Positive COVID-19 Test Research Articles

P-2037. Epidemiology, Clinical Features and Outcomes of COVID 19 Patients Post Evusheld Therapy Among Immunosuppressed Patients

Abstract Background Evusheld® is a combination of two monoclonal antibodies, Tixagevimab and Cilgavimab. It was developed for the pre-exposure prophylaxis (PrEP) and treatment of COVID-19 illness for those who are immunocompromised. There is paucity of long-term real-world data on the use of Evusheld among the immunosuppressed patients against the SARS-CoV-2 Omicron variants. Methods A retrospective cohort chart review of patients 18 years and older who received the two dose Evusheld regimen from December 1, 2021 to January 31, 2023 at a community teaching institution was performed to evaluate the effectiveness of Evusheld as PrEP of COVID-19 patients. Evusheld as PrEP was indicated for patients with active solid tumor and hematologic malignancies or those receiving immunosuppressive treatment including CART therapy, biologic agents and high-dose corticosteroids (i.e., ≥ 20 mg prednisone or equivalent per day when administered for ≥ 2 weeks). The following data was collected: patient demographic, development of COVID19 after receiving Evusheld®, intensive care unit (ICU) length of stay (LOS), hospital LOS, ventilation requirement, duration of ventilation, and mortality among these patients within six months of receiving Evusheld therapy. Results Of the 663 patients screened, 459 were excluded primarily for duplicate patients. The mean age of the 204 included patients was 68.3 years and 97 (47.5%) were female. Eighteen (8.8%) patients had a positive COVID-19 test within 180 days of receiving Evusheld. None of the COVID positive patients were admitted to the hospital or required mechanical ventilation. All COVID positive patients survived. Conclusion Our study shows that Evusheld was effective in preventing COVID-19 among the immunocompromised patients during the six-month follow-up period. This study also showed that patients who developed COVID-19 after Evusheld did not develop severe disease or require hospitalization. Disclosures All Authors: No reported disclosures

P-1962. SEAL: Serology-based Assessment of Evusheld in Lung Transplant Recipients

Abstract Background The primary strategy to combat severe COVID-19 infection in Lung Transplant Recipients (LTRs) is prevention through vaccination or the use of monoclonal antibodies such as Evusheld (tixagevimab/cilgavimab), for pre-exposure prophylaxis. Data on Evusheld efficacy overall and particularly in relation to the serological status of LTRs is scarce. We evaluated treatment outcomes in LTRs within 1 year after treatment with Evusheld based on their serological status before Evusheld administration. Study Design Of the 103 Lung Transplant recipients (LTRs*) who received Evusheld, 101 patients had been tested for anti-spike antibodies against SARS-CoV-2 prior to receiving Evusheld. 61 patients tested positive (seropositive) and 40 tested negative (seronegative). All patients were followed for 12 months. Outcomes were evaluated after the first 6 months when Evusheld was active, and after the second 6 months when Evusheld either was not used or had lost its efficacy against circulating strains. Methods This is a retrospective cohort analysis of 103 LTRs treated with Evusheld between January 27 and May 25, 2022, at Corwell Health in West Michigan. LTRs were classified into seropositive (SeroPos) and seronegative (SeroNeg) groups based on the presence of anti-spike antibodies against SARS-CoV-2 before Evusheld administration and evaluated after the first 6 months, when Evusheld was active, and after the second 6 months, when Evusheld was ineffective against circulating strains (Figure 1), for outcomes listed in Figure 2. We identified patients with positive COVID-19 test, either antigen or PCR. Morbidity was assessed through the rate of ED visits, hospital, and ICU admissions within 30 days from COVID-19 diagnosis. Mortality was assessed through COVID-19-related and all-cause deaths throughout the study period. Results Of 103 LTRs, 97% were vaccinated, 19% had COVID-19 and 59% were SeroPos before receiving Evusheld. Compared with SeroNeg LTRs, SeroPos LTRs were more likely to have had prior COVID-19 infection (22.95% v 12.5%, p=0.19). Vaccination rate was similar in both groups (98.36 vs 95%, p=0.56). SeroNeg LTRs were overall more likely to contract COVID-19, with a stable infection rate of 15% across the whole study period. In SeroPos LTRs, the positivity rate doubled in the 2nd 6 months compared with the 1st 6 months (6.5% vs. 13%, p=0.24). There was no difference in the disease severity between SeroPos and SeroNeg patients at any point (Figure 3). Overall, LTRs were less likely to contract COVID-19, be admitted to the hospital/intensive care unit, or die during the first 6 months when Evusheld was effective, compared with the second 6 months, but the difference was not statistically significant. (Figure 4). Characteristics and outcomes in seropositive and seronegative groups Conclusion Overall COVID-19 infection outcomes in LTRs had tendency to be better with Evsuheld use. SeroNeg LTRs were more likely to contract COVID-19 with and without Evusheld protection but serological status may not correlate with the disease severity. Our findings suggest that prior COVID-19 infection may induce a stronger immune response than the vaccine in LTRs. Outcome in all Lung Transplant Recipients Treated with Evusheld Lung transplant recipients were more likely to contract COVID-19 (13.73% vs. 9.71%, p=0.37), visit Emergency Department (ED (4.9% vs. 4.85%, p=1), get admitted to hospital (5.88% vs. 2.91%, p=0.33) or Intensive Care Unit (ICU) (1.96% vs. 0%, p=0.25), within the second 6 months compared with the first 6 months. All-cause mortality was significantly higher in the second 6 months (8.82% vs. 0.97%, p= 0.0097) but there was no difference in COVID-19 related deaths (0.98% vs. 0%, p=0.5). Disclosures All Authors: No reported disclosures

Early Predictive Value of Laboratory Inflammatory Markers in Evaluating Both Lung Involvement and Progression in Hospitalized Patients With COVID-19

Background The new coronavirus known as SARS-CoV-2, first discovered in Wuhan, China, in December 2019, rapidly spread over the globe. It has created many challenges for the world's health and treatment systems. Due to the outspread of this virus and the limited treatment facilities, one of the important issues is the early diagnosis of patients who may continue to suffer from a severe type of disease. This study aims to determine the relationship between hospitalized COVID-19 patients' computed tomography (CT) scan results and laboratory results such as neutrophil-to-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). Methods We created this retrospective study to investigate the relationship between the CT scan results of COVID-19 patients and laboratory results such as NLR and PLR ratios. We randomly sampled individuals whose hospitalization records from Shahada Kargar Hospital in Yazd in 2021 showed a positive COVID-19 test diagnosis. Results During this investigation, 17% of patients were hospitalized in the intensive care unit, and around 7% of patients passed away. These prognostic values have had a significant relationship with the mean NLR and (P = 0.004). In addition, this NLR laboratory index indicated a considerable positive correlation coefficient with the CT scan score (P = 0.014). Conclusions Our results reflect the significant predictive ability of NLR and PLR ratios regarding the prognosis of hospitalized patients with COVID-19. Imaging findings use the CT scan score as an indicator to predict the amount of NLR. In this way, the results of preliminary laboratory tests and imaging can determine the affected patient's progress to a large extent.

Sociodemographic characteristics and health status of women with breast cancer and COVID 19 diagnosis by menopausal status a cross sectional study

The goal of this work is to investigate the sociodemographic characteristics and health status of women with breast cancer (BC) in association with COVID-19 by menopausal status. In a Swedish register-based cross-sectional study, we compared women with BC and with or without a positive COVID-19 test, stratified by menopausal status (age ≥ 51 years). Socioeconomic characteristics and health status (represented by diagnoses registered in 5 years- and prescription dispensed in 2 years preceding Jan 2020) were considered in association with COVID-19 diagnosis. The study population included 38,523 women with BC. Median age at BC diagnosis was 45 years (IQR = 40–48) for premenopausal- and 67 (IQR = 60–73) for postmenopausal BC. A logistic regression model was used and found the significant covariate effects (adjusted odds ratios, ORs) for a positive COVID-19 test among women with premenopausal BC to be being born outside of Europe: 1.29, (1.13–1.46), being married: 1.23, (1.12–1.36), being unemployed 1.92 (1.59–2.30), having upper secondary school education 1.25 (1.01–1.54), having > 15 outpatient visits: 1.31, (1.07–1.61), and a history of being admitted to hospital 1–5 times: 1.12 (1.01–1.25). Corresponding significant covariate effects among women with postmenopausal BC were being born outside of Europe: 1.61 (1.41–1.83), being married: 1.12 (1.04–1.21), and being unemployed 1.54 (1.40–1.69). Postmenopausal women furthermore had more outpatient visits or hospital admissions before the pandemic in COVID-19 positive patients compared to patients without a COVID-19 positive test, e.g. 1.47 (1.26–1.71) for > 15 outpatient visits compared with no visit and 6.35 (3.33–12.11) for > 15 hospital admissions compared with no admission. Varied socioeconomical and clinical conditions were more frequent among patients with a positive COVID-19 test compared to patients without a positive test among women with BC in pre- or post-menopausal status. We conclude that some characteristics of women such as unemployment, country of birth or health status measured by number of prescribed drugs were more prevalent among women who developed COVID-19 compared to women without COVID-19 diagnosis and either of menopausal status of breast cancer.

Ecological study of the association between the English national vaccination programme and area deprivation inequalities in COVID-19 mortality

ObjectiveTo understand how area deprivation inequalities in COVID-19 mortality changed during the national vaccination programme in England and to identify the extent to which these inequalities might be explained by...

Mild acute biliary pancreatitis: still a surgical disease. A post-hoc analysis of the MANCTRA-1 international study

BackgroundThe current standard of care for mild acute biliary pancreatitis (MABP) involves early laparoscopic cholecystectomy (ELC) to reduce the risk of recurrence. The MANCTRA-1 project revealed a knowledge-to-action gap and higher recurrence rates in patients admitted to medical wards, attributable to fewer ELCs being performed. The project estimated a 35% to 70% probability of narrowing this gap by 2025. This study evaluates the safety of suboptimal ELC implementation and identifies risk factors for recurrent acute biliary pancreatitis (RAP) in patients not undergoing ELC after an MABP episode.MethodsWe conducted a post-hoc analysis of the MANCTRA-1 registry, including MABP patients who did not undergo ELC during the index hospitalization, excluding those with related complications. The primary outcome was the 30-day hospital readmission rate due to RAP. We performed multivariable logistic regression to find risk factors associated with the primary outcome.ResultsBetween January 2019 and December 2020, 1920, MABP patients from 150 centers were included in the study. The 30-day readmission rate due to RAP was 6%. Multivariable logistic regression found the admission to a medical ward (internal medicine or gastroenterology) (OR = 1.95, p = 0.001) and a positive COVID-19 test (OR = 3.08, p = 0.029) as independent risk factors for RAP.ConclusionOur analysis offers valuable insights into the management of MABP, particularly in centers where ELC cannot be fully implemented due to logistical and clinical constraints, worsened by the COVID-19 pandemic. Regardless of the admitting ward, prompt access to surgical care is crucial in reducing the risk of early recurrence, highlighting the need to implement surgical consultation pathways within MABP care bundles.

Leveraging the McGeer Criteria to Estimate the Frequency of Inappropriate Antibiotic Prescribing for Urinary and Respiratory Tract Infections Relative to the Onset of the COVID-19 Pandemic at a Skilled Nursing Facility.

Background/Objectives: The COVID-19 pandemic affected antimicrobial stewardship in healthcare, including Skilled Nursing Facilities (SNFs). This study aimed to (1) assess the appropriateness of antibiotic prescriptions for urinary tract infections (UTIs) and respiratory tract infections (RTIs) and identify predictors of inappropriate use; (2) analyze changes in prescribing practices relative to the pandemic's onset. Methods: A retrospective review of electronic medical records from a 300-bed SNF (March 2019-March 2021) identified suspected UTIs and RTIs based on laboratory tests and antibiotic requests. Antibiotic prescription appropriateness was defined by clinical and microbiological alignment with the McGeer criteria, which are standardized infection definitions for long-term care residents, for UTI and RTI. Logistic regression models identified predictors of inappropriate prescribing, and an interrupted time-series analysis (ITS) examined trends relative to the pandemic onset (11 March 2020) in Arizona. Results: Among 370 antibiotic prescriptions, 77% of UTI and 61% of RTI prescriptions were inappropriate per the McGeer criteria. Acute dysuria and increased urgency were associated with lower odds of inappropriate UTI prescribing. For RTIs, a positive COVID-19 test increased the odds of inappropriate prescribing, while fever and acute functional decline lowered them. UTI prescriptions and inappropriateness overall increased during the pandemic, but no significant ITS trends emerged. For RTIs, no significant changes in prescribing or inappropriateness relative to the pandemic were observed. Findings emphasize the need for robust antimicrobial stewardship during and after public health emergencies.

Impact of COVID-19 Diagnosis on Weight Trajectories of Children in the US National COVID Cohort Collaborative.

The COVID-19 pandemic has exacerbated the obesity epidemic, with both adults and children demonstrating rapid weight gain during the pandemic. However, the impact of having a COVID-19 diagnosis on this trend is not known. Using longitudinal data from January 2019 to June 2023 collected by the US National Institute for Health's National COVID Cohort Collaborative (N3C), children (age 2-18 years) with positive COVID-19 test results (n=11,474, 53% male, mean [SD] age 5.57 [±3.29] years, 54% white, mean [SD] 5.2 [±2.9] BMI observations per participants) were matched with COVID-19 negative children with identical demographic characteristics and similar observation window. We compared BMI percentile trajectories between the COVID-19 positive and COVID-19 negative cohorts, with further evaluation performed on COVID-19 positive patients stratified by hospitalization status. COVID-19 positive patients had a greater increase in %BMI p95 than COVID-19 negative patients (average increase of 2.34 (±7.73) compared to 1.46 (±6.09), p<0.0005). COVID-19 positive patients gained more weight after their diagnosis of COVID-19 than before. Non-hospitalized children gained more weight than hospitalized children (average increase in %BMI p95 of 2.38 (±7.65)) compared to 1.87 (±8.54)). Mixed effect regression analyses demonstrated that these associations remained even after adjusting for time, demographics, and baseline %BMI p95 . Having a COVID-19 diagnosis was associated with more rapid weight gain, especially after diagnosis and early in the pandemic. Future research should explore the reasons for this association and the implications for future health emergencies. M.M.M. drafted the initial manuscript and assisted with the data curation, formal analysis, methodology, and visualization. T.T.P. assisted with the study design, interpretation of results, funding acquisition, and manuscript drafting and editing. C.T.B. and C.G.C assisted with formal analysis and interpretation of results. L.A.P. assisted with the interpretation of results and manuscript editing. R.B. supervised the study with study design, resources, funding acquisition, and manuscript editing. All authors assisted in the conceptualization of the study and approved it for publication. The authors declare no conflicts of interest. This study investigating the weight trajectories of children during the COVID-19 pandemic shows that the pandemic has led to a significant increase in weight gain among US children aged 6-11, with boys gaining more weight than girls. Non-hospitalized COVID-19-positive children were found to be at greater risk of gaining weight. The analyses described in this publication were conducted with data or tools accessed through the NCATS N3C Data Enclave https://covid.cd2h.org and N3C Attribution & Publication Policy v 1.2-2020-08-25b supported by NCATS U24 TR002306, Axle Informatics Subcontract: NCATS-P00438-B, [DUR RP-0BDD0E] and was supported by NIH awards, P20GM103446 and U54-GM104941. This research was possible because of the patients whose information is included within the data and the organizations ( https://ncats.nih.gov/n3c/resources/data-contribution/data-transfer-agreement-signatories ) and scientists who have contributed to the ongoing development of this community resource [ https://doi.org/10.1093/jamia/ocaa196 ].

Anti-nucleocapsid SARS-CoV-2 antibody seroprevalence in previously infected persons with immunocompromising conditions-United States, 2020-2022.

People with immunocompromising conditions (IC) are at increased risk of severe COVID-19 and death. These individuals show weaker immunogenicity following vaccination than individuals without IC, yet immunogenicity after SARS-CoV-2 infection is poorly understood. To address this gap, the presence of infection-induced antibodies in sera following a positive COVID-19 test result was compared between patients with and without IC. A commercial laboratory provided patient data gathered during July 2020-February 2022 on COVID-19 viral test results and antibody assay results, which included infection-induced (anti-N) antibody presence. Participants were categorized into having or not having IC based on if there was an indicative diagnostic code on their health record for a five-year period prior to the study period. Anti-N presence in sera from people with a positive COVID-19 test result was compared by IC status for four post-infection periods: 14-90, 91-180, 181-365, and 365+ days. A longitudinal, logistic regression produced adjusted odds ratios comparing anti-N prevalence among specimens with and without associated IC, adjusted for age, sex, residence in a metro area, and social vulnerability index (SVI) tertile. Data included 17,025 anti-N test results from 14,690 patients, 1,424 (9.7%) of which had at least one IC on record. In an adjusted comparison to patients without IC, patients with any IC were 0.61 times as likely to have infection-induced antibodies (99% CI: 0.40-0.93), during the 14-90 days following infection. Similar patterns were found when comparing people with two specific types of IC to people without any IC: (1) solid malignancies and (2) other intrinsic immune conditions. These findings stress the importance of prevention measures for people with IC, such as additional vaccination doses and consistent mask use before and after a documented infection.

Impact of COVID-19 Diagnosis on Weight Trajectories of Children in the US National COVID Cohort Collaborative.

Background: The COVID-19 pandemic has exacerbated the obesity epidemic, with both adults and children demonstrating rapid weight gain during the pandemic. However, the impact of having a COVID-19 diagnosis on this trend is not known. Methods: Using longitudinal data from January 2019 to June 2023 collected by the US National Institute for Health's National COVID Cohort Collaborative (N3C), children (age 2-18 years) with positive COVID-19 test results {n = 11,474, 53% male, mean [standard deviation (SD)] age 5.57 [±3.29] years, 54% White, mean [SD] 5.2 [±2.9] BMI observations per participant} were matched with COVID-19-negative children with identical demographic characteristics and similar observation window. We compared BMI percentile trajectories between the COVID-19-positive and COVID-19-negative cohorts, with further evaluation performed on COVID-19-positive patients stratified by hospitalization status. Results: COVID-19-positive patients had a greater increase in than COVID-19-negative patients (average increase of 2.34 (±7.73) compared to 1.46 (±6.09), p < 0.0005). COVID-19-positive patients gained more weight after their diagnosis of COVID-19 than before. Nonhospitalized children gained more weight than hospitalized children [average increase in of 2.38 (±7.65) compared to 1.87 (±8.54)]. Mixed-effect regression analyses demonstrated that these associations remained even after adjusting for time, demographics, and baseline . Conclusions: Having a COVID-19 diagnosis was associated with more rapid weight gain, especially after diagnosis and early in the pandemic. Future research should explore the reasons for this association and the implications for future health emergencies.

Kidney Function Decline After COVID-19 Infection

COVID-19 infection has been associated with acute kidney injury. However, its possible association with long-term kidney function is not well understood. To investigate whether kidney function decline accelerated after COVID-19 compared with after other respiratory tract infections. This cohort study used linked data from the Stockholm Creatinine Measurements (SCREAM) Project between February 1, 2018, and January 1, 2022, in Stockholm, Sweden. All hospitalized and nonhospitalized adults in the database with at least 1 estimated glomerular filtration rate (eGFR) measurement in the 2 years prior to a COVID-19 positive test result or pneumonia diagnosis were selected. Statistical analyses were conducted between June 2023 and October 2024. COVID-19 and pneumonia (including influenza). Mean annual change in eGFR after COVID-19 and after pneumonia was calculated with a linear regression model. The COVID-19 cohort comprised 134 565 individuals (74 819 females [55.6%]; median [IQR] age, 51 [37-64] years). The pneumonia cohort consisted of 35 987 individuals (19 359 females [53.8%]; median [IQR] age, 71 [56-81] years). The median (IQR) baseline eGFR was 94 (79-107) mL/min/1.73m2 for the COVID-19 cohort and 79 (61-92) mL/min/1.73m2 for the pneumonia cohort. After adjustment for covariates, both infections demonstrated accelerated annual eGFR decline, with greater magnitude of decline after COVID-19 (3.4% [95% CI, 3.2%-3.5%] after COVID-19; 2.3% [95% CI, 2.1%-2.5%] after pneumonia). This decline was more severe among individuals hospitalized for COVID-19 (5.4%; 95% CI, 5.2%-5.6%) but remained similar among those hospitalized for pneumonia. This cohort study found an association between COVID-19 and accelerated decline in kidney function, particularly after hospitalization, compared with pneumonia. People who were hospitalized for COVID-19 should receive closer monitoring of kidney function to ensure early diagnosis and optimized management of chronic kidney disease to effectively prevent complications and further decline.

Elevated Ambient Temperature Associated With Reduced Infectious Disease Test Positivity Rates: Retrospective Observational Analysis of Statewide COVID-19 Testing and Weather Across California Counties.

From medication usage to the time of day, a number of external factors are known to alter human body temperature (BT), even in the absence of underlying pathology. In select cases, clinical guidance already suggests the consideration of clinical and demographic factors when interpreting BT, such as a decreased threshold for fever as age increases. Recent work has indicated factors impacting BT extend to environmental conditions including ambient temperature. However, the effect sizes of these relationships are often small, and it remains unclear if such relationships result in a meaningful impact on real-world health care practices. Temperature remains a common element in public health screening efforts. Leveraging the unique testing and reporting infrastructure developed around the COVID-19 pandemic, this paper uses a unique resource of daily-level statewide testing data to assess the relationship between ambient temperatures and positivity rates. As fever was a primary symptom that triggered diagnostic testing for COVID-19, this work hypothesizes that environmentally mediated BT increases would not reflect pathology, leading to decreased COVID-19 test positivity rates as temperature rises. Statewide COVID-19 polymerase chain reaction testing data curated by the California Department of Public Health were used to obtain the daily number of total tests and positivity rates for all counties across the state. These data were combined with ambient temperature data provided by the National Centers for Environmental Information for a period of 133 days between widespread testing availability and vaccine approval. A mixed-effects beta-regression model was used to estimate daily COVID-19 test positivity rate as a function of ambient temperature, population, and estimates of COVID prevalence, with nested random effects for a day of the week within unique counties across the state. Considering over 19 million tests performed over 4 months and across 45 distinct counties, adjusted model results highlighted a significant negative association between daily ambient temperature and testing positivity rate (P<.001). Results of the model are strengthened as, using the same testing data, this relationship was not present in a sensitivity analysis using random daily temperatures drawn from the range of observed values (P=.52). These results support the underlying hypothesis and demonstrate the relationship between environmental factors and BT can impact an essential public health activity. As health care continues to operate using thresholds of BT as anchor points (ie, ≥100.4 as fever) it is increasingly important to develop approaches to integrate the array of factors known to influence BT measurement. Moreover, as weather data are not often readily available in the same systems as patient data, these findings present a compelling case for future research into when and how environmental context can best be used to improve the interpretation of patient data.

Clinical Features and Outcomes of Patients With COVID-19 Infection and Acute Kidney Injury Requiring Hemodialysis in an Intensive Care Unit: A Retrospective Study From a Tertiary Care Center in Eastern India.

During the COVID-19 pandemic, it has been observed that acute kidney injury (AKI) especially requiring intervention support of hemodialysis has notably increased mortality rates among COVID-19-positive critically ill patients;however, comprehensive data regarding this from India, especially the eastern territory, remains sparse. This study aims to outline the demographic, clinical, and biochemical characteristics, along with the outcomes, of these patients. A retrospective study was performed at the All India Institute of Medical Sciences (AIIMS), Patna, from March 1, 2020, to March 31, 2021. Included were patients diagnosed with COVID-19 and AKI necessitating hemodialysis during their intensive care unit (ICU) stay. These patients tested positive for COVID-19 and met the Kidney Disease: Improving Global Outcomes (KDIGO) criteria for AKI stages 1-3, requiring ICU admission and hemodialysis. Medical history, clinical features, laboratory results, comorbidities, and demographic data were collected and analyzed. Patients were tracked from admission to discharge or death. Gaussian-distributed values were compared using the unpaired t-test or Pearson's test, while non-Gaussian continuous variables were analyzed using the Mann-Whitney test or Spearman's test. The study employed the Kolmogorov-Smirnov test to assess Gaussian distribution, while categorical data were compared using the Chi-square test. Among 773 patients with positive COVID-19 tests who were admitted to the ICU, 236 patients developed AKI, andamong them, 139 patients required hemodialysis. The total mortality rate was 167 (70.7%) among people who had AKI and 102(77%) in patients with AKI who required hemodialysis. AKI was also a risk factor associated with higher mortality rates in older patients (>45 years) (n=150 (73.2%)), those needing invasive ventilation (n=163 (88.1%)), and patients with elevated total leucocyte count (TLC) (n=130 (79.3%)), lactate dehydrogenase (LDH) (n=159 (72.9%)), interleukin-6 (IL-6) (n=153 (72.2%)), and serum ferritin (n=51 (73.7%)) and hypoalbuminemia (n=152 (73.1%)). AKI requiring hemodialysis significantly increases mortality risk in COVID-19 patients. Other risk factors for mortality with AKI in COVID-19-positive patients include age, elevated leucocyte count, invasive ventilation, and deranged inflammatory markers.

Menstrual Abnormalities Strongly Associated with Proximity to COVID-19 Vaccinated Individuals

In Spring 2021, MyCycleStorySM launched a secure online survey to which 92.3% of 6049 respondents self-reported menstrual irregularities occurring after the rollout of the COVID-19 injectables. Each respondent served as her own control because prior to the rollout of COVID-19 vaccination, the vast majority had regular menstrual cycles. A subgroup of 3390 respondents were only indirectly exposed to COVID-19 vaccines or the SARS-CoV-2 virus. This subgroup reported 1) being unvaccinated for COVID-19; 2) having had no COVID-19 symptoms; and 3) no positive test for COVID-19, yet a substantial majority of these women, who were only indirectly exposed to COVID-19 injectables or COVID-19 infections still had many of the same menstrual abnormalities as the 2659 women who were directly exposed to a COVID-19 injection (798), or had COVID-19 symptoms (1347), or tested positive for COVID-19 (514). Generalized linear mixed modeling was used to examine the association (not assuming causation) between abnormal menses experienced after the COVID-19 vaccine rollout by respondents who were only indirectly exposed by some degree of proximity to persons. Chi-Square, Student’s t, Kruskal-Wallis or ANOVA tests were used to assess the statistical significance of the similarities of menstrual irregularities reported by the directly exposed and indirectly exposed groups. The mean age of the entire cohort was 37.8 ± 0.1 years. The percentage of the indirectly exposed participants who reported being within 6 feet of a COVID-19 vaccinated person was 85.5%. Of these, 71.7% had irregular menstrual symptoms within one week and 50.1% had irregular menstrual symptoms within ≤3 days after exposure. When comparing daily proximity to a vaccinated person, the categories of “daily within 6 feet outside the household” versus “seldom/sometimes/daily outside 6 feet” had the highest relative risk at 1.34 (p&lt;0.01) for heavier menstrual bleeding, early menses at more than 7 days early with a relative risk at 1.28 (p=0.03), and extended bleeding for more than 7 days with relative risk at 1.26 (p=0.04). Indirect exposure to COVID-19 vaccinated persons was significantly associated with the likelihood of the onset of menstrual irregularities. This study provides additional data to complement a growing body of evidence raising concerns regarding the safety of mRNA vaccines.

Gastrointestinal symptoms related to COVID-19 in ileoanal pouch and stoma patients.

COVID-19 symptoms are often perceived as respiratory only. However, recent findings have shown that gastrointestinal symptoms are being reported in a significant number of patients, ranging from 17% to more than 50%, with some studies speculating that the figure may be even higher, but that it is under-reported and overlooked. Therefore, a hypothesis was put forward that gastrointestinal symptoms related to COVID-19 may make pouch or stoma function deteriorate or even mimic pouchitis symptoms in ileoanal pouches and gastroenteritis in stoma patients; the intention was to investigate this further and to test the hypothesis. A retrospective analysis of patients with a stoma or ileoanal pouch was conducted, including those who reported having gastrointestinal symptoms following a positive COVID-19 test in the preceding 4 years (2020-2024). It was anticipated that gaining insight into this topic can help improve care for this patient group.

Between compulsions and contagions: examining the protective role of OCD against COVID-19 in a large cohort study.

Since the onset of the COVID-19 pandemic in 2020, a significant body of research has explored the impact of the virus and its preventative measures on mental health among individuals with OCD. However, to our knowledge, no study has been conducted to test whether the very behaviors considered symptomatic of OCD inadvertently offer a protective shield against COVID-19 infection. This retrospective cohort study utilized the electronic health record database of Israel's largest healthcare provider, Clalit Health Services (CHS), to compare patients with and without recorded OCD diagnoses in terms of the number of COVID-19 tests taken, hospitalizations, vaccination rates, and infection rates during and after different pandemic waves. The OCD group had a slightly higher rate of positive COVID-19 tests compared to the control group (p<0.001), but only since the easing of restrictions after the end of the fifth wave. The OCD group was also more likely to receive a third dose of the COVID-19 vaccine (p<0.001). Our findings suggest that OCD may not confer protection against COVID-19 and may even be associated with slightly higher infection rates, particularly in the post-restrictions period.

Reevaluating Diabetes and COVID-19 outcomes using national-level data

PurposeUsing a US nationally representative survey of adults, we aimed to evaluate the association between prevalent diabetes and the uptake of COVID-19 testing, rate of positive testing and symptom severity. MethodsData were sourced from the 2020-2021 National Health Interview Survey. COVID-19 outcomes were defined as: (1) test uptake (2) test positivity (3) diagnosis of COVID-19 and (4) severe disease symptoms with a positive COVID-19 test result. We compared the prevalence of COVID-19 outcomes by diabetes status and examined their associations using multivariate adjusted logistic and ordered logistic regression models. ResultsThe prevalence of test uptake and test positivity were 50.7% and 9.4% in the US population, respectively. 10.3% were diagnosed with COVID-19 infection by health professionals. There were no statistically significant differences in the outcomes by diabetes status. However, individuals with diabetes were more likely to have severe symptoms. In adjusted regression model, we found no significant associations of diagnosed diabetes with all outcomes. ConclusionsOur findings contrast with prior evidence derived from hospitalized patients. Researchers and policy makers are encouraged to review the properties of data sources and their impact on public health recommendations, particularly in response to future pandemics.

Deriving and validating a risk prediction model for long COVID: a population-based, retrospective cohort study in Scotland.

Using electronic health records, we derived and internally validated a prediction model to estimate risk factors for long COVID and predict individual risk of developing long COVID. Population-based, retrospective cohort study. Scotland. Adults (≥18 years) with a positive COVID-19 test, registered with a general medical practice between 1 March 2020 and 20 October 2022. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for predictors of long COVID, and patients' predicted probabilities of developing long COVID. A total of 68,486 (5.6%) patients were identified as having long COVID. Predictors of long COVID were increasing age (aOR: 3.84; 95% CI: 3.66-4.03 and aOR: 3.66; 95% CI: 3.27-4.09 in first and second splines), increasing body mass index (BMI) (aOR: 3.17; 95% CI: 2.78-3.61 and aOR: 3.09; 95% CI: 2.13-4.49 in first and second splines), severe COVID-19 (aOR: 1.78; 95% CI: 1.72-1.84); female sex (aOR: 1.56; 95% CI: 1.53-1.60), deprivation (most versus least deprived quintile, aOR: 1.40; 95% CI: 1.36-1.44), several existing health conditions. Predictors associated with reduced long COVID risk were testing positive while Delta or Omicron variants were dominant, relative to when the Wild-type variant was dominant (aOR: 0.85; 95% CI: 0.81-0.88 and aOR: 0.64; 95% CI: 0.61-0.67, respectively) having received one or two doses of COVID-19 vaccination, relative to unvaccinated (aOR: 0.90; 95% CI: 0.86-0.95 and aOR: 0.96; 95% CI: 0.93-1.00). Older age, higher BMI, severe COVID-19 infection, female sex, deprivation and comorbidities were predictors of long COVID. Vaccination against COVID-19 and testing positive while Delta or Omicron variants were dominant predicted reduced risk.

ASSESSMENT OF THE VOLUME OF PERINATAL CARE DURING THE COVID-19 PANDEMIC IN A SEPARATE REGION

An evidence-based approach is needed to improve the quality of care for mothers and newborns, prevent infections, and combat pandemics. The aim is to assess the volume of perinatal care during the COVID-19 pandemic in a separate region of Ukraine (using the Ivano-Frankivsk region as an example). Materials and methods of research. Statistical analysis of cases was carried out based on data from the electronic integrated disease surveillance system (EIDSS) and data from the "Ivano-Frankivsk Regional Perinatal Center" (RPC). Data from the State Statistics Service of Ukraine and statistical documents from the Ministry of Health of Ukraine were used. Bibliosemantic, analytical, statistical, and conceptual methods were used. The research period is 2020–2023. Results. The shortcomings of providing perinatal medical care during the COVID-19 pandemic include incompleteness of statistical reporting, insufficient provision of diagnostic and treatment tools (test systems, means for respiratory support, etc.), inadequate methodological and informational support for doctors regarding the management of pregnant women with COVID-19 (especially in the initial stages of the pandemic), organizational shortcomings (insufficient compliance with sanitary and epidemiological regulations, as evidenced by 9 cases of pregnant medical staff and 8 cases of positive COVID-19 tests in newborns). Conclusion. The identified shortcomings indicate the need to improve the provision of perinatal care in the event of possible future pandemics.

The Impact of Comorbidity and Age on the Risk of Hospitalization and Mortality in Patients with Previous COVID-19 Infection-Based on Nationwide Data.

Objectives: The influence of comorbidity on long-term hospitalization and mortality after COVID-19 in adults (40-59 years) and older adults (≥60 years) is yet to be explored. Methods: This is a Danish population-based cohort study of patients with a first-time positive PCR test for COVID-19 from 1 March 2020, to 28 February 2022 (N = 1,034,103). Exposed cohorts were patients with 1) a Charlson Comorbidity Index (CCI) score of 1-2 and 2) a CCI score ≥3, who were compared to patients without comorbidity (CCI of zero) within the groups of adults (67.9%) and older adults (32.1%) for the risk of hospitalization and mortality. Next, within the age groups, each disease category of the CCI was considered as an exposed cohort and compared to patients who did not have the specific disease of interest. Adjusted hazard ratios (HR) for hospitalization and mortality were estimated by Cox regression models adjusted for confounders. Results: The highest HRs were in adult patients with a CCI score of ≥3. The adjusted HR was 4.54 (95%CI: 4.38-4.70) for hospitalization, and among older adults it was 3.05 (95%CI: 2.99-3.11). The adjusted HR for mortality among adults with a CCI score ≥3 was 21.04 (95%CI: 18.86-23.47), and the adjusted HR for mortality among older adults was 4.61 (95%CI: 4.44-4.78). The underlying disease influenced the risk estimates among adults and older adults, and "dementia" had the highest impact on mortality. Conclusion: A CCI score of 1 or above increases the risk of hospitalization and mortality up to 2 years after a positive PCR test of COVID-19 for adults and older adults. Further, the type of underlying disease in older adults highly influences the risk of hospitalization and mortality.