Experienced Symptoms Research Articles

Subsyndromes and symptom clusters: Multilevel factor analysis of behavioral and psychological symptoms of dementia with intensive longitudinal data.

Behavioral and psychological symptoms in dementia (BPSD) are dynamic phenomena with a high amount of intraindividual variability. We applied a multilevel framework to identify subsyndromes (between-person factors) that represent clinically relevant profiles of BPSD and identify symptom clusters (within-person factors) that represent contextually driven daily symptom experiences. This study used an intensive longitudinal design in which 68 co-residing family caregivers to persons living with dementia were recruited to proxy report on their care recipient's daily symptom experiences of 23 different BPSD for eight consecutive days (n=443 diaries). A multilevel exploratory/confirmatory factor analysis was used to account for nested data and separate within-person variances from between-level factor estimates. Exploratory factor analysis identified a 4-between 3-within factor structure based on fit statistics and clinical interpretability. This study offers major methodological and conceptual advancements for management of BPSD within Alzheimer's disease and related dementias by introducing two related but distinct concepts of subsyndromes and symptom clusters. Because behavioral and psychological symptoms of dementia (BPSD) are dynamic temporal phenomenon, this introduces measurement error into aggregate group-level estimates when trying to create subsyndromes. We propose a multilevel analysis to provide a more valid and reliable estimation by separating out variance due to within-person daily fluctuations. Using a multilevel exploratory factor analysis with intensive longitudinal data, we identified distinct and meaningful groups of BPSD. The four factors at the between-person level represented subsyndromes that are based on how BPSD co-occurred among persons with Alzheimer's disease (AD). These subsyndromes are clinically relevant because they share features of established clinical phenomena and may have similar neurobiological etiologies. We also found three within-person factors representing distinct symptom clusters. They are based on how BPSD clustered together on a given day for an individual with AD and related dementias. These clusters may have shared environmental triggers.

COVID-19 and Its Influence on Prevalence of Dementia and Agitation in Australian Residential Aged Care: A Comparative Study

Agitation is one of the most common and persistent behavioral and psychological symptoms among persons with dementia (PWD) in residential aged care facilities (RACFs). While most studies have explored the general impact of COVID-19 on the mental health and well-being of aged care residents, there has been limited research on the pandemic’s impact on agitation in dementia within RACFs. This knowledge is crucial to ensuring that RACFs are better equipped to handle future public health emergencies. Therefore, this retrospective cohort study investigates the impact of the pandemic on agitation incidents within 40 Australian RACFs. Using Python, we extracted agitation symptoms from nursing notes and compared the frequency and percentage of symptom occurrence pre-pandemic versus during-pandemic. Chi-square tests examined any significant change in the prevalence of dementia and agitation in dementia between the comparative groups and periods. Dementia prevalence dropped significantly during the second year of the pandemic, with a concurrent increase in early-onset dementia cases. Overall, agitation symptoms decreased by 20.1%, but six symptoms significantly increased: resisting (28.98%), wandering (11.78%), restlessness (3.19%), complaining (10.1%), arguing (2.36%), and outbursts (1.74%). Conversely, pacing decreased by 15.88% and speaking loudly decreased by 10.9%. Over half of the care recipients with dementia experienced agitation symptoms 2–5 times each year, increasing from 50.56% in 2019 to 58.28% in 2021. Despite the co-occurrence of symptoms such as falls, confusion, and weakness, there was no evidence to suggest that these comorbidities were specific to COVID-19; rather, they appeared to be prevalent even before the pandemic. Persons with agitation in dementia had a significantly higher death rate during the COVID-19 pandemic than otherwise.

MENSTRÜEL SEMPTOM YAŞAMA DURUMU İLE AİLEDE MENSTRÜEL SEMPTOM ÖYKÜSÜ VE ALGILADIKLARI SOSYAL DESTEK İLŞKİLİ Mİ: KESİTSEL ÇALIŞMA

This study aims to determine the relationship between menstrual symptom experience, the presence of menstrual symptoms in the family, and perceived social support in women of reproductive age. This descriptive and cross-sectional study was conducted with women aged 18–49 living in XXX on online platforms between April 1 and June 30, 2022. Participants were invited to the study through social media platforms. The women 942 constituted the sample of the research. The mean age of the women who participated in the study was 28.45±6.75 years. Of the participating women, 80.1% reported that they had regular menstruation and 71.1% had a family history of menstrual symptoms. The mean total scores of the Menstruation Symptom Questionnaire (MSQ) and Multidimensional Perceived Social Support Scale (MSPSS) were 63.02±16.07 and 66.97±14.95, respectively. The results of the study showed a strong relationship between experiencing menstrual symptoms and a history of menstrual symptoms in the family. There was a low-level significant relationship between experiencing menstrual symptoms and social support. Accordingly, it is recommended to conduct more studies on the relationship between social support and menstrual symptoms using an increased sample size and prospective methods.

A Rare Case of Occupational Aniline Poisoning: Management in a Limited-Facility Setting

Introduction Cyanosis along with altered mental should bring all the possible ethiologies into her mind in a minimum of time, based on the trauma, medical, environmental, and occupational history of the patient. Poisoning with methemoglobinemia inducing agents is one of the most important differentials especially when a history of occupational exposure to these agents is present. Case Report The patient, a 41-year-old healthy woman and engineer, experienced symptoms after exposure to aniline leading to dizziness and weakness, prompting a visit to the emergency department with cyanosis and low oxygen saturation. Initial vital signs showed decreased oxygen levels and elevated respiratory rate with normal ABG values despite ongoing cyanosis. Patient required intubation, mechanical ventilation, and was diagnosed with ARDS based on chest X-ray findings. Management included IV diuretics, 100% oxygen, and antioxidant treatment in the ICU. Despite treatment, oxygen saturation remained at 88% on the first day. Conclusion This case is a reminder of the importance of taking occupational history and management of aniline toxicity in a setting where methylene blue, the drug of choice for aniline toxicity, is not available in the drug stock.

Long COVID among healthcare workers: a narrative review of definitions, prevalence, symptoms, risk factors and impacts.

Long COVID (LC) occurs when people experience symptoms for weeks, months or even years after a COVID-19 infection. This review looks at research exploring the LC definitions, prevalence, symptoms, risk factors, and associated impacts in research on healthcare workers (HCWs). We systematically searched five electronic databases (CINAHL, EMBASE, Medline, PsycInfo and PubMed) and compiled a narrative literature review based on 56 relevant studies. LC is prevalent among HCWs who become infected by COVID-19. Many of the most frequent symptoms associated with LC in the general population are also reported among HCWs. Some risk factors for LC are also similar to those in the general population, such as female sex, older age, and having a pre-existing respiratory illness. The mechanism(s) responsible for LC remains unknown. A variety of terms, timeframes and symptoms are used to define LC, creating difficulties in comparing results across studies. Much of the research is cross-sectional and fails to explore the impacts that prolonged symptoms have on HCWs' personal and professional lives. The need to support HCWs with LC is clear. Identifying the mechanism(s) responsible for LC is a key priority, as this will inform treatments. Future research should move towards a standard definition for LC. Greater attention should be paid to longitudinal and qualitative studies, which could give insights into prognosis, lived experience and work participation. Finally, studies evaluating treatments suitable for people with LC are timely.

Cut-off point development for the Everyday Memory Questionnaire – Revised in perimenopausal women

Objective Subjective cognitive complaints have been reported in women during perimenopause and the Everyday Memory Questionnaire – Revised (EMQ-R) has been recently evaluated as a standardized instrument to measure subjective cognitive changes. The purpose of this study was to identify potential cut-off points for the EMQ-R retrieval subscale and attentional subscale, and to assess the validity of these cut-off points in detecting objective cognitive changes associated with reported subjective cognitive complaints. Method After screening, 232 perimenopausal women were included in the analyses. The supervised classification and regression tree was applied to identify optimal cut-off points. Its performance was evaluated by the value of the receiver operating characteristics curve, sensitivity and specificity. Results Findings revealed that the optimal cut-off point for the attentional subscale was 7, and for the retrieval subscale was 13. Both cut-off points presented acceptable discrimination performance. An independent t-test indicated that both cut-off points were associated with significant differences in scores on neuropsychological measures of retrieval (episodic memory and verbal fluency) as well as neuropsychological measures of higher-level attention (working memory). Conclusion The identified cut-off points may be helpful for women to track or quantify their subjective experiences of brain fog or cognitive symptoms during the menopause transition.

The Association Between Lifestyle and Symptoms of Polycystic Ovary Syndrome: A Study Conducted on Taif University Medical Students.

Introduction Polycystic ovary syndrome (PCOS) is a common endocrinological disorder affecting millions of women worldwide, often leading to significant physiological and psychological challenges among medical students because of unhealthy lifestyle behaviors. Methods A cross-sectional study was conducted among female medical students at Taif University in Saudi Arabia in January 2024 using an online questionnaire distributed via a Google form. Results Out of 243 participants, 23 students (9.5%) were diagnosed with PCOS. One hundred and fifty-six (64.9%) of females experienced skin symptoms, including acne and oily skin, mostly during exam periods. More than half (n=131, 54.4%) had generalized anxiety, and 42 students (17.4%) reported delays in the menstrual cycle. Significant associations were found between being diagnosed with PCOS and experiencing generalized anxiety(p=0.020), irregular menstrual cycles (p=0.004), having diabetes (p=0.006), family history of PCOS (p=0.001), and being aware of PCOS and lifestyle relation (p=0.022). Conclusion The study findings showed that Taif University medical students do not exhibit a noticeably increased prevalence of PCOS. Still, most students are at risk of developing PCOS due to thepositive family history of PCOS andexcessive generalized anxiety and females with irregularity in the menstrual cycle and those who have diabetes.

Picturing the Multiple Sclerosis Patient Journey: A Symptomatic Overview.

Background: Multiple sclerosis (MS) presents a wide range of clinical symptoms, historically understood through long-term studies of earlier patient cohorts. However, due to improved diagnostic criteria, modern patients are diagnosed earlier and benefit from effective treatments, altering the disease's natural history. This study aimed to assess the clinical symptoms of MS patients in a modern population at various stages: before diagnosis, at diagnosis, during the disease course, and at the time of the survey. Methods: This was an observational study with retrospective and cross-sectional components; patients that fulfilled the 2017 revised McDonald criteria for MS completed a survey evaluating demographic and clinical data. Results: We included 163 patients, 69.9% female, with a mean age of 48.21 years; 87.1% had relapsing-remitting MS (RRMS), with a median EDSS of 2.0. Before diagnosis, 74.2% of patients experienced symptoms, mainly sensory issues (39.3%), fatigue (29.4%), and imbalance (27%). Motor and coordination symptoms were more common in progressive forms. At diagnosis, sensory (46.6%) and motor complaints (36.8%) were most prevalent. In RRMS and secondary progressive MS (SPMS), sensory and motor complaints predominated alongside imbalance, while primary progressive MS (PPMS) was characterized by motor, imbalance, and genitourinary symptoms. Throughout the disease, sensory symptoms were most common (76.1%), with fatigue (73%) and motor issues (62.6%) more prevalent in progressive forms. At the time of the survey, 50.7% of RRMS patients were asymptomatic, while progressive patients continued to experience motor symptoms, imbalance, and fatigue. Conclusions: The study reflects the modern spectrum of MS symptoms, consistent with previous research.

Capturing the experience of borderline personality disorder symptoms in the daily lives of women with eating disorders.

Capturing the experience of borderline personality disorder symptoms in the daily lives of women with eating disorders.

Pulmonary embolism and intracardiac foreign bodies caused by bone cement leakage: a case report and literature review

Percutaneous vertebroplasty (PVP) is a surgical procedure that involves injecting polymethylmethacrylate (PMMA) bone cement into the diseased vertebrae to rapidly relieve pain and strengthen the vertebrae. We reported a 73-year-old patient who underwent percutaneous vertebroplasty (PVP) surgery for thoracolumbar vertebral compression fracture. After the surgery, the patient experienced symptoms such as chest tightness and dyspnea. Further examination revealed multiple high-density foreign bodies in the blood vessels/heart and concomitant multi-organ dysfunction. It was considered that the multi-organ embolism was caused by bone cement leakage. The patient improved after undergoing surgical treatment and anticoagulant therapy.

Integrating the Symptom Experience in Patients with Stage I-III Breast Cancer in China: A Qualitative Study

PurposeTo develop an in-depth understanding of the meaning of symptoms in the context of how women with stage I-III breast cancer in China coped with the effects of primary and adjuvant therapies for breast cancer. MethodA qualitative descriptive approach was used. A purposive sample of women diagnosed with stage I-III breast cancer were recruited from the “Be Resilient to Breast Cancer” study between November 2023 and March 2024. Data was collected from in person interviews using a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim. The framework analysis method was used to generate codes and themes. ResultsA sample of 17 women with breast cancer agreed to participate. The average age was 50.1 years (SD=8.45), and the majority (65%) had stage III. The overarching theme was Confronting Physical and Psychological Symptoms. The four themes explaining the experience were Changed Identity, Uncertainty, Finding Meaning and Seeking Support and Solace. Changed Identity and Uncertainty reflected the challenges of coping with multiple symptoms from the treatment. The themes of Finding Meaning and Seeking Support and Solace captured how women adapted a positive perspective to cope with the experience. ConclusionsThis study contributed to the evidence of the integration of the symptom experience in coping with breast cancer treatment in the context of a collectivist Chinese culture. It enhanced the understanding of the physical and psychological symptom experience of curative intent breast cancer therapy and offered insight into how women from China cope in early survivorship.

Abstract C013: Racial disparities in Interpersonal Processes of Care (IPC) during early stage breast cancer chemotherapy: Associations with symptoms and the ability to receive dose-intensive chemotherapy

Abstract Purpose: Documented racial disparities exist in the dose intensity of early-stage breast cancer (ESBC) chemotherapy, partly due to chemotherapy symptom toxicity and subsequent dose modifications. Effective communication is crucial for early symptom mitigation. We explored the associations between racial differences in patient-clinician communication, symptom experience, and the ability to receive the full dose of ESBC chemotherapy. Methods - A descriptive, correlational design compared clinician communication, symptoms, and the ability to obtain dose-intensive ESBC chemotherapy by race. Multi-site - large, urban breast cancer outpatient clinics. Patients completed the 18-item Interpersonal Processes of Care (IPC) and 13-item Symptom Distress Scale (SDS) at baseline and each chemotherapy visit. The IPC assesses clarity of communication, elicitation of concerns, explaining results, shared decision-making, compassion, discrimination due to race/ethnicity, and disrespectful office staff. Mean scores for IPC and SDS were calculated for each visit, and average scores across all visits were created for each participant; chemotherapy dose intensity - Receiving 85% or more of the prescribed chemotherapy within the projected timeline, dichotomized to yes or no—Analysis - IBM® SPSS®, version 27. Descriptive statistics were generated for raw data. Pearson’s correlations were used to examine bivariate associations and univariate and multivariate logistic or linear regression models to explore associations further. Results – N = 216 women, 37% - Black and 63% - White. The mean age was 52.99 ± 12.31 years. IPC - Black patients reported significantly higher (worse) IPC scores for "lack of clarity," "discrimination," and "disrespectful office staff" compared to White patients (all ps ≤ 0.01). Associations of SDS and IPC - Patients with higher IPC subscale scores for "lack of clarity," "discrimination," and "disrespectful office staff," and lower scores for "compassion and respect" experienced significantly higher levels of symptom distress (all ps < 0.05). Associations between IPC and Dose Intensity - Patients reporting higher (worse) discrimination scores were less likely to receive 85% of the prescribed chemotherapy. The IPC "discrimination" subdomain score was significantly associated with chemotherapy dose intensity (χ2(1)=6.910, p=0.009). Each one-unit increase in perceived "discrimination" subdomain score increased the likelihood of not receiving prescribed chemotherapy (B=0.985, OR=2.602, p=0.014) by approximately 160.2%. Conclusions - Black patients perceive poorer quality IPC than White patients during ESBC chemotherapy. Specific subdomains of IPC are associated with worse symptom distress and the inability to receive the full dose of ESBC chemotherapy, primarily driven by perceived discrimination. We must understand the relationship between race, communication, symptoms, and the ability to receive appropriate chemotherapy dose intensity. Citation Format: Margaret Q. Rosenzweig, Hiba Q. Abujaradeh. Racial disparities in Interpersonal Processes of Care (IPC) during early stage breast cancer chemotherapy: Associations with symptoms and the ability to receive dose-intensive chemotherapy [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C013.

Supplemental Material for Capturing the Experience of Borderline Personality Disorder Symptoms in the Daily Lives of Women With Eating Disorders

Supplemental Material for Capturing the Experience of Borderline Personality Disorder Symptoms in the Daily Lives of Women With Eating Disorders

Correlation between symptom experience and fear of cancer recurrence in postoperative breast cancer patients undergoing chemotherapy in China: A cross-sectional study.

To analyze the relationship between experience of symptoms (e.g., pain, fatigue) and fear of cancer recurrence (FCR) in Chinese postoperative patients with breast cancer undergoing chemotherapy. A total of 225 patients were recruited using convenience sampling. The Fear of Cancer Recurrence Inventory-Chinese Version and the Symptom Experience Index were used to collect data. The Mann-Whitney U test, Spearman's correlation, and multivariate analysis were employed to explore the relationships between symptom experience and FCR. The total Fear of Cancer Recurrence Inventory score in postoperative patients with breast cancer undergoing chemotherapy was 43.19±22.83, and >64.0% of participants exhibited significant fear of cancer recurrence. The total score of symptom experience was 27.41±16.77, including scores of symptom severity (16.91±8.70) and symptom distress (10.50±8.89). Participants' symptom experience was positively correlated with fear of cancer recurrence (r = 0.353, P < 0.001). Patients with clinically relevant FCR had higher scores for total symptom experience (Z = -3.911, P<0.001), symptom severity (Z = -3.245, P = 0.001), and symptom distress (Z = -4.185, P<0.001), compared to patients without clinically relevant FCR. Symptom experience (b = 0.511, t = 6.474, P<0.001), age (b = -0.591, t = -4.201, P<0.001), and educational level (b = 4.147, t = 3.955, P<0.001) were statistically correlated with FCR, accounting for 27.0% of the variance. Among these variables, symptom experience demonstrated the strongest correlation, with a beta value of 0.371. This study followed others in identifying a cross-sectional relationship between symptom experience and FCR. Further prospective research is required to better understand the nature of this relationship.

Measurement of Patients' Acceptable Symptom Levels and Priorities for Symptom Improvement in Advanced Prostate Cancer.

Limited research has evaluated the success criteria and priorities for symptom improvement of patients with cancer to inform patient-centered care. In this study, we adapted and tested a measure of these constructs, the Patient-Centered Outcomes Questionnaire (PCOQ), for patients with advanced prostate cancer. We compared acceptable symptom severity levels following symptom treatment across 10 symptoms and identified patient subgroups based on symptom importance. Patients with advanced prostate cancer (N = 99) participated in a one-time survey, which included a modified version of the PCOQ, standard symptom measures, and additional clinical characteristics. The modified PCOQ demonstrated construct validity through its correlations with related theoretical constructs. There was a moderate correlation between symptom severity and importance. Acceptable symptom severity levels were generally low, with sexual dysfunction having a higher acceptable severity than most other symptoms. Three patient subgroups were identified: (1) those who rated all symptoms as low in importance (n = 43); (2) those who rated all symptoms as moderately important (n = 33); and (3) those who rated all symptoms as highly important (n= 18). Subgroups were associated with functional status, fatigue, sleep problems, pain, and emotional distress. The modified PCOQ demonstrated preliminary evidence of construct validity. Patients generally considered low symptom severity to be acceptable, with variations across symptoms. Results suggest that symptom severity and importance are related but distinct aspects of the symptom experience in advanced prostate cancer. Patients' diverse priorities for symptom improvement point to the need for individualized treatment plans.

Affective symptoms in pregnancy are associated with the vaginal microbiome

BackgroundComposition of the vaginal microbiome in pregnancy is associated with adverse maternal, obstetric, and child health outcomes. Therefore, identifying sources of individual differences in the vaginal microbiome is of considerable clinical and public health interest. The current study tested the hypothesis that vaginal microbiome composition during pregnancy is associated with an individual's experience of affective symptoms and stress exposure. MethodsData were based on a prospective longitudinal study of a medically healthy community sample of 275 mother-infant pairs. Affective symptoms and stress exposure and select measures of associated biomarkers (diurnal salivary cortisol, serum measures of sex hormones) were collected at each trimester; self-report, clinical, and medical records were used to collect detailed data on socio-demographic factors and health behavior, including diet and sleep. Vaginal microbiome samples were collected in the third trimester (34–40 weeks) and characterized by 16S rRNA sequencing. Identified taxa were clustered into three community clusters (CC1–3) based on dissimilarity of vaginal microbiota composition. ResultsResults indicate that depressive symptoms during pregnancy were reliably associated with individual taxa and CC3 in the third trimester. Prediction of functional potential from 16S taxonomy revealed a differential abundance of metabolic pathways in CC1–3 and individual taxa, including biosynthetic pathways for serotonin and dopamine. We did not find robust evidence linking symptom- and stress-related biomarkers and CCs. ConclusionsOur results provide further evidence of how prenatal psychological distress during pregnancy alters the maternal-fetal microbiome ecosystem that may be important for understanding maternal and child health outcomes.

Traumatic stress in parents of children with congenital heart disease: a scoping review.

Congenital heart disease is the most common birth defect in the United States, with many of the affected infants requiring surgical and/or interventional procedures within their first year of life. The parental impacts of a child's diagnosis, subsequent hospitalization, and transition to home after discharge are numerous and burdensome, and many experience symptoms of traumatic stress along this trajectory. The purpose of this scoping review was to summarize current available literature related to the traumatic stress experienced by parents of children with heart disease to better understand the prevalence, related factors, and consequences. The Joanna Briggs Institute Scoping Review Framework was implemented to identify 31 relevant peer-reviewed articles published between 2000 and early 2024, including 25 quantitative studies, 3 qualitative studies, and 3 systematic reviews or meta-analyses. This scoping review provides an overview of parent traumatic stress for clinicians caring for children with heart disease at every stage of their clinical course.

Effectiveness of treatment with budesonide orodispersible tablets in 76 patients with eosinophilic oesophagitis – real-life experience from the population-based DanEoE cohort

Background Eosinophilic oesophagitis (EoE) is a chronic immune-mediated disease. In Denmark, the budesonide orodispersible tablet (BOT) is recommended as a second-line treatment for proton pump inhibitor-refractory EoE patients. Aims To evaluate the effectiveness of treatment with BOT in adult EoE patients in a population-based setting in Denmark. Methods This was a retrospective, registry-based, DanEoE cohort study of all 76 adult EoE patients treated with BOT and diagnosed between 2007 and 2021 in the North Denmark Region. After medical record revision, the EoE diagnosis was defined according to the AGREE consensus. Symptomatic response was based on the information found in the patients’ medical reports and histologic remission was defined as <15 eosinophils per high-power field (eos/hpf). Results Histologic remission was achieved in 89% of the patients treated with BOT who underwent histologic evaluation. Clinicohistologic remission was achieved in 71% of the patients who underwent both symptomatic and histologic evaluation. Despite histologic remission, 18% of patients still experienced symptoms. Non-responders were found in 7% of the patients. Complications were rare, with dilation of strictures performed in 7% and food bolus obstruction (FBO) occurring in 3%. Discontinuation of the treatment due to unacceptable side effects was observed in 11% of the treated patients. Conclusions Treatment with BOT effectively induced histologic remission in most of the EoE patients. Despite achieving histologic remission, approximately 1/5 of the patients were still symptomatic. Complications were rare. In non-responders and those with unacceptable side effects, alternative treatment options such as biologic agents might be needed.

COVID-19 vaccine uptake in a predominantly minoritized cohort hospitalized during the early pandemic in New York City

BackgroundMinoritized communities in the United States have had higher COVID-19 mortality and lower vaccine uptake. The influence of previous SARS-CoV-2 infection, initial disease severity, and persistent symptoms on COVID-19 vaccine uptake in Black and Latinx communities has not been examined. ObjectiveTo investigate whether initial COVID-19 severity, persistent symptoms, and other correlates affected vaccine uptake in a predominantly minoritized cohort hospitalized for COVID-19 during the early pandemic in New York City. DesignIn this historical cohort study, we abstracted electronic health record data on demographics, comorbidities, hospital oxygen requirements, symptoms at 3 and 6 months post-admission, COVID-19 vaccinations through November 2022, and influenza vaccinations during the 2018–2019 through 2021–2022 seasons. Unadjusted and adjusted odds ratios were estimated through logistic regression analyses of correlates of COVID-19 vaccination, on-time vaccination, and boosting. ParticipantsSurvivors among the first 1186 adult patients hospitalized for COVID-19 between March 1 and April 8, 2020 at a large quaternary care medical center in Northern Manhattan. Main MeasuresUptake of at least one COVID-19 vaccine dose, uptake of at least one booster, and on-time vaccination. Key ResultsThe 890 surviving individuals were predominantly Latinx (54%) and Non-Hispanic Black (15%). Most had one or more comorbidities (67%), and received at least one COVID-19 vaccine dose (78%). Among those vaccinated, 57% received at least one booster, and 31% delayed vaccination. 67% experienced persistent symptoms. Multiple logistic regression showed no association between vaccine uptake and disease severity or symptom persistence. However, older age and influenza vaccination during the COVID-19 era were associated with increased vaccination, booster uptake, and on-time vaccination. ConclusionsPinpointing drivers of vaccine uptake and hesitancy is critical to increasing and sustaining COVID-19 vaccination as the field transitions to annual boosters. The association between influenza vaccination and increased vaccine uptake suggests that bundling vaccines for adults may be an effective delivery strategy.

Incidence, symptom clusters and determinants of post-acute COVID symptoms: a population-based surveillance in community-dwelling users of the COVID RADAR app

ObjectivesThis study aims to describe the incidence, symptom clusters and determinants of post-acute COVID symptoms using data from the COVID RADAR app in the Netherlands.DesignProspective cohort.SettingGeneral population in the Netherlands...