA, Kalil A, Russell JA. Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study. BMJ Open Respir Res 2023; 10:e001810. [PMID: 37865420 PMCID: PMC10603472 DOI: 10.1136/bmjresp-2023-001810] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic could impact frequency and mortality of non-COVID-19 community-acquired pneumonia (CAP). Changes in frequency, patient mix, treatment and organ dysfunction could cascade together to increase mortality of CAP during compared with pre-COVID-19. METHODS Hospitalised CAP patients at St. Paul's Hospital, Vancouver, Canada pre-COVID-19 (fiscal years 2018/2019 and 2019/2020) and during COVID-19 pandemic (2020/2021 and 2021/2022) were evaluated. RESULTS In 5219 CAP patients, there was no significant difference prepandemic versus during pandemic in mean age, gender and Charlson Comorbidity Score. However, hospital mortality increased significantly from pre-COVID-19 versus during COVID-19 (7.5% vs 12.1% respectively, (95% CI for difference: 3.0% to 6.3%), p<0.001), a 61% relative increase, coincident with increases in ICU admission (18.3% vs 25.5%, respectively, (95% CI for difference: 5.0% to 9.5%) p<0.001, 39% relative increase) and ventilation (12.7% vs 17.5%, respectively, (95% CI for difference: 2.8% to 6.7%) p<0.001, 38% relative increase). Results remained the same after regression adjustment for age, sex and Charlson score. CAP hospital admissions decreased 27% from pre-COVID-19 (n=1349 and 1433, 2018/2019 and 2019/2020, respectively) versus the first COVID-19 pandemic year (n=1047 in 2020/2021) then rose to prepandemic number (n=1390 in 2021/2022). During prepandemic years, CAP admissions peaked in winter; during COVID-19, the CAP admissions peaked every 6 months. CONCLUSIONS AND RELEVANCE This is the first study to show that the COVID-19 pandemic was associated with increases in hospital mortality, ICU admission and invasive mechanical ventilation rates of non-COVID-19 CAP and a transient, 1-year frequency decrease. There was no winter seasonality of CAP during the COVID-19 pandemic era. These novel findings could be used to guide future pandemic planning for CAP hospital care.
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Affiliation(s)
- Terry Lee
- Centre for Health Evaluation and Outcome Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Keith R Walley
- Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John H Boyd
- Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly A Cawcutt
- Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Andre Kalil
- Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - James A Russell
- Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Dezman ZD, Lemkin D, Papier A, Browne B. The impact of a point-of-care visual clinical decision support tool on admissions for cellulitis in the University of Maryland medical system. J Am Coll Emerg Physicians Open 2023; 4:e12969. [PMID: 37304858 PMCID: PMC10250818 DOI: 10.1002/emp2.12969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 03/20/2023] [Accepted: 04/05/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Cellulitis is commonly diagnosed in emergency departments (EDs), yet roughly one third of ED patients admitted for presumed cellulitis have another, usually benign, condition instead (eg, stasis dermatitis). This suggests there is an opportunity to reduce health care resource use through improved diagnosis at the point of care. This study seeks to test whether a clinical decision support (CDS) tool interoperable with the electronic medical record (EMR) can reduce inappropriate hospital admissions and drive more appropriate and accurate care. Methods This study was a trial of an EMR-interoperable, image-based CDS tool for evaluation of ED patients with suspected cellulitis. At the point of assigning a provisional diagnosis of cellulitis in the EMR, the clinician was randomly prompted to use the CDS. Based on the patient features entered into the CDS by the clinician, the CDS provided the clinician a list of likely diagnoses. The following were recorded: patient demographics, disposition and final diagnosis of patients, and whether antibiotics were prescribed. Logistic regression methods were used to determine the impact of CDS engagement on our primary outcome of admission for cellulitis, adjusted for patient factors. Antibiotic use was a secondary end point. Results From September 2019 to February 2020 (or 7 months), the CDS tool was deployed in the EMR at 4 major hospitals in the University of Maryland Medical System. There were 1269 encounters for cellulitis during the study period. The engagement with the CDS was low (24.1%, 95/394), but engagement was associated with an absolute reduction in admissions (7.1%, p = 0.03). After adjusting for age greater than 65 years, female sex, non-White race, and private insurance, CDS engagement was associated with a significant reduction of admissions (adjusted OR = 0.62, 95% confidence interval (CI): 0.40-0.97, p = 0.04) and antibiotic use (Adjusted OR = 0.63, 95% CI: 0.40-0.99, p = 0.04). Conclusions CDS engagement was associated with decreased admissions for cellulitis and decreased antibiotic use in this study, despite low levels of CDS engagement. Further research should examine the impact of CDS engagement in other practice environments and measure longer-term outcomes in patients discharged from the ED.
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Affiliation(s)
- Zachary D.W. Dezman
- Department of Emergency MedicineUniversity of Maryland School of MedicineUniversity of MarylandBaltimoreMarylandUSA
- Department of Epidemiology and Public HealthUniversity of Maryland School of MedicineUniversity of MarylandBaltimoreMarylandUSA
| | - Daniel Lemkin
- Department of Emergency MedicineUniversity of Maryland School of MedicineUniversity of MarylandBaltimoreMarylandUSA
| | - Art Papier
- Department of DermatologyUniversity of Rochester School of MedicineRochesterNew YorkUSA
- VisualDxRochesterNew YorkUSA
| | - Brian Browne
- Department of Emergency MedicineUniversity of Maryland School of MedicineUniversity of MarylandBaltimoreMarylandUSA
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Bai Z, Ma Z, Jing L, Li Y, Wang S, Wang BG, Wu Y, Han X. Estimation and sensitivity analysis of a COVID-19 model considering the use of face mask and vaccination. Sci Rep 2023; 13:6434. [PMID: 37081069 PMCID: PMC10116124 DOI: 10.1038/s41598-023-33499-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/13/2023] [Indexed: 04/22/2023] Open
Abstract
To model the COVID-19 infection and develop effective control measures, this paper proposes an SEIR-type epidemic model considering the impact of face-mask wearing and vaccination. Firstly, the effective reproduction number and the threshold conditions are obtained. Secondly, based on the data of South Korea from January 20, 2022 to March 21, 2022, the model parameters are estimated. Finally, a sensitivity analysis and the numerical study are conducted. The results show that the face-mask wearing is associated with [Formula: see text] and [Formula: see text] reductions in the numbers of cumulative cases and newly confirmed cases, respectively, after a period of 60 days, when the face mask wearing rate increases by [Formula: see text]. Furthermore, the vaccination rate is associated with [Formula: see text] and [Formula: see text] reductions in the numbers of cumulative cases and the newly confirmed cases, respectively, after the same period of 60 days when the vaccination rate is increased by [Formula: see text]. A combined measure involving face-mask wearing and vaccination may be more effective and reasonable in preventing and controlling this infection. It is also suggested that disease control departments should strongly recommended the wearing of face masks s as well as vaccination to prevent the unvaccinated people from becoming infected.
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Affiliation(s)
- Zhongtian Bai
- The Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou, 730000, Gansu, People's Republic of China
| | - Zhihui Ma
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
| | - Libaihe Jing
- School of Life Sciences, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yonghong Li
- NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, People's Republic of China
| | - Shufan Wang
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Bin-Guo Wang
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yan Wu
- School of Mathematics and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xiaotao Han
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, 730000, Gansu, People's Republic of China
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Endaryanto A, Dewi A, Kusbaryanto, Nugraha RA. Trend in the admissions of patients with non-COVID-19 respiratory symptoms during COVID-19 pandemic and its impact on hospital finances in surabaya, Indonesia. Heliyon 2023; 9:e15122. [PMID: 37035376 PMCID: PMC10065813 DOI: 10.1016/j.heliyon.2023.e15122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Background COVID-19 cases surge, it has a crucial impact on healthcare systems, with rapidly increasing demand for healthcare resources in hospitals and intensive care units (ICUs) in Indonesia and worldwide. It is necessary to quantify the extent to which the effects of the COVID-19 pandemic on the hospital admissions, and clinical and financial outcomes of patients with non-COVID-19 respiratory symptoms. Objective To determine whether the COVID-19 pandemic changed the hospitalisation of child and adult patients with non-COVID-19 respiratory conditions and whether these changes affected the patient's disease condition, clinical outcomes, and hospital finances. Methods A retrospective cohort study was conducted from May 1, 2018 (before the COVID-19 pandemic) until December 31, 2021. Total sampling was done to compare hospital admission of patients with non-COVID-19 respiratory symptoms before versus during the COVID-19 pandemic. The results were analyzed using SPSS 26.0 and SmartPLS.v.3.2.9. Results There was a reduction in hospitalisations for respiratory disorders unrelated to COVID-19 during the pandemic by 55.3% in children and 47.8% in adult patients. During the pandemic, the average hospital revenue per patient of child and adult patients increased significantly, but the profit per patient decreased. Pathway analysis showed that in children, the COVID-19 Pandemic changed disease severity and complexity (β = 0.132, P < 0.001), as well as clinical outcomes (β = 0.029, P < 0.05). In adults, the COVID-19 pandemic improves disease severity and complexity (β = -0.020, P < 0.001), as well as clinical outcomes (β = -0.013, P < 0.001). COVID-19 pandemic increases care charges (in children with β = 0.135, P < 0.001; and in the adult patients with β = 0.110, P < 0.001), worsens hospital financial outcomes relating to child (β = -0.093, P < 0.001) and adult patient (β = -0.073, P < 0.001). In adult patients, seasonal variations moderate the impact of the COVID-19 pandemic on improving disease conditions (β = -0.032, P=<0.001). The child structural model effectively predicted clinical outcomes (Q2 = 0.215) and financial outcomes (Q2 = 0.462). The adult structural model effectively predicted clinical outcomes (Q2 = 0.06) and financial outcomes (Q2 = 0.472). Conclusion The conclusions are that the number of non-COVID respiratory patients decreased during the COVID-19 pandemic (47.8% in adult patients, 55.3% in child patients). Disease severity and complexity increased in child patients but decreased in adult patient. Costs of care and insurance payments increased. Since the insurance payments did not increase as much as the cost of care, hospital profit decreased.
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Chow EJ, Uyeki TM, Chu HY. The effects of the COVID-19 pandemic on community respiratory virus activity. Nat Rev Microbiol 2023; 21:195-210. [PMID: 36253478 PMCID: PMC9574826 DOI: 10.1038/s41579-022-00807-9] [Citation(s) in RCA: 193] [Impact Index Per Article: 96.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 01/14/2023]
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused substantial global morbidity and deaths, leading governments to turn to non-pharmaceutical interventions to slow down the spread of infection and lessen the burden on health care systems. These policies have evolved over the course of the COVID-19 pandemic, including after the availability of COVID-19 vaccines, with regional and country-level differences in their ongoing use. The COVID-19 pandemic has been associated with changes in respiratory virus infections worldwide, which have differed between virus types. Reductions in respiratory virus infections, including by influenza virus and respiratory syncytial virus, were most notable at the onset of the COVID-19 pandemic and continued in varying degrees through subsequent waves of SARS-CoV-2 infections. The decreases in community infection burden have resulted in reduced hospitalizations and deaths associated with non-SARS-CoV-2 respiratory infections. Respiratory virus evolution relies on the maintaining of a diverse genetic pool, but evidence of genetic bottlenecking brought on by case reduction during the COVID-19 pandemic has resulted in reduced genetic diversity of some respiratory viruses, including influenza virus. By describing the differences in these changes between viral species across different geographies over the course of the COVID-19 pandemic, we may better understand the complex factors involved in community co-circulation of respiratory viruses.
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Affiliation(s)
- Eric J Chow
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helen Y Chu
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
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12
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Zarur‐Torralvo S, Stand‐Niño I, Flórez‐García V, Mendoza H, Viana‐Cárdenas E. Viruses responsible for acute respiratory infections before (2016-2019) and during (2021) circulation of the SARS-CoV-2 virus in pediatric patients in a reference center at Barranquilla Colombia: A pattern analysis. J Med Virol 2023; 95:e28439. [PMID: 36573419 PMCID: PMC9880681 DOI: 10.1002/jmv.28439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/02/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate the behavior of the viruses responsible for acute respiratory infections before (2016-2019) and after (2020-2021) the start of the circulation of the SARS-CoV-2 virus in pediatric patients treated at a reference center from Barranquilla, Colombia. MATERIALS AND METHODS A descriptive observational study was carried out, and data were obtained by reviewing the influenza-like illness and severe acute respiratory infection database in the pediatric population of the sentinel surveillance reference center in the district of Barranquilla during the years 2016-2021, applying inclusion and exclusion criteria. RESULTS During 2016-2019, the average age of individuals was 1.3 (±1.7) years, during 2021, it was 2.3 (±3.5) years. The distribution by sex was similar, predominantly male. August and February were the months with the highest record of symptoms for 2016-2019 and 2021, respectively, the most frequent being cough, fever, shortness of breath, and diarrhea. By 2021 there was a higher use of antibiotics and antivirals reported than in 2016-2019. Most patients tested negative for viral detection. When comparing the percentage of viruses detected by age group and years of detection, positivity was lower in 2021 by every age group, and respiratory syncytial virus (RSV) was the most frequently detected. CONCLUSIONS There was less virus positivity in viral detection tests in the pediatric population in 2021. RSV persists as the main etiology affecting this population, especially infants. The use of antibiotic therapy in viral infections continues to be a problematic practice in their management. Sentinel surveillance can be strengthened throughout the country.
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Affiliation(s)
- Shiara Zarur‐Torralvo
- Department of PediatricsSchool of Medicine, Universidad del NorteBarranquillaColombia
| | - Iván Stand‐Niño
- Department of Pediatric PulmonologySchool of Medicine, Universidad del NorteBarranquillaColombia
| | - Victor Flórez‐García
- Department of Public HealthUniversidad del NorteBarranquillaColombia,Department of Public HealthJoseph J. Zilber School of Public Health, University of Wisconsin‐MilwaukeeWisconsinMilwaukeeUSA
| | - Humberto Mendoza
- Department of Public HealthUniversidad del NorteBarranquillaColombia,Division of Public HealthSecretary of Health of Barranquilla City HallBarranquillaColombia
| | - Erika Viana‐Cárdenas
- Department of Public HealthUniversidad del NorteBarranquillaColombia,Division of Public HealthSecretary of Health of Barranquilla City HallBarranquillaColombia
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13
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Bräunlich J, Wirtz H. Decreased COPD exacerbation rates during the COVID-19 pandemic. DEUTSCHES ÄRZTEBLATT INTERNATIONAL 2022; 120:115-116. [PMID: 37070181 PMCID: PMC10132283 DOI: 10.3238/arztebl.m2022.0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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14
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Romão M, Bulhosa C, Mendes Z, Sousa C, Silva G, Pereira M, Bernardo F, Teixeira Rodrigues A, Fonseca JA, Correia de Sousa J. Characteristics of Oral Corticosteroid Users Among Persons with Asthma on GINA Step 3 Therapy and Above: A Cross-Sectional Study in Portuguese Community Pharmacies. J Asthma Allergy 2022; 15:1579-1592. [PMID: 36387837 PMCID: PMC9656491 DOI: 10.2147/jaa.s377896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/28/2022] [Indexed: 11/26/2023] Open
Abstract
PURPOSE Oral corticosteroids (OCS) are frequently used in asthma management but have an important risk-profile. The aim of the study is to characterize and compare the sociodemographic and clinical characteristics, treatment regimen and asthma control between OCS users and non-users among the population of asthma patients (≥18 years) at GINA step 3 and above treated with a fixed combination of an inhaled corticosteroid and a long-acting beta-agonist (ICS/LABA). METHODS Cross-sectional study in Portuguese community pharmacies. Data was collected via paper-based interview delivered at the pharmacy (sociodemographic characteristics and asthma treatment regimen, namely ICS/LABA and OCS utilization), followed by a telephonic interview collecting smoking history, comorbidities, body mass index (BMI), history of exacerbations and asthma-related healthcare resource utilization (HCRU) in the previous 12 months, as well as asthma control using the Control of Allergic Rhinitis and Asthma Test (CARAT®). RESULTS A total of 347 patients recruited in 98 pharmacies were included in the analysis. Of those, 328 had completed both questionnaires. A quarter of the individuals reported OCS use in the previous 12 months (OCS users), either as add-on therapy (6%) or exacerbation treatment (19%). Patients were mostly females (72%), with an average age of 59.5 years (SD=15.4). OCS users were significantly older and reported more frequently having conjunctivitis (25.9% vs 15.0%), osteoporosis (25.9% vs 13.4%), arthritis (14.6% vs 6.9%), and gastrointestinal disease (16.1% vs 8.1%). OCS users also reported greater urgent HCRU: unscheduled consultations (33.3% vs 9.3%) and emergency department (ED) visits (32.1% vs 12.1%). Both groups presented poor disease control (85.2% of OCS users vs 72.9% of non-OCS users). CONCLUSION These results highlight the burden of OCS therapy to asthma patients and the need to improve asthma management, by adopting OCS sparing strategies in this subgroup of patients.
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Affiliation(s)
- Mariana Romão
- Centre for Health Evaluation & Research/Infosaude (CEFAR/IS), National Association of Pharmacies (ANF), Lisbon, Portugal
| | - Carolina Bulhosa
- Centre for Health Evaluation & Research/Infosaude (CEFAR/IS), National Association of Pharmacies (ANF), Lisbon, Portugal
| | - Zilda Mendes
- Centre for Health Evaluation & Research/Infosaude (CEFAR/IS), National Association of Pharmacies (ANF), Lisbon, Portugal
| | | | - Graça Silva
- Medical Department, AstraZeneca, Barcarena, Portugal
| | - Mariana Pereira
- MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
| | | | - António Teixeira Rodrigues
- Centre for Health Evaluation & Research/Infosaude (CEFAR/IS), National Association of Pharmacies (ANF), Lisbon, Portugal
- Life and Health Sciences Research Institute (ICVS), PT Government Associate Laboratory, School of Medicine, University of Minho, Braga, Portugal
| | - João A Fonseca
- MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
- CUF Allergy Unit, Porto Hospital and Institute, Porto, Portugal
| | - Jaime Correia de Sousa
- Life and Health Sciences Research Institute (ICVS), PT Government Associate Laboratory, School of Medicine, University of Minho, Braga, Portugal
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Baracy Jr MG, Hagglund K, Kulkarni S, Afzal F, Arends K, Morris RT, Solomon LA, Aslam MF, Corey L. Decreased incidence of febrile neutropenia in Michigan following masking and social distancing orders for the COVID-19 pandemic: A population based cohort study. World J Clin Oncol 2022; 13:609-615. [PMID: 36157163 PMCID: PMC9346421 DOI: 10.5306/wjco.v13.i7.609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/15/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been theorized that 75%-80% of febrile neutropenia (FN) is caused by endogenous pathogens, while up to 20% of cases are thought to be caused by a viral infection. It is unknown if precautions such as masking and social distancing reduce the risk of FN in susceptible populations.
AIM To determine whether coronavirus disease 2019 (COVID-19) infection mitigation efforts, namely masking and social distancing, were associated with a reduction in the incidence of FN.
METHODS This was a retrospective population based cohort study comparing the incidence of FN in the 13 mo prior to (Year 0) and 13 mo following (Year 1) the public health executive orders (PHEO) in Michigan. Data was queried for all emergency department (ED) visits from April 1, 2019 to March 31, 2021 from the National Syndromic Surveillance Program, a program which collects data that is voluntarily submitted by approximately 89% of Michigan EDs. The primary study outcome was the incidence of FN as a proportion of ED visits in the 13-mo before and 13-mo after COVID-19 mitigations efforts, namely masking and social distancing. We hypothesized that there would be a significant decrease in the incidence of FN in the period following the PHEO aimed at reducing the spread of the severe acute respiratory syndrome coronavirus 2 virus.
RESULTS There was a total of 8979221 total ED visits captured during the study period. In Year 0 there were 5073081 recorded ED visits and 3906140 in Year 1. There was a significant reduction in the proportion of total ED visits with a diagnosis of FN, decreasing 13.3% across periods (0.15% vs 0.13%, P = 0.036). In patients with a hematologic malignancy a more impressive reduction in the incidence of FN was evident following PHEO (22% vs 17%, P = 0.02).
CONCLUSION We found a significant association between social distancing and mask guidelines implemented on a large public scale with decreased rates of FN, particularly in those with a hematologic malignancy. These findings may be useful in the design of future research and recommendations regarding the prevention of FN.
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Affiliation(s)
- Michael Gerard Baracy Jr
- Department of Obstetrics and Gynecology, Ascension St. John Hospital, Detroit, MI 48236, United States
| | - Karen Hagglund
- Medical Research, Ascension St John Hospital and Medical Center, Detroit, MI 48236, United States
| | - Sanjana Kulkarni
- Department of Obstetrics and Gynecology, Ascension St. John Hospital, Detroit, MI 48236, United States
| | - Fareeza Afzal
- Department of Obstetrics and Gynecology, Ascension St. John Hospital, Detroit, MI 48236, United States
| | - Katherine Arends
- Surveillance and Infectious Disease Epidemiology Section, Michigan Department of Health and Human Services, Lansing, MI 48933, United States
| | - Robert T Morris
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Karmanos Cancer Institute, Detroit, MI 48201, United States
| | - Leigh Ann Solomon
- Department of Obstetrics and Gynecology, Ascension St. John Hospital, Detroit, MI 48236, United States
| | - Muhammad Faisal Aslam
- Female Pelvic Medicine and Reconstructive Surgery, Ascension St. John Hospital, Detroit, MI 48236, United States
| | - Logan Corey
- Department of Gynecologic Oncology, Wayne State University, Detroit, MI 48202, United States
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16
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Ryu MY, Park HA, Han S, Park HJ, Lee CA. Emergency Transport Refusal during the Early Stages of the COVID-19 Pandemic in Gyeonggi Province, South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148444. [PMID: 35886295 PMCID: PMC9323224 DOI: 10.3390/ijerph19148444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 11/17/2022]
Abstract
We analyzed the changes in patients’ clinical characteristics and transport refusal pre- and post-COVID-19 and identified the reasons for transport refusal using emergency medical services run sheet data from pre-COVID-19 (April−December 2019) and post-COVID-19 (April−December 2020) in Gyeonggi Province, South Korea. We included patients aged ≥18 years. Univariate and multivariate logistic regression analyses were performed to identify the relationship between patients’ personal factors and clinical characteristics and emergency transport refusal. During the control and study periods, 612,681 cases were reported; the transport refusal rates during the control and study periods were 6.7% and 8.2%, respectively. Emergency transport refusal was associated with younger age, the male sex, a normal mental status, a shock index < 1, and trauma in both the pre- and post-COVID-19 periods. Although fever prevented transport refusal during the pre-COVID-19 period (aOR, 0.620; 95% CI, 0.567−0.679), it became a significant risk factor for transport refusal during the post-COVID-19 period (aOR, 1.619; 95% CI, 1.534−1.709). The most common reason for transport refusal by critically ill patients was “because it was not accepted within the jurisdiction and remote transport was required.” It is necessary to expand the response capacity of patients with fever in the community to reduce the refusal of transport by critically ill patients.
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Affiliation(s)
- Min Young Ryu
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong-si 18450, Korea; (M.Y.R.); (H.A.P.); (H.J.P.)
| | - Hang A. Park
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong-si 18450, Korea; (M.Y.R.); (H.A.P.); (H.J.P.)
| | - Sangsoo Han
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea;
| | - Hye Ji Park
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong-si 18450, Korea; (M.Y.R.); (H.A.P.); (H.J.P.)
| | - Choung Ah Lee
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong-si 18450, Korea; (M.Y.R.); (H.A.P.); (H.J.P.)
- Correspondence: ; Tel.: +82-31-8086-2611
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17
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Johnson KJ, Goss CW, Thompson JJ, Trolard AM, Maricque BB, Anwuri V, Cohen R, Donaldson K, Geng E. Assessment of the impact of the COVID-19 pandemic on health services use. PUBLIC HEALTH IN PRACTICE 2022; 3:100254. [PMID: 35403073 PMCID: PMC8979834 DOI: 10.1016/j.puhip.2022.100254] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives The coronavirus disease of 2019 (COVID-19) pandemic declared by the World Health Organization on March 11, 2020 impacted healthcare services with provider and patient cancellations, delays, and patient avoidance or delay of emergency department or urgent care. Limited data exist on the population proportion affected by delayed healthcare, which is important for future healthcare planning efforts. Our objective was to evaluate the impact of the COVID-19 pandemic on healthcare service cancellations or delays and delays/avoidance of emergency/urgent care overall and by population characteristics. Study design This was a cross-sectional study. Methods Our sample (n = 2314) was assembled through a phone survey from 8/12/2020–10/27/2020 among non-institutionalized St. Louis County, Missouri, USA residents ≥18 years. We asked about provider and patient-initiated cancellations or delays of appointments and pandemic-associated delays/avoidance of emergency/urgent care overall and by participant characteristics. We calculated weighted prevalence estimates by select resident characteristics. Results Healthcare services cancellations or delays affected ∼54% (95% CI 50.6%–57.1%) of residents with dental (31.1%, 95% CI 28.1%–34.0%) and primary care (22.1%, 95% CI 19.5%–24.6%) being most common. The highest prevalences were among those who were White, ≥65 years old, female, in fair/poor health, who had health insurance, and who had ≥1 medical condition. Delayed or avoided emergency/urgent care impacted ∼23% (95% CI 19.9%–25.4%) of residents with a higher prevalence in females than males. Conclusions Healthcare use disruptions impacted a substantial proportion of residents. Future healthcare planning efforts should consider these data to minimize potential morbidity and mortality from delayed care.
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Downes KJ, Statler VA, Orscheln RC, Cousino MK, Green M, Michaels MG, Muller WJ, Sharma TS, Danziger-Isakov LA, Ardura MI. Return to School and COVID-19 Vaccination for Pediatric Solid Organ Transplant Recipients in the United States: Expert Opinion for 2021-2022. J Pediatric Infect Dis Soc 2022; 11:43-54. [PMID: 34734268 PMCID: PMC8689907 DOI: 10.1093/jpids/piab098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/24/2021] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic continues to generate challenges for pediatric solid organ transplant (SOT) recipients and their families. As rates of COVID-19 fluctuate, new SARS-CoV-2 variants emerge, and adherence to and implementation of mitigation strategies vary from community to community, questions remain about the best and safest practices to prevent COVID-19 in vulnerable patients. Notably, decisions about returning to school remain difficult. We assembled a team of specialists in pediatric infectious diseases, transplant infectious diseases, public health, transplant psychology, and infection prevention and control to re-address concerns about school re-entry, as well as COVID-19 vaccines, for pediatric SOT recipients in the United States in 2021. Based on available literature and guidance from national organizations, we generated expert statements specific to pediatric SOT recipients focused on school attendance in 2021.
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Affiliation(s)
- Kevin J Downes
- Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Victoria A Statler
- Division of Infectious Diseases, Norton Children’s Hospital, Louisville, Kentucky, USA
- Department of Pediatrics, University of Louisville, Louisville, Kentucky, USA
| | - Rachel C Orscheln
- Division of Pediatric Infectious Diseases, St. Louis Children’s Hospital, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University, St. Louis, Missouri, USA
| | - Melissa K Cousino
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
- University of Michigan Transplant Center, Ann Arbor, Michigan, USA
| | - Michael Green
- Division of Pediatric Infectious Diseases, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Departments of Pediatrics and Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Marian G Michaels
- Division of Pediatric Infectious Diseases, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Departments of Pediatrics and Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - William J Muller
- Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tanvi S Sharma
- Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Lara A Danziger-Isakov
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Monica I Ardura
- Division of Infectious Diseases and Host Defense, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA
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