scholarly journals Burdens of post-acute sequelae of COVID-19 by severity of acute infection, demographics and health status

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Yan Xie ◽  
Benjamin Bowe ◽  
Ziyad Al-Aly

AbstractThe Post-Acute Sequelae of SARS-CoV-2 infection (PASC) have been characterized; however, the burden of PASC remains unknown. Here we used the healthcare databases of the US Department of Veterans Affairs to build a cohort of 181,384 people with COVID-19 and 4,397,509 non-infected controls and estimated that burden of PASC—defined as the presence of at least one sequela in excess of non-infected controls—was 73.43 (72.10, 74.72) per 1000 persons at 6 months. Burdens of individual sequelae varied by demographic groups (age, race, and sex) but were consistently higher in people with poorer baseline health and in those with more severe acute infection. In sum, the burden of PASC is substantial; PASC is non-monolithic with sequelae that are differentially expressed in various population groups. Collectively, our results may be useful in informing health systems capacity planning and care strategies of people with PASC.

2021 ◽  
Author(s):  
Ziyad Al-Aly ◽  
Yan Xie ◽  
Benjamin Bowe

Abstract The Post-Acute Sequelae of SARS-CoV-2 infection (PASC) have been characterized; however, the burden of PASC remains unknown. And whether the burden of individual sequela varies in different population groups is also not clear. Here we estimate that PASC — defined as the presence of at least one sequela in excess of non-infected controls — was 73.43 (72.10, 74.72) per 1000 persons at 6 months. The burden of PASC was 44.51 (43.09, 45.85), 217.08 (212.43, 222.23), and 360.16 (350.53, 369.38) among non-hospitalized, hospitalized, and those who required intensive care during the first 30-days of infection. Burdens of some sequelae were more pronounced in younger individuals, and some were more pronounced in older adults; the same picture was evident in analyses across race, and sex groups. The burden of individual sequela was consistently higher in people with poorer baseline health and increased in a graded fashion according to care setting of the acute infection. In sum, the burden of PASC is substantial; however, PASC is non-monolithic with sequelae that are differentially expressed in various population groups. Collectively, our results may be useful in informing health systems capacity planning and care strategies of people with PASC.


2006 ◽  
Vol 1 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Jonathan B. Perlin

Ten years ago, it would have been hard to imagine the publication of an issue of a scholarly journal dedicated to applying lessons from the transformation of the United States Department of Veterans Affairs Health System to the renewal of other countries' national health systems. Yet, with the recent publication of a dedicated edition of the Canadian journal Healthcare Papers (2005), this actually happened. Veterans Affairs health care also has been similarly lauded this past year in the lay press, being described as ‘the best care anywhere’ in the Washington Monthly, and described as ‘top-notch healthcare’ in US News and World Report's annual health care issue enumerating the ‘Top 100 Hospitals’ in the United States (Longman, 2005; Gearon, 2005).


2006 ◽  
Vol 7 (4) ◽  
pp. 268-272 ◽  
Author(s):  
Mark Thomas Dransfield ◽  
Brion Jacob Lock ◽  
Robert I. Garver

2004 ◽  
Vol 2 (3) ◽  
pp. 75-80 ◽  
Author(s):  
Mark Brown ◽  
John Beatty ◽  
Steve O'Keefe ◽  
Arnold Bierenbaum ◽  
Margie Scott ◽  
...  

2016 ◽  
Vol 32 (1) ◽  
pp. 46-57 ◽  
Author(s):  
Claudia Der-Martirosian ◽  
Tiffany A. Radcliff ◽  
Alicia R. Gable ◽  
Deborah Riopelle ◽  
Farhad A. Hagigi ◽  
...  

AbstractIntroductionThere have been numerous initiatives by government and private organizations to help hospitals become better prepared for major disasters and public health emergencies. This study reports on efforts by the US Department of Veterans Affairs (VA), Veterans Health Administration, Office of Emergency Management’s (OEM) Comprehensive Emergency Management Program (CEMP) to assess the readiness of VA Medical Centers (VAMCs) across the nation.Hypothesis/ProblemThis study conducts descriptive analyses of preparedness assessments of VAMCs and examines change in hospital readiness over time.MethodsTo assess change, quantitative analyses of data from two phases of preparedness assessments (Phase I: 2008-2010; Phase II: 2011-2013) at 137 VAMCs were conducted using 61 unique capabilities assessed during the two phases. The initial five-point Likert-like scale used to rate each capability was collapsed into a dichotomous variable: “not-developed=0” versus “developed=1.” To describe changes in preparedness over time, four new categories were created from the Phase I and Phase II dichotomous variables: (1) rated developed in both phases; (2) rated not-developed in Phase I but rated developed in Phase II; (3) rated not-developed in both phases; and (4) rated developed in Phase I but rated not- developed in Phase II.ResultsFrom a total of 61 unique emergency preparedness capabilities, 33 items achieved the desired outcome – they were rated either “developed in both phases” or “became developed” in Phase II for at least 80% of VAMCs. For 14 items, 70%-80% of VAMCs achieved the desired outcome. The remaining 14 items were identified as “low-performing” capabilities, defined as less than 70% of VAMCs achieved the desired outcome.Conclusion:Measuring emergency management capabilities is a necessary first step to improving those capabilities. Furthermore, assessing hospital readiness over time and creating robust hospital readiness assessment tools can help hospitals make informed decisions regarding allocation of resources to ensure patient safety, provide timely access to high-quality patient care, and identify best practices in emergency management during and after disasters. Moreover, with some minor modifications, this comprehensive, all-hazards-based, hospital preparedness assessment tool could be adapted for use beyond the VA.Der-MartirosianC, RadcliffTA, GableAR, RiopelleD, HagigiFA, BrewsterP, DobalianA. Assessing hospital disaster readiness over time at the US Department of Veterans Affairs. Prehsop Disaster Med. 2017;32(1):46–57.


2015 ◽  
Vol 105 (9) ◽  
pp. 1935-1942 ◽  
Author(s):  
John F. McCarthy ◽  
Robert M. Bossarte ◽  
Ira R. Katz ◽  
Caitlin Thompson ◽  
Janet Kemp ◽  
...  

Cancer ◽  
2018 ◽  
Vol 124 (13) ◽  
pp. 2858-2858 ◽  
Author(s):  
Ibrahim Azar ◽  
Saghi Esfandiarifard ◽  
Pedram Sinai ◽  
Syed Mehdi

2018 ◽  
Vol 136 (5) ◽  
pp. 524 ◽  
Author(s):  
Kevin T. Stroupe ◽  
Joan A. Stelmack ◽  
X. Charlene Tang ◽  
Yongliang Wei ◽  
Scott Sayers ◽  
...  

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