Medicine and Health Sciences Commons^™

Opioid-Related Emergency Department Visits Before And During Covid-19: Association With Community-Level Factors, Timothy F. Page, Weiwei Chen, François Sainfort, Julie A. Jacko

HCA Healthcare Journal of Medicine

Background

The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased. While visits for avoidable conditions decreased, the opposite was true for opioid-related visits.

Methods

We combined data from Florida EDs with community-level variables from the 2020 American Community Survey. The outcome measures of the study were quarterly ZIP code tabulation-area-level ED visit rates for opioid-related ED visits as well as visit rates for all other causes. Associations …

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …

Dental Care During The Covid-19 Pandemic: Patient Perceptions Of Barriers To Dental Care, Covid-19 Safety Precautions, And Administration Of The Covid-19 Vaccine At The Dental Office, Brunilda Lugo, Sheri Denslow, Jill Fromewick, Scott Davis, Katherine Jowers, J. Amadeo Valdez

HCA Healthcare Journal of Medicine

Background

The Mountain Area Health Education Center (MAHEC) Dental Health Center sought to learn how COVID-19 affected dental care attainment and patient perceptions of appropriate safety measures, as well as their acceptance of the dental office as a site for COVID-19 vaccinations.

Methods

A cross-sectional online survey of dental patients was performed to inquire about barriers to care, safety precautions, including COVID-19 testing, and the acceptability of vaccination for COVID-19 in the dental office. All adult patients of the MAHEC Dental Health Center with an email address on file and a clinic visit in the past year were randomized for …

Clinical Characteristics Of Covid-19 Waves In The Southeastern United States: A Retrospective Study, Omar Kandah, Robert Sherertz, Richard Duff, Erica Junqueira

South Atlantic Division Research Day 2023

No abstract provided.

Vertical Transmission Of Sars-Cov-2 In A Twin Pregnancy, Tiffany C. Chang, Rebecca F. Herbert, Stacey N. Tran, Victoria M. Weprinsky, Bhaskari Burra, Chi Dola

HCA Healthcare Journal of Medicine

Transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in 2019 and rapidly evolved into the global coronavirus disease 2019 (COVID-19) pandemic. The emergence of a highly morbid disease has posed ongoing challenges in the diagnosis, management, and prevention of COVID-19. The uncertainty underlying medical decision making is further compounded by preexisting conditions, including pregnancy. Here, we report a twin pregnancy complicated by maternal COVID-19 and the vertical transmission of SARS-CoV-2. We hope that our experiences contribute to a better understanding of the disease in pregnancy and, ultimately, guide the development of effective treatment and prevention …

Co2 Levels Behind And In Front Of Different Protective Mask Types, Hossein Akhondi, Sassan Kaveh, Kimball Kaufman, Tina Danai, Napatkamon Ayutyanont

HCA Healthcare Journal of Medicine

Objectives

Many individuals have difficulty adapting to face mask use and report symptoms while using masks. Our primary objective was to determine whether continuous mask-wearing causes elevated levels of carbon dioxide (CO₂) behind the facemasks.

Methods

CO₂ concentrations were measured behind 3 different types of face masks and were compared to CO^₂ concentrations at the mask front in 261 subjects who continuously wore masks for at least 5 minutes. These CO₂ concentrations were also measured in several randomly selected subjects after a 5-minute walk.

Results

There were significantly higher CO₂ concentrations behind the mask …

Covid: Health Inequities Exposed And How We Can Do Better, Timothy Mcnamara, Kara Mann, Josephin Mathai

HCA Healthcare Journal of Medicine

If a fair and just healthcare system is the goal, then the COVID-19 pandemic proves America still has a long way to go in its effort to achieve health equity for all. Inequalities in the healthcare landscape have been amassing for decades. Lack of access to quality care, underfunded public health programs, and the rising cost of treatment are just a few of the proposed origins of systemic inequity—all of which were apparent long before COVID-19’s arrival. Will observing these deep-seated issues under the lens of an ongoing pandemic shine a brighter light on these enduring disparities? More importantly, what …

The Impact Of Covid-19 In The Latinx Community, Laura Pedraza, Ricardo Villela, Vikki Kamatgi, Kaitlyn Cocuzzo, Ricardo Correa, Miriam Zylberglait Lisigurski

HCA Healthcare Journal of Medicine

The COVID-19 pandemic has intensified the existing health and social disparities that affect minority groups in the United States (US), including the Latinx community. This situation has been reflected in many aspects of health, including increased morbi-mortality and reduced adherence to medical and scientific recommendations. Limited access to health care, financial challenges, migrant status, and health literacy, or lack thereof, have all hampered the Latinx community's ability to seek aid quickly and to be tested or treated effectively for this disease. This pandemic has shown that the Latinx community's socioeconomic status correlates with greater mortality rates when compared to other …

Primary Care Practices In Western North Carolina: Adaptation To The Covid-19 Pandemic And Ongoing Challenges, Hannah R. Friedman, Joseph Konstanzer, Erica Richman, Brian Cass, Bryan Hodge, Sheri Denslow, Jacqueline Halladay

HCA Healthcare Journal of Medicine

Introduction

The COVID-19 pandemic has created unique challenges for primary care practices while also highlighting their importance in the pandemic response. To understand primary care practice needs, a survey was conducted of practices in Western North Carolina.

Methods

Phase 2 of a primary care needs assessment was administered to 63 practices in Western North Carolina over the course of six weeks, from July 23 to August 31, 2021.

Results

Most practices were operating with normal hours, though some still operated with reduced hours. Many practices reported insufficient personal protective equipment (PPE) supplies. While most practices provided at least some care …

Hand Hygiene And Hospital-Acquired Infections During Covid-19 Increased Vigilance: One Hospital’S Experience, Alexander Kong, Carlos S. Botero Suarez, Bebe Rahamatalli, Jennifer Shankweiler, Olga Karasik

HCA Healthcare Journal of Medicine

Background

Hospital-acquired infections are associated with increased morbidity, mortality, costs and length of stay. Prior studies have linked increased hand hygiene compliance with reduced hospital-acquired infection rate. With the increased vigilance for personal and institutional hygiene practices during the COVID-19 pandemic, we hypothesized increased hand hygiene compliance and, as a result, decrease in hospital-acquired infections in our hospital.

Methods

Hand hygiene compliance data was provided by the hospital’s Quality Department. We queried and empirically analyzed local hospital-acquired infection data obtained from our Quality Department and the National Healthcare Safety Network. We compared local hand hygiene compliance rates before and after …

Covid-19: The Vaccine Race Continues, L. Hayley Burgess, Carley Castelein, Andrew Rubio, Mandelin K. Cooper

HCA Healthcare Journal of Medicine

Over a year has passed since the discovery of SARS-CoV-2 and the subsequent COVID-19 pandemic. As mitigation efforts continue, COVID-19 has claimed over half a million lives in the United States and 3.1 million lives globally. The development and availability of vaccines delivering immunity to prevent COVID-19 offers hope to end the pandemic.

Emergency use authorizations from the Food and Drug Administration have been issued in the United States for three vaccines, one each from Pfizer-BioNTech, Moderna and Janssen/J&J. Pfizer-BioNTech and Moderna are both mRNA vaccines with efficacy of 95% and 94.1% respectively, while the vector-based vaccine from Janssen/J&J has …

Covid-19: Race For Vaccine, L. Hayley Burgess, Jason J. Braithwaite, Emily Singleton, Aaron M. Young, Mandelin K. Cooper

HCA Healthcare Journal of Medicine

The world is in the midst of a pandemic from COVID-19, a disease caused by the virus SARS-CoV-2. Despite broad mitigation efforts, new cases continue with 74 million cases and 1.6 million deaths worldwide. Regardless of previous research efforts, there is no commercially available vaccine for any coronavirus. Novel vaccine development has historically taken at least 10 years from discovery to availability with only a 6% market entry probability.

With the global impact, there is an urgency to expedite a vaccine to protect the population. The U.S. government launched Operation Warp Speed with the goal to produce and deliver 300 …

Importance Of Awareness Of Adverse Drug Reaction Reporting During The Covid-19 Pandemic, Heather Ellis, Hale Z. Toklu

HCA Healthcare Journal of Medicine

Health care professionals hold the responsibility of reporting any adverse drug reactions in order to learn about new therapy and how best to safely care for our patients. The information derived from case publications and FDA MedWatch reports are essential to accumulate information and increase awareness for the possible risks of new drugs.

Informing Strategy To Ensure Detection: Perceptions Of Coronavirus Testing In A Southeastern U.S. Urban Homeless Population, Colleen Bell, Theodore Bosi, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction: Attitudes of those in the homeless population toward testing, particularly during a pandemic, are critical to understand, so that they and their communities may be safely triaged and protected. Homeless persons are more likely to be exposed during viral epidemics, and have greater vulnerability for more severe viral illness, due to greater medical comorbidities. The literature reflects a dearth of published papers describing the perceptions, interest, and motivations of homeless people to seek or receive viral testing, despite their status as a high-risk population.

Methods: A quality improvement project consisting of a cross-sectional survey took place at 8 SARS-CoV-2 …

Covid-19 Needs Assessment And Support For Primary Care Practices In Western North Carolina, Sheri Denslow, Jill Fromewick, Kacey Scott, Jesse Bossingham, Brian Cass, Bryan Hodge, Erica L. Richman, Tammy Garrity, Kathleen Mottus, Jacqueline R. Halladay

HCA Healthcare Journal of Medicine

Background: It is critical to ensure that Primary Care Providers (PCPs) have adequate personal protective equipment (PPE), supplies, training, staffing, and contingency planning during pandemics, particularly in rural areas. In March 2020, during the onset of the COVID-19 pandemic, the Mountain Area Health Education Center (MAHEC), in collaboration with the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, rapidly created and conducted a needs assessment of PCPs in western North Carolina (WNC).

Methods: A group of twenty volunteers conducted a telephone survey of PCPs in a 16 county region of WNC. Practices were asked about their …

Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction: Coronavirus disease (COVID-19) is an emerging and rapidly evolving public health issue that has become globally widespread and an overwhelming pandemic. Clinical manifestations of the disease include asymptomatic carrier states, acute respiratory distress syndrome, and even multiorgan dysfunction. Here, we present a unique and rare case of an acute ischemic stroke (AIS) in an asymptomatic pregnant woman with no predisposing medical illnesses.

Discussion: An 18-year-old G2P1 African American woman at 7 weeks gestational age with no significant medical or family history presenting to the Emergency Department during the initial phases of the pandemic with complaints of new onset left …

Neuropsychiatric Presentation Of Covid-19: A Case Report Of Disinhibition In An Acute Sars-Cov-2 Infection, I. Jack Abramson, Kristy A. Fisher, Clara V. Alvarez, Jacqueline Horan Fisher

HCA Healthcare Journal of Medicine

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral infection is notable for a high degree of symptom diversity. Emerging evidence suggests viral invasion of the central nervous system; therefore, serious neurological and psychiatric manifestations are anticipated. We present the case of a 67-year-old male physician with a history of stable Bipolar Disorder for decades, hospitalized for persistent COVID-19 symptoms with documented positive serology, who presented with new and acute onset neuropsychiatric symptoms of disinhibition proximate the viral infection. We postulate neuroinvasion as the putative origin of the patient’s psychiatric instability. Further investigation is needed to expand upon our understanding of the …

Fear-Based Barriers To Care In The Covid-19 Pandemic, Christopher Ott

HCA Healthcare Journal of Medicine

COVID-19 has made patients afraid to engage with providers in-person to manage acute, chronic and preventive non-COVID-related health care needs. As health care providers, we must continue to do everything within our power to address our patients’ fear of our infrastructure and the increasing barriers they are experiencing to accessing the care that they need.