Epidemiology Commons^™

Pneumothorax And Pneumomediastinum In Covid-19: A Case Series, Stephan Reyes, Brad Roche, Farah Kazzaz, Daniel Ocazionez, Aditya P Lal, Rosa M Estrada-Y-Martin, Sujith V Cherian

Faculty, Staff and Student Publications

COVID- 19 has become a major pandemic affecting more than 11 million people worldwide. Common radiological manifestations of COVID-19 include peripheral based ground-glass or consolidative opacities; however, pneumothorax and pneumo-mediastinum are very rare manifestations; even more so within patients not on mechanical ventilation. We present a case series of 5 patients with COVID-19 who either presented with or developed spontaneous pneumothorax or pneumo-mediastinum within the course of hospitalization. With the exception of one patient, all other patients developed pneumothorax as a late manifestation in their illness; more than 10 days after initial symptom onset in COVID-19. From within this case …

On The Front Lines Of The Covid-19 Pandemic: Occupational Experiences Of The Intimate Partner Violence And Sexual Assault Workforce, Leila Wood, Rachel Voth Schrag, Elizabeth Baumler, Dixie Hairston, Shannon Guillot-Wright, Elizabeth Torres, Jeff R Temple

Faculty, Staff and Student Publications

In the face of increasing risk for intimate partner violence (IPV) and sexual assault during the COVID-19 pandemic, there is an urgent need to understand the experiences of the workforce providing support to survivors, as well as the evolving service delivery methods, shifting safety planning approaches, and occupational stress of frontline workers. We addressed this gap by conducting an online survey of members of IPV and sexual assault workforce using a broad, web-based recruitment strategy. In total, 352 staff from 24 states participated. We collaborated with practitioner networks and anti-violence coalitions to develop the brief survey, which included questions about …

Factors Associated With Covid-19 Death In The United States: Cohort Study, Uan-I Chen, Hua Xu, Trudy Millard Krause, Raymond Greenberg, Xiao Dong, Xiaoqian Jiang

Faculty, Staff and Student Publications

Background: Since the initial COVID-19 cases were identified in the United States in February 2020, the United States has experienced a high incidence of the disease. Understanding the risk factors for severe outcomes identifies the most vulnerable populations and helps in decision-making.

Objective: This study aims to assess the factors associated with COVID-19-related deaths from a large, national, individual-level data set.

Methods: A cohort study was conducted using data from the Optum de-identified COVID-19 electronic health record (EHR) data set; 1,271,033 adult participants were observed from February 1, 2020, to August 31, 2020, until their deaths due to COVID-19, deaths …

Mechanistic Origin Of Different Binding Affinities Of Sars-Cov And Sars-Cov-2 Spike Rbds To Human Ace2, Zhi-Bi Zhang, Yuan-Ling Xia, Jian-Xin Shen, Wen-Wen Du, Yun-Xin Fu, Shu-Qun Liu

Faculty, Staff and Student Publications

The receptor-binding domain (RBD) of the SARS-CoV-2 spike protein (RBDCoV2) has a higher binding affinity to the human receptor angiotensin-converting enzyme 2 (ACE2) than the SARS-CoV RBD (RBDCoV). Here, we performed molecular dynamics (MD) simulations, binding free energy (BFE) calculations, and interface residue contact network (IRCN) analysis to explore the mechanistic origin of different ACE2-binding affinities of the two RBDs. The results demonstrate that, when compared to the RBDCoV2-ACE2 complex, RBDCoV-ACE2 features enhanced dynamicsand inter-protein positional movements and increased conformational entropy and conformational diversity. Although the inter-protein electrostatic attractive interactions are the primary determinant for the high ACE2-binding affinities of …

Of Vascular Defense, Hemostasis, Cancer, And Platelet Biology: An Evolutionary Perspective, David G Menter, Vahid Afshar-Kharghan, John Paul Shen, Stephanie L Martch, Anirban Maitra, Scott Kopetz, Kenneth V Honn, Anil K Sood

Faculty, Staff and Student Publications

We have established considerable expertise in studying the role of platelets in cancer biology. From this expertise, we were keen to recognize the numerous venous-, arterial-, microvascular-, and macrovascular thrombotic events and immunologic disorders are caused by severe, acute-respiratory-syndrome coronavirus 2 (SARS-CoV-2) infections. With this offering, we explore the evolutionary connections that place platelets at the center of hemostasis, immunity, and adaptive phylogeny. Coevolutionary changes have also occurred in vertebrate viruses and their vertebrate hosts that reflect their respective evolutionary interactions. As mammals adapted from aquatic to terrestrial life and the heavy blood loss associated with placentalization-based live birth, platelets …

Decontamination Of Geobacillus Stearothermophilus Using The Arca Aerosolized Hydrogen Peroxide Decontamination System, Loren Benjamin Mead, Tanner Mathison, Garry Osborne, Anne Marie Richards

Faculty, Staff and Student Publications

INTRODUCTION: In response to the limited supply of personal protective equipment during the pandemic caused by SARS-CoV-2, recent studies demonstrate that gaseous H2O2 is an effective decontaminant of N95 filtering facepiece respirators to enable reuse of these items in a clinical setting. This paper evaluates the efficacy of the Arca Aerosolized Hydrogen Peroxide Decontamination System (Arca), a novel aerosolized H2O2 decontamination system, using biologic indicator testing.

MATERIALS AND METHODS: The Arca produces and circulates H2O2 aerosol inside of a sealed stainless steel chamber. The Arca's decontamination efficacy was evaluated in 8 decontamination trials with 2 H2O2 concentrations (3% and 12%) …

Cerebral Infarctions In An Infant With Covid-19 Delta Variant Infection And Disseminated Tuberculosis, Stuart Fraser, Misti Ellsworth, Norma Perez, Hunter Hamilton, Stephen Fletcher, Deborah Brown, Lakshmi Srivaths

Faculty, Staff and Student Publications

No abstract provided.

Use Of Modeling To Inform Decision Making In North Carolina During The Covid-19 Pandemic: A Qualitative Study, Karl Johnson, Caitlin B Biddell, Kristen Hassmiller Lich, Julie Swann, Paul Delamater, Maria Mayorga, Julie Ivy, Raymond L Smith, Mehul D Patel

Faculty, Staff and Student Publications

Background. The COVID-19 pandemic has popularized computer-based decision-support models, which are commonly used to inform decision making amidst complexity. Understanding what organizational decision makers prefer from these models is needed to inform model development during this and future crises. Methods. We recruited and interviewed decision makers from North Carolina across 9 sectors to understand organizational decision-making processes during the first year of the COVID-19 pandemic (N = 44). For this study, we identified and analyzed a subset of responses from interviewees (n = 19) who reported using modeling to inform decision making. We used conventional content analysis to …

Invasive Haemophilus Influenza Type B In An Infant During The Covid-19 Pandemic: The Return Of Diseases We Hoped Never To See Again…, Christy Tabarani, Stephen A Fletcher, Gloria P Heresi, Susan H Wootton

Faculty, Staff and Student Publications

No abstract provided.

Global “Flu-Ization” Of Covid-19: A Perspective From Vietnam, Khoi Quan Nguyen, Le My Anh Nguyen, Andrew W Taylor-Robinson

Faculty, Staff and Student Publications

No abstract provided.

Covid-19 Outcomes In Myasthenia Gravis Patients: Analysis From Electronic Health Records In The United States, Youngran Kim, Xiaojin Li, Yan Huang, Minseon Kim, Aziz Shaibani, Kazim Sheikh, Guo-Qiang Zhang, Thy Phuong Nguyen

Faculty, Staff and Student Publications

BACKGROUND: Myasthenia gravis (MG) is an autoimmune, neuromuscular condition and patients with MG are vulnerable due to immunosuppressant use and disease manifestations of dyspnea and dysphagia during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS: We conducted a retrospective cohort study using the Optum® de-identified COVID-19 Electronic Health Record (EHR) dataset. Primary outcomes, such as hospitalization, ventilator use, intensive care unit (ICU) admission, and death in COVID-19 patients with MG, were compared with those of COVID-19 patients without MG: the subgroups of non-MG included those with rheumatoid arthritis (RA), systemic lupus (SLE), and multiple sclerosis (MS). We further analyzed factors affecting …

Trends And Correlates Of Breakthrough Infections With Sars-Cov-2, Jose-Miguel Yamal, Savitri Appana, Mengxi Wang, Luis Leon-Novelo, Eric Bakota, Yuanqing Ye, Shreela Sharma, Alanna C Morrison, Dritana Marko, Stephen H Linder, Alison Rector, Katelyn K Jetelina, Eric Boerwinkle, Marcia De Oliveira Otto

Faculty, Staff and Student Publications

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant has been hypothesized to decrease the efficacy of COVID-19 vaccines. Factors associated with infections with SARS-CoV-2 after vaccination are unknown. In this observational cohort study, we examined two groups in Harris County, Texas: (1) individuals with positive Nucleic Acid Amplification test between 12/14/2020 and 9/30/2021 and (2) the subset of individuals fully vaccinated in the same time period. Infected individuals were classified as a breakthrough if their infection occurred 14 days after their vaccination had been completed. Among fully vaccinated individuals, demographic and vaccine factors associated with breakthrough infections were …

Characterizing Cancer And Covid-19 Outcomes Using Electronic Health Records, Youngran Kim, Liang Zhu, Huili Zhu, Xiaojin Li, Yan Huang, Chunhui Gu, Heather Bush, Caroline Chung, Guo-Qiang Zhang

Faculty, Staff and Student Publications

PURPOSE: Patients with cancer often have compromised immune system which can lead to worse COVID-19 outcomes. The purpose of this study is to assess the association between COVID-19 outcomes and existing cancer-specific characteristics.

PATIENTS AND METHODS: Patients aged 18 or older with laboratory-confirmed COVID-19 between June 1, 2020, and December 31, 2020, were identified (n = 314 004) from the Optum® de-identified COVID-19 Electronic Health Record (EHR) derived from more than 700 hospitals and 7000 clinics in the United States. To allow sufficient observational time, patients with less than one year of medical history in the EHR dataset before their …

Incidence Rate Of Psychiatric Disorders In 2020: The Pivotal Role Played By Sars-Cov-2 Infection, Antonio L Teixeira, Regina M Hansen, Joseph S Wozny, Caroline M Schaefer, Rodrigo Machado-Vieira, Lokesh Shahani, Scott D Lane, Jair C Soares, Trudy M Krause

Faculty, Staff and Student Publications

IMPORTANCE: The Coronavirus Disease (COVID-19) pandemic has significantly impacted mental health outcomes. While the frequency of anxiety and depressive symptoms has increased in the whole population, the relationship between COVID-19 and new psychiatric diagnoses remains unclear.

OBJECTIVE: to compare the population incidence rate of emergence of de novo psychiatric disorders in 2020 compared to the previous years, and to compare the incidence rate of new psychiatric disorder diagnoses between people with vs without COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This study utilized administrative claims data from the Clinformatics® Data Mart database, licensed from Optum®. The study is a cross-sectional analysis that …

"Don't Know Where To Go For Help": Safety And Economic Needs Among Violence Survivors During The Covid-19 Pandemic, Leila Wood, Elizabeth Baumler, Rachel Voth Schrag, Shannon Guillot-Wright, Dixie Hairston, Jeff Temple, Elizabeth Torres

Faculty, Staff and Student Publications

The COVID-19 pandemic and related quarantine has created additional problems for survivors of interpersonal violence. The purpose of this study is to gain a preliminary understanding of the health, safety, and economic impacts of the COVID-19 pandemic on people that are experiencing or have previously experienced violence, stalking, threats, and/or abuse. An online survey, open from April to June 2020, was taken by people with safety concerns from interpersonal violence. Participants were recruited from IPV and sexual assault-focused agencies, state coalitions, and social media. Quantitative data were summarized using descriptive methods in SPSS and coding methods from thematic and content …

Timing Of Surgery Following Sars-Cov-2 Infection: An International Prospective Cohort Study, Covidsurg Collaborative, Globalsurg Collaborative

Faculty, Staff and Student Publications

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 …

Prevalence Of Functional Limitation In Covid-19 Recovered Patients Using The Post Covid-19 Functional Status Scale, Pankaj Pant, Aishana Joshi, Babin Basnet, Bibek Man Shrestha, Navindra Raj Bista, Niraj Bam, Santa Kumar Das

Faculty, Staff and Student Publications

INTRODUCTION: COVID-19 is an emerging global health pandemic causing tremendous morbidity and mortality worldwide. Chronic symptoms progressing to poor functional status have been reported in a substantial proportion of COVID-19 patients worldwide. This study aimed to determine the prevalence of functional limitation in COVID-19 recovered patients using the post-COVID-19 functional status scale.

METHODS: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital. COVID-19 recovered patients with reverse transcription-polymerase chain reaction negative status were included and assessed using the post-COVID-19 functional status scale. Data entry and analysis was done in Statistical Package for the Social Sciences version 20.0. Descriptive …

Awareness And Preparedness Of Healthcare Workers Against The First Wave Of The Covid-19 Pandemic: A Cross-Sectional Survey Across 57 Countries, Nguyen Tien Huy, R Matthew Chico, Vuong Thanh Huan, Hosam Waleed Shaikhkhalil, Vuong Ngoc Thao Uyen, Ahmad Taysir Atieh Qarawi, Shamael Thabit Mohammed Alhady, Nguyen Lam Vuong, Le Van Truong, Mai Ngoc Luu, Shyam Prakash Dumre, Atsuko Imoto, Peter N Lee, Dao Ngoc Hien Tam, Sze Jia Ng, Mohammad Rashidul Hashan, Mitsuaki Matsui, Nguyen Tran Minh Duc, Sedighe Karimzadeh, Nut Koonrungsesomboon, Chris Smith, Sharon Cox, Kazuhiko Moji, Kenji Hirayama, Le Khac Linh, Kirellos Said Abbas, Tran Nu Thuy Dung, Tareq Mohammed Ali Al-Ahdal, Emmanuel Oluwadare Balogun, Nguyen The Duy, Mennatullah Mohamed Eltaras, Trang Huynh, Nguyen Thi Linh Hue, Bui Diem Khue, Abdelrahman Gad, Gehad Mohamed Tawfik, Kazumi Kubota, Hoang-Minh Nguyen, Dmytro Pavlenko, Vu Thi Thu Trang, Le Thuong Vu, Tran Hai Yen, Nguyen Thi Yen-Xuan, Luong Thi Trang, Vinh Dong, Akash Sharma, Vu Quoc Dat, Mohammed Soliman, Jeza Abdul Aziz, Jaffer Shah, Pham Dinh Long Hung, Yap Siang Jee, Dang Thuy Ha Phuong, Tran Thuy Huong Quynh, Hoang Thi Nam Giang, Vy Thi Nhat Huynh, Nguyen Anh Thi, Nacir Dhouibi, Truc Phan, Vincent Duru, Nguyen Hai Nam, Sherief Ghozy, Tmgh-Global Covid-19 Collaborative

Faculty, Staff and Student Publications

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave.

METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training.

RESULTS: We surveyed 24,653 …

Examining Social Vulnerability And The Association With Covid-19 Incidence In Harris County, Texas, Guillermo A Tortolero, Marcia De Oliveira Otto, Ryan Ramphul, Jose-Miguel Yamal, Alison Rector, Michael Brown, Melissa F Peskin, Dania Mofleh, Eric Boerwinkle

Faculty, Staff and Student Publications

Studies have investigated the association between social vulnerability and SARS-CoV-2 incidence. However, few studies have examined small geographic units such as census tracts, examined geographic regions with large numbers of Hispanic and Black populations, controlled for testing rates, and incorporated stay-at-home measures into their analyses. Understanding the relationship between social vulnerability and SARS-CoV-2 incidence is critical to understanding the interplay between social determinants and implementing risk mitigation guidelines to curtail the spread of infectious diseases. The objective of this study was to examine the relationship between CDC's Social Vulnerability Index (SVI) and SARS-CoV-2 incidence while controlling for testing rates and …

Comparison Of Sars-Cov-2 Detection From Nasopharyngeal Swab Samples By The Roche Cobas 6800 Sars-Cov-2 Test And A Laboratory-Developed Real-Time Rt-Pcr Test, Elisabet Pujadas, Nnaemeka Ibeh, Matthew M Hernandez, Aneta Waluszko, Tatyana Sidorenko, Vanessa Flores, Biana Shiffrin, Numthip Chiu, Alicia Young-Francois, Michael D Nowak, Alberto E Paniz-Mondolfi, Emilia M Sordillo, Carlos Cordon-Cardo, Jane Houldsworth, Melissa R Gitman

Faculty, Staff and Student Publications

The urgent need to implement and rapidly expand testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has led to the development of multiple assays. How these tests perform relative to one another is poorly understood. We evaluated the concordance between the Roche Diagnostics cobas 6800 SARS-CoV-2 test and a laboratory-developed test (LDT) real-time reverse transcription-polymerase chain reaction based on a modified Centers for Disease Control and Prevention protocol, for the detection of SARS-CoV-2 in samples submitted to the Clinical Laboratories of the Mount Sinai Health System. A total of 1006 nasopharyngeal swabs in universal transport medium from persons under …