scholarly journals Epidemiological and Clinical Characteristics of Coronavirus Disease 2019 in Shenzhen, the Largest Migrant City of China

2020 ◽  
Author(s):  
Ying Wen ◽  
Lan Wei ◽  
Yuan Li ◽  
Xiujuan Tang ◽  
Shuo Feng ◽  
...  
Keyword(s):  
Clinical Features ◽  
Large Population ◽  
Population Based ◽  
Clinical Severity ◽  
Risk Assessments ◽  
Severe Illness ◽  
Close Monitoring ◽  
Population Mobility ◽  
Medical Visit ◽  
And Control

AbstractWe conducted a retrospective study among 417 confirmed COVID-19 cases from Jan 1 to Feb 28, 2020 in Shenzhen, the largest migrant city of China, to identify the epidemiological and clinical features in settings of high population mobility. We estimated the median incubation time to be 5.0 days. 342 (82.0%) cases were imported, 161 (38.6%) cases were identified by surveillance, and 247 (59.2%) cases were reported from cluster events. The main symptoms on admission were fever and dry cough. Most patients (91.4%) had mild or moderate illnesses. Age of 50 years or older, breathing problems, diarrhea, and longer time between the first medical visit and admission were associated with higher level of clinical severity. Surveillance-identified cases were much less likely to progress to severe illness. Although the COVID-19 epidemic has been contained in Shenzhen, close monitoring and risk assessments are imperative for prevention and control of COVID-19 in future.Article Summary LineWe characterized epidemiological and clinical features of a large population-based sample of COVID-19 cases in the largest migrant city of China, and our findings could provide knowledge of SARS-CoV-2 transmission in the context of comprehensive containment and mitigation efforts in similar settings.

Pregnancy Experience after Delivery of a Child with a Major Birth Defect: A Population Study

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 59-65
Author(s):  
Margarett K. Davis ◽  
Muin J. Khoury ◽  
J. David Erickson
Keyword(s):  
Birth Defects ◽  
Reproductive Behavior ◽  
Birth Defect ◽  
Large Population ◽  
Population Based ◽  
Subsequent Pregnancy ◽  
Pregnancy Rates ◽  
Wide Range ◽  
First Year Of Life ◽  
And Control

Objective. Data from a large population-based, case-control study were analyzed to determine whether women giving birth to children with major birth defects have different subsequent pregnancy patterns than those giving birth to live-born babies without defects. Other studies examining this phenomenon have been smaller, have not been population-based, or have not addressed the different effects that a wide range of major defects might have on mothers' subsequent pregnancy rates. Methods. Mothers of 4918 infants with major birth defects born from 1968 through 1980 in metropolitan Atlanta were compared with mothers of 3029 control infants, frequency-matched on birth year, birth hospital, and race. Results. The pregnancy rate in the first 3 years after the index birth was higher among case mothers (36%) than among control mothers (30%, P < .0001). This excess was seen for mothers of stillborn case infants (64%) and mothers of case infants who died in infancy (58%), but not for mothers of case infants who survived the first year of life (31%). Pregnancy rates varied by birth defect type. Maternal and infant factors varied among case and control subjects and influenced subsequent pregnancy rates. Conclusion. The reproductive behavior observed in this study supports the theory that mothers of nonsurviving children with birth defects compensate by acting to "replace" the lost child. Reproductive behavior was also strongly associated with having completed a previous pregnancy and by the type of birth defect.

scholarly journals Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Julio García-Suárez ◽  
◽  
Javier de la Cruz ◽  
Ángel Cedillo ◽  
Pilar Llamas ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cancer Therapy ◽  
Hematologic Malignancy ◽  
Large Population ◽  
Hematologic Malignancies ◽  
Population Based ◽  
Clinical Severity ◽  
Primary Study ◽  
Registry Study ◽  
Population Based Registry

Abstract Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. Methods In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. Results Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17–10.1 vs < 50 years), > 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). Conclusions In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.

scholarly journals Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study

2020 ◽  
Author(s):  
Julio García-Suárez* ◽  
Javier de la Cruz* ◽  
Ángel Cedillo ◽  
Pilar Llamas ◽  
Rafael Duarte ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cancer Therapy ◽  
Hematologic Malignancy ◽  
Large Population ◽  
Hematologic Malignancies ◽  
Population Based ◽  
Clinical Severity ◽  
Primary Study ◽  
Registry Study ◽  
Population Based Registry

Abstract Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumours. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterise disease severity and mortality, and evaluate potential prognostic factors for mortality.Methods In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centres between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy.Results Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male, and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥60 years (hazard ratios 3·17–10·1 vs <50 years), >2 comorbidities (1·41 vs ≤2), acute myeloid leukemia (2·22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) or conventional chemotherapy (1·50 vs no active therapy) were associated with increased mortality. Conversely, Ph-negative myeloproliferative neoplasms (0·33) and active treatment with hypomethylating agents (0·47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20).Conclusions In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk-stratification.

scholarly journals Frequency of soy food consumption and serum isoflavone concentrations among Chinese women in Shanghai

2004 ◽  
Vol 7 (6) ◽  
pp. 765-772 ◽  
Author(s):  
Cara L Frankenfeld ◽  
Johanna W Lampe ◽  
Jackilen Shannon ◽  
Dao L Gao ◽  
Roberta M Ray ◽  
...  
Keyword(s):  
Food Consumption ◽  
Chinese Women ◽  
Linear Trend ◽  
Large Population ◽  
Breast Disease ◽  
Population Based ◽  
Case Control ◽  
Dietary Factors ◽  
Significant Linear Trend ◽  
And Control

AbstractObjective:The food-frequency questionnaire (FFQ) can be an efficient tool to evaluate dietary intake in large, population-based studies, especially for specific foods. The objective of this study was to validate the assessment of soy and isoflavone (daidzein and genistein) intakes, measured by an FFQ, by comparing intakes with serum isoflavone concentrations.Design and setting:Soy and isoflavone intakes and serum isoflavone concentrations were determined as part of a case–control study of dietary factors and risks of benign breast disease and breast cancer. The FFQ, administered during an in-person interview, included six soy-specific line items. Blood was drawn within one week of FFQ completion.Subjects:In total, 1823 women living in Shanghai, People's Republic of China.Results:In this population, soybean milk, fresh bean curd and other bean foods were eaten once per week, and fermented bean curd, fried bean curd puff and soybeans were eaten less than once per week. A significant linear trend (P > 0.01) in serum isoflavone concentrations across increasing categories of soy and isoflavone intakes was observed, indicating that soy and isoflavone intakes, measured by the FFQ, well distinguished serum isoflavone concentrations. Linear trends were also observed in both case and control groups in stratified analyses, suggesting little differential bias by case–control status.Conclusions:The results suggest that the FFQ provides a useful marker of soy food consumption and isoflavone exposure in this population.

scholarly journals Clinical features and the maternal and neonatal outcomes of pregnant women with coronavirus disease 2019

2020 ◽  
Author(s):  
Rui Nie ◽  
Shao-shuai Wang ◽  
Qiong Yang ◽  
Cui-fang Fan ◽  
Yu-ling Liu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pregnant Women ◽  
Clinical Features ◽  
Neonatal Outcomes ◽  
Clinical Severity ◽  
Severe Illness ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes

ABSTRACTBACKGROUNDThere is little information about the coronavirus disease 2019 (Covid-19) during pregnancy. This study aimed to determine the clinical features and the maternal and neonatal outcomes of pregnant women with Covid-19.METHODSIn this retrospective analysis from five hospitals, we included pregnant women with Covid-19 from January 1 to February 20, 2020. The primary composite endpoints were admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Secondary endpoints included the clinical severity of Covid-19, neonatal mortality, admission to neonatal intensive care unit (NICU), and the incidence of acute respiratory distress syndrome (ARDS) of pregnant women and newborns.RESULTSThirty-three pregnant women with Covid-19 and 28 newborns were identified. One (3%) pregnant woman needed the use of mechanical ventilation. No pregnant women admitted to the ICU. There were no moralities among pregnant women or newborns. The percentages of pregnant women with mild, moderate, and severe symptoms were 13 (39.4%),19(57.6%), and 1(3%). One (3.6%) newborn developed ARDS and was admitted to the NICU. The rate of perinatal transmission of SARS-CoV-2 was 3.6%.CONCLUSIONSThis report suggests that pregnant women are not at increased risk for severe illness or mortality with Covid-19 compared with the general population. The SARS-CoV-2 infection during pregnancy might not be associated with as adverse obstetrical and neonatal outcomes that are seen with the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection during pregnancy. (Funded by the National Key Research and Development Program.)

scholarly journals The role of HIV infection in the clinical spectrum of COVID-19: a population-based cohort analysis based on US National COVID Cohort Collaborative (N3C) Enclave data

2021 ◽  
Author(s):  
Xueying Yang ◽  
Jiajia Zhang ◽  
Siyuan Guo ◽  
Bankole Olatosi ◽  
Sharon Beth Weissman ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Population Based ◽  
Elevated Risk ◽  
Clinical Severity ◽  
Severe Illness ◽  
People Living With Hiv ◽  
Electronic Health Record Data ◽  
Interaction Terms ◽  
The Us ◽  
Age And Sex

Background Evidence of whether people living with HIV (PLWH) are at elevated risk of adverse COVID-19 outcomes is limited. We aimed to investigate this association using the population-based National COVID Cohort Collaborative (N3C) data in the US. Methods The harmonized, high-granularity electronic health record data from 54 clinical sites in N3C were used for this study. Logistic and multinomial logistic regression models were employed to estimate the association between HIV infection and hospitalization, mortality, and clinical severity of COVID-19, with models being initially adjusted for age and sex, then cumulatively adjusted for race and ethnicity, smoking and obesity, and a broad range of comorbidities. Interaction terms were added to assess the modification effect by age, sex, and race. Findings Among a total of 1,436,622 adult COVID-19 cases between January 2020 and May 2021, 13,170 had HIV infection. A total of 26,130 deaths occurred, with 445 among PLWH. PLWH had a higher risk of COVID-19 death and hospitalization than non-PLWH after adjusting for age and sex. The associations were attenuated, but remained significant, after adjusting for lifestyle factors and comorbidities (COVID-19 death: [adjusted OR(AOR): 1.38; 95%CI: 1.25-1.54]; hospitalization: [AOR: 1.23; 95%CI: 1.18-1.28]). In terms of COVID-19 disease severity, PLWH were less likely to have mild/moderate illness but more likely to have a severe illness when only controlling for demographics, smoking and BMI, although the estimated risk was obviated after controlling for comorbidities. Interaction terms revealed that the elevated risk was higher among the older age group, males, and black/African American. Interpretation PLWH in the US had an increased risk of COVID-19 hospitalization and mortality comparing with non-PLWH. The adverse COVID-19 outcomes might not only be accounted for by HIV but also by other risk factors that are highly prevalent in PLWH. Funding National Center for Advancing Translational Sciences, National Institute of Allergy And Infectious Diseases, US

scholarly journals Epidemiology and costs of post-sepsis morbidity, nursing care dependency, and mortality in Germany

2021 ◽  
Author(s):  
Carolin Fleischmann-Struzek ◽  
Norman Rose ◽  
Antje Freytag ◽  
Melissa Spoden ◽  
Hallie C. Prescott ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Nursing Care ◽  
Healthcare Costs ◽  
Large Population ◽  
Population Based ◽  
Severe Illness ◽  
First Year ◽  
Care Dependency ◽  
Hospitalization Costs ◽  
Health Insurance Provider

AbstractPurposeTo quantify the frequency and co-occurrence of new diagnoses consistent with post-sepsis morbidity, mortality, new nursing care dependency, and total healthcare costs after sepsis.MethodsPopulation-based cohort study using healthcare claims data from 23 million beneficiaries of a German health insurance provider. We included adult patients with incident hospital-treated sepsis identified by ICD-10 codes in 2013-2014. New medical, psychological and cognitive diagnoses associated with post-sepsis morbidity; mortality; dependency on nursing care; and total health care costs in survivors were assessed to 3 years after hospital discharge.ResultsAmong 116,507 sepsis patients who survived hospitalization for sepsis, 74.3% had a new medical, psychological or cognitive diagnosis in the first year after discharge. 20.6% and 3.8% had new diagnoses in two and three domains, respectively. 31.5% were newly dependent on nursing care, and 30.7% died within the first year. In the second and third year, 65.8% and 59.4% of survivors had new diagnoses, respectively. Healthcare costs totaled an average 36,585 Euro/patient in three years, including index hospitalization costs. Occurrence of new diagnoses in predefined subgroups was: 73.7% (survivors of non-severe sepsis), 75.6% (severe sepsis), 78.3% (ICU-treated sepsis), 72.8% (non-ICU treated sepsis) and 68.5% (survivors without prior diagnoses).ConclusionsNew medical, psychological and cognitive diagnoses consistent with post-sepsis morbidity are common after sepsis, including among patients with less severe sepsis, no prior diagnoses, and younger age. This calls for more efforts to elucidate the underlying mechanisms, define optimal screening for common new diagnoses, and test interventions to prevent and treat post-sepsis morbidity.Trial RegistrationDRKS00016340Take home messageThis large population-based cohort of over 100,000 survivors of hospital-treated sepsis found high rates and a broad spectrum of new diagnoses consistent with post-sepsis morbidity, frequent new nursing care dependency, and high long-term mortality 1-3 years post sepsis. Post-sepsis morbidity was not limited to the oldest survivors or those with the most severe illness, but also affected younger survivors and those without pre-existing diagnoses.

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