scholarly journals Impact of Coronavirus Disease 2019 (COVID‐19) on Patients With Congenital Heart Disease Across the Lifespan: The Experience of an Academic Congenital Heart Disease Center in New York City

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Matthew J. Lewis ◽  
Brett R. Anderson ◽  
Michael Fremed ◽  
Melissa Argenio ◽  
Usha Krishnan ◽  
...  
Keyword(s):  
New York ◽  
Congenital Heart Disease ◽  
New York City ◽  
Heart Disease ◽  
York City ◽  
Congenital Heart ◽  
Severe Infection ◽  
Genetic Syndrome ◽  
Physiological Stage ◽  
The Impact

Background We sought to assess the impact and predictors of coronavirus disease 2019 (COVID‐19) infection and severity in a cohort of patients with congenital heart disease (CHD) at a large CHD center in New York City. Methods and Results We performed a retrospective review of all individuals with CHD followed at Columbia University Irving Medical Center who were diagnosed with COVID‐19 between March 1, 2020 and July 1, 2020. The primary end point was moderate/severe response to COVID‐19 infection defined as (1) death during COVID‐19 infection; or (2) need for hospitalization and/or respiratory support secondary to COVID‐19 infection. Among 53 COVID‐19‐positive patients with CHD, 10 (19%) were <18 years of age (median age 34 years of age). Thirty‐one (58%) had complex congenital anatomy including 10 (19%) with a Fontan repair. Eight (15%) had a genetic syndrome, 6 (11%) had pulmonary hypertension, and 9 (17%) were obese. Among adults, 18 (41%) were physiologic class C or D. For the entire cohort, 9 (17%) had a moderate/severe infection, including 3 deaths (6%). After correcting for multiple comparisons, the presence of a genetic syndrome (odds ratio [OR], 35.82; P =0.0002), and in adults, physiological Stage C or D (OR, 19.38; P =0.002) were significantly associated with moderate/severe infection. Conclusions At our CHD center, the number of symptomatic patients with COVID‐19 was relatively low. Patients with CHD with a genetic syndrome and adults at advanced physiological stage were at highest risk for moderate/severe infection.

Abstract MP30: The Health and Economic Impact of a Sugar Sweetened Beverage Tax in New York City: A Modeling Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Daniel D Bu ◽  
Stella S Yi ◽  
Heesun Eom ◽  
Rienna Russo ◽  
Brandon Bellows ◽  
...  
Keyword(s):  
New York ◽  
Coronary Heart Disease ◽  
New York City ◽  
Heart Disease ◽  
Economic Impact ◽  
York City ◽  
Cost Savings ◽  
Healthcare Sector ◽  
Health Improvement ◽  
The Impact

Background: Sugar-sweetened beverages (SSB) are currently the single largest source of added sugar in the US diet, and consumption in New York City (NYC) remains high. Evidence suggests that a high sugar consumption increases the risk of coronary heart disease. To date, excise taxes on SSB have been implemented in several US jurisdictions. While reductions in SSB consumption have been reported in several places where the SSB tax was implemented, it is unclear what the long term health and economic impact an SSB tax could have within the demographically and socioeconomically diverse NYC. In addition, the impact of varying tax structures remains unknown. Objective: To project the cardiovascular health outcomes and cost-savings of variations on the penny-per-ounce SSB tax structure (simulating a half-penny to two-penny range) using a validated microsimulation model of cardiovascular disease. Methods: The Simulations for Health Improvement and Equity (SHINE) CVD Model was used to estimate the lifetime direct medical costs (2019 USD) and effectiveness of SSB tax from a healthcare sector perspective. Population demographics and health profiles were estimated using data from the 2013-2014 NYC Health and Nutrition Examination Survey. CVD risk factor trajectories and risk of incident CVD events were derived from six pooled prospective U.S. cohorts. Policy effects and price elasticity were derived from recent meta-analyses. SSB tax was modeled to directly affect incidence rates of CVD events and was derived from variations of the penny-per-ounce tax scheme. Costs were discounted at 3%. Results: Compared to the non-policy situation, the SHINE CVD model projected that an SSB tax would prevent 29,341 (95% CI: 11,747-46,935) coronary heart disease (CHD) events at a half penny-per-ounce rate, 37,034 (95% CI: 19,336-54,732), at one penny-per-ounce, and 68,846 CHD events (95% CI: 51,306- 86,386) at a two-pennies-per-ounce rate over the simulated lifetimes of the NYC population. Total cost savings over this time period ranged from $662 million (95% CI $584-$741 million), $714 million (95% CI: $620-$808 million), and $1.03 billion (95% CI $0.92 - $1.16 billion), or $13.5 million/year, $14.6 million/year, $21.0 million/year for half-penny, one-penny, and two-pennies-per-ounce taxes respectively. Conclusion: Using a computer simulation model, we showed how different increments of the penny-per-ounce SSB tax could result in substantial benefits within the NYC population in terms of CVD outcomes and overall health care cost savings. Results from the SHINE CVD model may inform the ongoing policymaking efforts.

Congenital Cardiovascular Anomalies in Twins

PEDIATRICS ◽  
1960 ◽  
Vol 25 (1) ◽  
pp. 20-20
Author(s):  
S. G.
Keyword(s):  
New York ◽  
Congenital Heart Disease ◽  
New York City ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Investigation ◽  
Monozygotic Twins ◽  
Dizygotic Twins ◽  
Genetic And Environmental Factors ◽  
Cardiovascular Anomalies

This paper reports on a very carefully conducted clinical investigation of the etiologic factors involved in cardiovascular anomalies in twins. The author studied 37 pairs of twins in whom congenital heart disease was known to be present in at least one member of the pair. The patients were selected from several clinics in New York City; only those pairs of twins were chosen for whom the zygosity could be definitely determined and the presence or absence of a cardiovascular anomaly established. There were 26 pairs of dizygotic twins and 11 pairs of monozygotic twins in the study. Two pairs in each group were concordant (both co-twins affected) for the presence of cardiovascular anomalies; all other pairs were discordant (only one twin had congenital heart disease). The relative etiologic significance of genetic and environmental factors is discussed in the light of these observations.

The impact of medical interventions on admission characteristics in children with congenital heart disease and cardiomyopathy

2020 ◽  
pp. 1-8
Author(s):  
Rohit S. Loomba ◽  
Jacqueline Rausa ◽  
Vincent Dorsey ◽  
Ronald A. Bronicki ◽  
Enrique G. Villarreal ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Length Of Stay ◽  
Congenital Heart ◽  
Unit Length ◽  
Channel Blockers ◽  
Regression Analyses ◽  
Converting Enzyme Inhibitors ◽  
Medical Interventions ◽  
The Impact

Abstract Introduction: Children with congenital heart disease and cardiomyopathy are a unique patient population. Different therapies continue to be introduced with large practice variability and questionable outcomes. The purpose of this study is to determine the impact of various medications on intensive care unit length of stay, total length of stay, billed charges, and mortality for admissions with congenital heart disease and cardiomyopathy. Materials and methods: We identified admissions of paediatric patients with cardiomyopathy using the Pediatric Health Information System database. The admissions were then separated into two groups: those with and without inpatient mortality. Univariate analyses were conducted between the groups and the significant variables were entered as independent variables into the regression analyses. Results: A total of 10,376 admissions were included these analyses. Of these, 904 (8.7%) experienced mortality. Comparing patients who experienced mortality with those who did not, there was increased rate of acute kidney injury with an odds ratio (OR) of 5.0 [95% confidence interval (CI) 4.3 to 5.8, p < 0.01], cardiac arrest with an OR 7.5 (95% CI 6.3 to 9.0, p < 0.01), and heart transplant with an OR 0.3 (95% CI 0.2 to 0.4, p < 0.01). The medical interventions with benefit for all endpoints after multivariate regression analyses in this cohort are methylprednisolone, captopril, enalapril, furosemide, and amlodipine. Conclusions: Diuretics, steroids, angiotensin-converting enzyme inhibitors, calcium channel blockers, and beta blockers all appear to offer beneficial effects in paediatric cardiomyopathy admission outcomes. Specific agents within each group have varying effects.

The Impact of Customer Loyalty and Restaurant Sanitation Grades on Revisit Intention and the Importance of Narrative Information: The Case of New York Restaurant Sanitation Grading System

2017 ◽  
Vol 59 (3) ◽  
pp. 275-284 ◽  
Author(s):  
Min Gyung Kim ◽  
Hyunjoo Yang ◽  
Anna S. Mattila
Keyword(s):  
New York ◽  
New York City ◽  
Customer Loyalty ◽  
York City ◽  
Letter Grades ◽  
The Difference ◽  
Revisit Intentions ◽  
Using Data ◽  
The Impact ◽  
Loyal Customers

New York City launched a restaurant sanitation letter grade system in 2010. We evaluate the impact of customer loyalty on restaurant revisit intentions after exposure to a sanitation grade alone, and after exposure to a sanitation grade plus narrative information about sanitation violations (e.g., presence of rats). We use a 2 (loyalty: high or low) × 4 (sanitation grade: A, B, C, or pending) between-subjects full factorial design to test the hypotheses using data from 547 participants recruited from Amazon MTurk who reside in the New York City area. Our study yields three findings. First, loyal customers exhibit higher intentions to revisit restaurants than non-loyal customers, regardless of sanitation letter grades. Second, the difference in revisit intentions between loyal and non-loyal customers is higher when sanitation grades are poorer. Finally, loyal customers are less sensitive to narrative information about sanitation violations.

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