scholarly journals Doxycycline and Hydroxychloroquine as Treatment for High-Risk COVID-19 Patients: Experience from Case Series of 54 Patients in Long-Term Care Facilities

2020 ◽  
Author(s):  
Imtiaz Ahmad ◽  
Mohammud Alam ◽  
Ryan Saadi ◽  
Saborny Mahmud ◽  
Emily Saadi
Keyword(s):  
New York ◽  
High Risk ◽  
Combination Therapy ◽  
Long Term Care ◽  
Indirect Comparison ◽  
Case Series ◽  
Term Care ◽  
Clinical Recovery ◽  
Care Facilities

Importance: Patients in long-term care facilities (LTCF) are at a high-risk of contracting COVID-19 due to advanced age and multiple comorbidities. Without effective treatments, outbreaks in such facilities will become commonplace and will result in severe morbidity and mortality. The effectiveness of doxycycline (DOXY) and hydroxychloroquine (HCQ) combination therapy in high risk COVID-19 patients in long-term care facilities is not yet understood. Objective: The goal of this analysis is to describe outcomes after use of DOXY-HCQ combination in high-risk COVID-19 patients in LTCF. Design: Case-series analysis. Setting: Three (3) LTCFs in New York. Participants: From March 19 to March 30, 2020, fifty-four (54) patients, residents of three (3) LTCFs in New York and diagnosed (confirmed or presumed) with COVID-19, were included in this analysis. Exposure: All patients who were diagnosed (confirmed or presumed) with COVID-19 received DOXY-HCQ combination therapy along with standard of care. Main Outcomes and Measures: Patients characteristics, clinical recovery, radiological improvements, medication side-effects, hospital transfer, and death were assessed as outcome measures. Results: A series of fifty-four (54) high-risk patients, who developed a sudden onset of fever, cough, and shortness of breath (SOB) and were diagnosed or presumed to have COVID-19, were started with a combination of DOXY-HCQ and 85% (n=46) patients showed clinical recovery defined as: resolution of fever and SOB, or a return to baseline setting if patients are ventilator-dependent. A total of 11% (n=6) patients were transferred to acute care hospitals due to clinical deterioration and 6% (n=3) patients died in the facilities. Naive Indirect Comparison suggests these data were significantly better outcomes than the data reported in MMWR (reported on March 26, 2020) from a long-term care facility in King County, Washington where 57% patients were hospitalized, and 22% patients died. Conclusion: The clinical experience of this case series indicates DOXY-HCQ treatment in high-risk COVID-19 patients is associated with a reduction in clinical recovery, decreased transfer to hospital and decreased mortality were observed after treatment with DOXY-HCQ.

scholarly journals Clinical Outcomes of Early Treatment With Doxycycline for 89 High-Risk COVID-19 Patients in Long-Term Care Facilities in New York

Cureus ◽  
2020 ◽  
Author(s):  
Mohammud M Alam ◽  
Saborny Mahmud ◽  
Mohammad M Rahman ◽  
JoAnn Simpson ◽  
Sandeep Aggarwal ◽  
...  
Keyword(s):  
New York ◽  
High Risk ◽  
Clinical Outcomes ◽  
Early Treatment ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities

Building-level analyses to prospectively detect influenza outbreaks in long-term care facilities: New York City, 2013-2014

2015 ◽  
Vol 43 (8) ◽  
pp. 839-843 ◽  
Author(s):  
Alison Levin-Rector ◽  
Beth Nivin ◽  
Alice Yeung ◽  
Annie D. Fine ◽  
Sharon K. Greene
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Influenza Outbreaks ◽  
Building Level

Improving the Fate of Nursing Homes During the COVID-19 Pandemic: The Need for Policy

2021 ◽  
pp. e1-e3
Author(s):  
R. Tamara Konetzka
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
Nursing Homes ◽  
Long Term Care ◽  
New York Times ◽  
The United States ◽  
Term Care ◽  
Care Facilities

Approximately 40% of all COVID-19 deaths in the United States have been linked to long-term care facilities.1 Early in the pandemic, as the scope of the problem became apparent, the nursing home sector generated significant media attention and public alarm. A New York Times article in mid-April referred to nursing homes as “death pits”2 because of the seemingly uncontrollable spread of the virus through these facilities. This devastation continued during subsequent surges,3 but there is a role for policy to change this trajectory. (Am J Public Health. Published online ahead of print January 28, 2021: e1–e3. https://doi.org/10.2105/AJPH.2020.306107 )

High-Risk Medication Use in Older Residents of Long-Term Care Facilities: Prevalence, Harms, and Strategies to Mitigate Risks and Enhance Use

2020 ◽  
Vol 35 (10) ◽  
pp. 419-433 ◽  
Author(s):  
Janet K. Sluggett ◽  
Stephanie L. Harrison ◽  
Leona A. Ritchie ◽  
Alexander J. Clough ◽  
Debbie Rigby ◽  
...  
Keyword(s):  
High Risk ◽  
Long Term Care ◽  
Medication Use ◽  
Aged Care ◽  
Residential Aged Care ◽  
Term Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Older residents of long-term care facilities (LTCFs), also known as nursing homes, care homes, or residential aged care facilities, often have multiple health conditions and are exposed to polypharmacy. Use of high-risk medications such as opioids, glucose-lowering medications, antithrombotics, and antipsychotics is prevalent among residents of LTCFs. Ensuring appropriate use of high-risk medications is important to minimize the risk of medication-related harm in this vulnerable population. This paper provides an overview of the prevalence and factors associated with high-risk medication use among residents of LTCFs. Evidencebased strategies to optimize the use of high-risk medications and enhance resident outcomes are also discussed.

High-Risk Medication Use in Older Residents of Long-Term Care Facilities: Prevalence, Harms, and Strategies to Mitigate Risks and Enhance Use

2020 ◽  
Vol 35 (10) ◽  
pp. 419-433
Author(s):  
Janet K. Sluggett ◽  
Stephanie L. Harrison ◽  
Leona A. Ritchie ◽  
Alexander J. Clough ◽  
Debbie Rigby ◽  
...  
Keyword(s):  
High Risk ◽  
Long Term Care ◽  
Medication Use ◽  
Aged Care ◽  
Residential Aged Care ◽  
Term Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Older residents of long-term care facilities (LTCFs), also known as nursing homes, care homes, or residential aged care facilities, often have multiple health conditions and are exposed to polypharmacy. Use of high-risk medications such as opioids, glucose-lowering medications, antithrombotics, and antipsychotics is prevalent among residents of LTCFs. Ensuring appropriate use of high-risk medications is important to minimize the risk of medication-related harm in this vulnerable population. This paper provides an overview of the prevalence and factors associated with high-risk medication use among residents of LTCFs. Evidencebased strategies to optimize the use of high-risk medications and enhance resident outcomes are also discussed.

Cross-sectional Survey of Long-Term Care Facilities in the Rockaway Peninsula: Preparedness and Response During Hurricane Sandy

2017 ◽  
Vol 12 (2) ◽  
pp. 194-200
Author(s):  
Lynn Jiang ◽  
Christopher Tedeschi ◽  
Saleena Subaiya
Keyword(s):  
New York ◽  
Large Scale ◽  
Long Term Care ◽  
Geographic Area ◽  
Hurricane Sandy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities

AbstractBackgroundFew studies have described the challenges experienced by long-term care facilities (LTCFs) following Hurricane Sandy. This study examined LTCF preparedness and experiences during and after the storm.MethodsA cross-sectional survey was conducted 2 years after Hurricane Sandy to assess LTCF demographics, preparation, and post-storm resources. Surveys were conducted at LTCFs located on the Rockaway Peninsula of New York City. All LTCFs located in a heavily affected area were approached.ResultsOf 29 facilities, 1 had closed, 5 did not respond, 9 declined to participate, and 14 participated, yielding a response rate of 50% for open facilities. Twenty-one percent of the facilities had preparations specifically for hurricanes. More than 70% of the facilities had lost electricity, heat, and telephone service, and one-half had evacuated. Twenty-one percent of the facilities reported not receiving any assistance and over one-half reported that relief resources did not meet their needs.ConclusionsMany LTCFs lacked plans specific to such a large-scale event. Since nearly all of the LTCFs in the region were affected, preexisting transportation and housing plans may have been inadequate. Future preparation could include hazard-specific planning and reliance on resources from a wider geographic area. Access to electricity emerged as a top priority. (Disaster Med Public Health Preparedness. 2018;12:194–200)

scholarly journals Environmental Noise in New York City Long Term Care Facilities: A Window into the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jennifer L. Martin ◽  
Diana Hernandez ◽  
Mary P. Cadogan ◽  
Abraham A. Brody ◽  
Cathy A. Alessi ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Long Term Care ◽  
Environmental Noise ◽  
Term Care ◽  
Care Facilities

scholarly journals Immunogenicity of SARS-CoV-2 Vaccine in Dialysis

2021 ◽  
Author(s):  
Eduardo Lacson ◽  
Christos P Argyropoulos ◽  
Harold J Manley ◽  
Gideon Aweh ◽  
Andrew I Chin ◽  
...  
Keyword(s):  
High Risk ◽  
Long Term Care ◽  
Morbidity And Mortality ◽  
Dialysis Patients ◽  
Term Care ◽  
Seropositive Rate ◽  
Care Facilities ◽  
Maximum Titer ◽  
Maintenance Dialysis

Abstract Importance: Patients receiving maintenance dialysis patients are at high risk for morbidity and mortality from COVID-19. The immunogenicity of SARS-CoV-2 mRNA vaccines is unknown in this vulnerable population where immune compromise is common. Objective: To determine seroresponse to vaccination against SARS-CoV-2 utilizing mRNA vaccines among patients receiving maintenance dialysis. Design: Retrospective observational study. Setting: Dialysis Clinic, Inc. (DCI) outpatient dialysis clinics in the United States. Participants: All patients receiving maintenance dialysis that received two doses of SARS-CoV-2 mRNA vaccines with SARS-CoV-2 spike-antibody test results drawn at least 14 days after the second dose, as documented in the electronic health record through March 18, 2021. Exposure: Two doses of BNT162b2/Pfizer or of mRNA-1273/Moderna vaccines administered per manufacturer recommendations. Main Outcomes and Measures: Levels of immunoglobulin-G against the receptor binding domain of the S1 subunit of SARS-CoV-2 spike antigen (seropositive: 2 or greater) using FDA-approved semi-quantitative chemiluminescent assay (ADVIA Centaur XP/XPT COV2G). The DCI clinical protocol for in-clinic administration included baseline and follow-up levels although initial administration of the vaccine occurred primarily elsewhere (e.g. long-term care facilities, hospitals, etc.) during the evaluation period. Hence, only post-vaccination antibody levels were reported. Results: Among 186 patients receiving maintenance dialysis from 32 clinics in 8 states tested an average of 23 days after receiving 2 vaccine doses, mean age was 68 years, with 47% women, 21% Black, 26% residents in long-term care facilities and 97% undergoing in-center hemodialysis. Overall seropositive rate was 165/186 (88.7%) with 70% at maximum titer and with no significant difference in seropositivity between BNT162b2/Pfizer (N=148) and mRNA-1273/Moderna (N=18) vaccines (88.1% vs. 94.4%, p=0.42). Among patients with COVID-19 history, seropositive rate was 38/38 (100%) with 97% at maximum titer. Conclusions and Relevance: Most patients receiving maintenance dialysis were seropositive after two doses of BNT162b2/Pfizer or mRNA-1273/Moderna vaccine. Early evidence suggests that vaccinated dialysis patients with prior COVID-19 develop robust antibody response. These results support an equitable and aggressive vaccination strategy for all eligible patients receiving maintenance dialysis, regardless of age, sex, race, ethnicity, or disability, to prevent the extremely high morbidity and mortality associated with COVID-19 in this high risk population.

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