Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021

Kompaniyets, Lyudmyla; Pennington, Audrey F.; Goodman, Alyson B.; Rosenblum, Hannah G.; Belay, Brook; Ko, Jean Y.; Chevinsky, Jennifer; Schieber, Lyna Z.; Summers, April D; Lavery, Amy M.; Preston, Leigh Ellyn; Danielson, Melissa L.; Cui, Zhaohui; Namulanda, Gonza; Yusuf, Hussain; Kenzie, William R. Mac; Wong, Karen K.; Baggs, James; Boehmer, Tegan K.; Gundlapalli, Adi V.

doi:10.5888/pcd18.210123

Cited by 252 publications

(266 citation statements)

References 23 publications

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“…Interestingly, several factors did not correlate with hesitancy, including age, testing positive or knowing someone who tested positive for COVID-19, BMI, or knowledge of COVID-19 symptoms. Despite well-characterized associations with medical complications and poor outcomes [ 41 ], no specific chronic condition nor the total number of chronic conditions were associated with vaccine hesitancy in our healthcare worker population. In multivariable models, race/ethnicity, marital status, job classification, immunocompromised status, annual flu vaccination and importance of childhood vaccinations were significant independent predictors of vaccine hesitancy.…”

Section: Resultsmentioning

confidence: 93%

Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey

et al. 2021

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Since health professionals provide frontline care to COVID-19 patients, information on vaccine acceptance among healthcare workers is needed. We developed and implemented an anonymous internet-based cross-sectional survey with direct solicitation among employees of a safety net health system. Items queried demographic and health-related characteristics, experience with and knowledge of COVID-19, and determinants of decisions to vaccinate. COVID-19 vaccine acceptance groups (acceptors, hesitant, refusers) were defined; an adapted version of the WHO vaccine hesitancy scale was included. The survey demonstrated good reliability (Cronbach’s alpha = 0.92 for vaccine hesitancy scale; 0.93 for determinants). General linear and logistic regression methods examined factors which were univariately associated with vaccine hesitancy and vaccine acceptance, respectively. Multivariable models were constructed with stepwise model-building procedures. Race/ethnicity, marital status, job classification, immunocompromised status, flu vaccination and childhood vaccination opinions independently predicted hesitancy scale scores. Gender, education, job classification and BMI independently predicted acceptance, hesitancy, and refusal groups. Among hesitant employees, uncertainty was reflected in reports of motivating factors influencing their indecision. Despite a strong employee-support environment and job protection, respondents reported physical and mental health effects. The appreciation of varied reasons for refusing vaccination should lead to culturally sensitive interventions to increase vaccination rates amongst healthcare workers.

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Section: Resultsmentioning

confidence: 93%

Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey

et al. 2021

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“…7 The same report identified obesity as the strongest risk factor for mortality in this cohort, followed by anxiety and fear disorders, and diabetes with complication. 7 Current global epidemiological efforts are focused on identifying risk factors for morbidity and mortality, as this information is of utmost importance in order to protect the populations that are most at risk. As we emerge from the pandemic, it will be of value to also extract information on the determinants of health, wellness, and longevity, such as why some older persons can survive the SARS-CoV-2 infection, even when they have surpassed the average global life expectancy by more than 40 years, whereas others do not.…”

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confidence: 54%

Secrets to longevity: The Methuselahs that survived COVID‐19

Siopis

2021

J American Geriatrics Society

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closures due to poor performers downsizing or exiting the market may be a positive outcome, if higher-quality or safety-net facilities leave the market, older adults will have reduced access to high-quality services.As our reports from NH administrators convey, the crisis of this pandemic compels us to fundamentally reimagine long-term care delivery for vulnerable older adults now to prepare for the unforeseen future. Although provision of care in the community will likely expand in the coming years, some older adults will nonetheless require NH services. In the context of an evolving and uncertain financial outlook, policymakers must adequately fund the provision of highquality NH care.

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“…Second, adjusting for covariables in a small sample may lead to overfitting of the multiple logistic regression model. Third, mortality could be affected by additional demographic and clinical factors [ 31 ] that were not accounted for, which further limits the generalizability of our findings. Despite the sample size limitation, our exploratory results nevertheless present an addition to the discussion on the interplay between COVID-19 and mental health [ 18 ] as well as the post-COVID recovery [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19

et al. 2021

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Objectives Older adults are particularly vulnerable to the negative consequences of antipsychotic exposure and are disproportionally affected by higher mortality from coronavirus disease 2019 (COVID-19). Our goal was to determine whether concurrent antipsychotic medication use was associated with increased COVID-19 mortality in older patients with preexisting behavioral health problems. We also report on findings from post-COVID follow-ups. Design Retrospective observational study. Participants Outpatients at a geriatric psychiatric clinic in New York City. Measurements Demographic and clinical data including medication, diagnosis and Clinical Global Impression Severity (CGI-S) scales on outpatients who had COVID-19 between February 28th and October 1st 2020 were extracted from the electronic health records (EHR) from the hospital. Results A total of 56 patients were diagnosed with COVID-19 (mean age 76 years; median age 75 years) and 13 (23.2%) died. We found an increased mortality risk for patients who were prescribed at least one antipsychotic medication at the time of COVID-19 infection (Fisher’s exact test P = 0.009, OR = 11.1, 95% confidence interval: 1.4–96.0). This result remains significant after adjusting for age, gender, housing context and dementia (Logistic regression P = 0.035, Beta = 2.4). Furthermore, we found that most patients who survived COVID-19 (88.4%) recovered to pre-COVID baseline in terms of psychiatric symptoms. Comparison of pre- and post-COVID assessments of CGI-S for 33 patients who recovered from COVID-19 were not significantly different. Conclusion We observed a higher COVID-19 mortality associated with concurrent antipsychotics use in older patients receiving behavioral health services. The majority of patients in our geriatric clinic who recovered from COVID-19 appeared to return to their pre-COVID psychiatric function. More precise estimates of the risk associated with antipsychotic treatment in older patients with COVID-19 and other underlying factors will come from larger datasets and meta-analyses.

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Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021

Cited by 252 publications

References 23 publications

Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey

Correlates of COVID-19 Vaccine Acceptance, Hesitancy and Refusal among Employees of a Safety Net California County Health System with an Early and Aggressive Vaccination Program: Results from a Cross-Sectional Survey

Secrets to longevity: The Methuselahs that survived COVID‐19

Mortality in association with antipsychotic medication use and clinical outcomes among geriatric psychiatry outpatients with COVID-19

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