Increases in SARS-CoV-2 Test Positivity Rates Among Hispanic People in a Northern California Health System

Racial/ethnic minority groups are disproportionately affected by the COVID-19 pandemic. We examined ethnic differences in SARS-CoV-2 testing patterns and positivity rates in a large health care system in Northern California. The study population included patients tested for SARS-CoV-2 from March 4, 2020, through January 12, 2021, at Stanford Health Care. We used adjusted hierarchical logistic regression models to identify factors associated with receiving a positive test result. During the study period, 282 916 SARS-CoV-2 tests were administered to 179 032 unique patients, 32 766 (18.3%) of whom were Hispanic. Hispanic patients were 3 times more likely to receive a positive test result than patients in other racial/ethnic groups (odds ratio = 3.16; 95% CI, 3.00-3.32). The rate of receiving a positive test result for SARS-CoV-2 among Hispanic patients increased from 5.4% in mid-March to 15.7% in mid-July, decreased to 3.9% in mid-October, and increased to 21.2% toward the end of December. Hispanic patients were more likely than non-Hispanic patients to receive a positive test result for SARS-CoV-2, with increasing trends during regional surges. The disproportionate and growing overrepresentation of Hispanic people receiving a positive test result for SARS-CoV-2 demonstrates the need to focus public health prevention efforts on these communities.

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COVID-19 positive test result from a private hospital laboratory: Neglecting to report and problems with national infection control

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.93 ◽

2020 ◽

Vol 41 (7) ◽

pp. 875-876 ◽

Cited By ~ 1

Author(s):

Won Sriwijiatalai ◽

Viroj Wiwanitkit

Keyword(s):

Infection Control ◽

Private Hospital ◽

Positive Test ◽

Positive Test Result ◽

Hospital Laboratory ◽

Test Result

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Basic Predictive Risk Factors for Cytokine Storms in COVID-19 Patients

Frontiers in Immunology ◽

10.3389/fimmu.2021.745515 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sergey G. Shcherbak ◽

Anna Yu Anisenkova ◽

Sergei V. Mosenko ◽

Oleg S. Glotov ◽

Alexander N. Chernov ◽

...

Keyword(s):

Risk Factors ◽

Lymphocyte Count ◽

Absolute Lymphocyte Count ◽

Early Warning Score ◽

Positive Test ◽

City Hospital ◽

Cytokine Storm ◽

Positive Test Result ◽

Test Result ◽

D Dimer

ObjectiveA critical role in coronavirus disease 2019 (COVID-19) pathogenesis is played by immune dysregulation that leads to a generalized uncontrolled multisystem inflammatory response, caused by overproduction of proinflammatory cytokines, known as “a cytokine storm” (CS), strongly associated with a severe course of disease. The aim of this study is to identify prognostic biomarkers for CS development in COVID-19 patients and integrate them into a prognostic score for CS-associated risk applicable to routine clinical practice.Materials and MethodsThe authors performed a review of 458 medical records from COVID-19 patients (241 men and 217 women aged 60.0 ± 10.0) who received treatment in the St. Petersburg State Budgetary Institution of Healthcare City Hospital 40 (City Hospital 40, St. Petersburg), from Apr. 18, 2020 to Nov. 21, 2020. The patients were split in two groups: one group included 100 patients with moderate disease symptoms; the other group included 358 patients with progressive moderately severe, severe, and extremely severe disease. The National Early Warning Score (NEWS) score was used alongside with clinical assessment, chest computed tomographic (CT) scans, electrocardiography (ECG), and lab tests, like ferritin, C-reactive protein (CRP), interleukin (IL)-6, lactate dehydrogenase (LDH), and D-dimer.ResultsThe basic risk factors for cytokine storms in COVID-19 patients are male gender, age over 40 years, positive test result for replicative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, absolute lymphocyte count, dynamics in the NEWS score, as well as LDH, D-dimer, ferritin, and IL-6 levels. These clinical and instrumental findings can be also used as laboratory biomarkers for diagnosis and dynamic monitoring of cytokine storms. The suggested prognostic scale (including the NEWS score dynamics; serum IL-6 greater than 23 pg/ml; serum CRP 50 mg/L or greater; absolute lymphocyte count less than 0.72 × 109/L; positive test result for replicative coronavirus (SARS-CoV-2) RNA; age 40 years and over) is a useful tool to identify patients at a high risk for cytokine storm, requiring an early onset of anti-inflammatory therapy.

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Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021: population based case-control study

BMJ ◽

10.1136/bmj.n2060 ◽

2021 ◽

pp. n2060

Author(s):

Lynda Fenton ◽

Ciara Gribben ◽

David Caldwell ◽

Sam Colville ◽

Jen Bishop ◽

...

Keyword(s):

General Population ◽

Hospital Admission ◽

Healthcare Workers ◽

Population Based ◽

Positive Test ◽

Positive Test Result ◽

Working Age ◽

Household Members ◽

Test Result ◽

Control Study

Abstract Objective To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. Design Population based nested case-control study. Setting Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. Participants All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. Main outcome measures The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. Results Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed. Conclusion Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.

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Explaining a Positive Test Result to a Patient

Teaching Statistics ◽

10.1111/j.1467-9639.2009.00377.x ◽

2010 ◽

Vol 32 (3) ◽

pp. 76-77

Author(s):

Xian-Jin Xie

Keyword(s):

Positive Test ◽

Positive Test Result ◽

Test Result

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A Systematic Review of Interventions to Improve Initiation of Mental Health Care Among Racial-Ethnic Minority Groups

Psychiatric Services ◽

10.1176/appi.ps.201700382 ◽

2018 ◽

Vol 69 (6) ◽

pp. 628-647 ◽

Cited By ~ 9

Author(s):

Su Yeon Lee-Tauler ◽

John Eun ◽

Dawn Corbett ◽

Pamela Y. Collins

Keyword(s):

Mental Health ◽

Systematic Review ◽

Health Care ◽

Mental Health Care ◽

Ethnic Minority ◽

Minority Groups ◽

Ethnic Minority Groups ◽

Racial Ethnic

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Abstract 13150: Racial/Ethnic Disparities of the Impact of the COVID-19 Pandemic Out-of-Hospital Cardiac Arrest (OHCA) in Texas

Circulation ◽

10.1161/circ.144.suppl_2.13150 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Summer Chavez ◽

Ryan Huebinger ◽

Kevin Schulz ◽

Hei Kit Chan ◽

Micah Panczyk ◽

...

Keyword(s):

Cardiac Arrest ◽

Hospital Admission ◽

Minority Groups ◽

Ethnic Disparities ◽

Mixed Effect ◽

Neurological Outcomes ◽

Random Intercept ◽

Hispanic Patients ◽

The Impact ◽

Racial Ethnic

Introduction: Prior research shows a greater disease burden, lower BCPR rates, and worse outcomes in Black and Hispanic patients after OHCA. The CDC has declared that the COVID-19 pandemic has disproportionately affected many racial and ethnic minority groups. However, the influence of the COVID-19 pandemic on OHCA incidence and outcomes in different races and ethnicities is unknown. Purpose: To describe racial/ethnic disparities in OHCA incidence, processes of care and outcomes in Texas during the COVID-19 pandemic. Methods: We used data from the Texas Cardiac Arrest Registry to Enhance Survival (CARES) comparing adult OHCA from the pre-pandemic period (March 11 - December 31, 2019) to the pandemic period (March 11- December 31, 2020). The racial and ethnic categories were White, Black, Hispanic or Other. Outcomes were rates of BCPR, AED use, sustained ROSC, prehospital termination of resuscitation (TOR), survival to hospital admission, survival to discharge and good neurological outcomes. We fit a mixed effect logistic regression model, with EMS agency designated as the random intercept to obtain aORs. We adjusted for the pandemic and other covariates. Results: A total of 8,070 OHCAs were included. The proportion of cardiac arrests increased for Blacks (903 to 1, 113, 24.9% to 25.5%) and Hispanics (935 to 1,221, 25.8% to 27.5%) and decreased for Whites (1 595 to 1,869, 44.0% to 42.1%) and Other (194 to 220, 5.4% to 5.0%) patients. Compared to Whites, Black (aOR = 0.73, 95% CI 0.65-0.82) and Hispanic patients (aOR = 0.78, 95% CI 0.68-0.87) were less likely to receive BCPR. Compared to Whites, Blacks were less likely to have sustained ROSC (aOR = 0.81, 95% CI 0.70-0.93%), with lower rates of survival to hospital admission (aOR = 0.87, 95% CI 0.75-1.0), and worse neurological outcomes (aOR = 0.45, 95% 0.28-0.73). Hispanics were less likely to have prehospital TOR compared to Whites (aOR = 0.86, 95% CI = 0.75-0.99). The Utstein bystander survival rate was worse for Blacks (aOR = 0.72, 95% CI 0.54-0.97) and Hispanics (aOR = 0.71, 95% 0.53-0.95) compared to Whites. Conclusion: Racial and ethnic disparities persisted during the COVID-19 pandemic in Texas.

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‘Immunity Passports’ for SARS-CoV-2: an online experimental study of the impact of antibody test terminology on perceived risk and behaviour

BMJ Open ◽

10.1136/bmjopen-2020-040448 ◽

2020 ◽

Vol 10 (8) ◽

pp. e040448

Author(s):

Jo Waller ◽

G James Rubin ◽

Henry W W Potts ◽

Abigail L Mottershaw ◽

Theresa M Marteau

Keyword(s):

Perceived Risk ◽

Antibody Test ◽

Open Science ◽

Hand Washing ◽

Physical Contact ◽

Positive Test ◽

Positive Test Result ◽

Risk Of Infection ◽

The Impact ◽

Test Result

ObjectiveTo assess the impact of describing an antibody-positive test result using the terms Immunity and Passport or Certificate, alone or in combination, on perceived risk of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and protective behaviours.Design2×3 experimental design.SettingOnline.Participants1204 adults from a UK research panel.InterventionParticipants were randomised to receive one of six descriptions of an antibody test and results showing SARS-CoV-2 antibodies, differing in the terms describing the type of test (Immunity vs Antibody) and the test result (Passport vs Certificate vs Test).Main outcome measuresPrimary outcome: proportion of participants perceiving no risk of infection with SARS-CoV-2 given an antibody-positive test result. Other outcomes include: intended changes to frequency of hand washing and physical distancing.ResultsWhen using the term Immunity (vs Antibody), 19.1% of participants (95% CI 16.1% to 22.5%) (vs 9.8% (95% CI 7.5% to 12.4%)) perceived no risk of catching coronavirus given an antibody-positive test result (adjusted OR (AOR): 2.91 (95% CI 1.52 to 5.55)). Using the terms Passport or Certificate—as opposed to Test—had no significant effect (AOR: 1.24 (95% CI 0.62 to 2.48) and AOR: 0.96 (95% CI 0.47 to 1.99) respectively). There was no significant interaction between the effects of the test and result terminology. Across groups, perceiving no risk of infection was associated with an intention to wash hands less frequently (AOR: 2.32 (95% CI 1.25 to 4.28)); there was no significant association with intended avoidance of physical contact (AOR: 1.37 (95% CI 0.93 to 2.03)).ConclusionsUsing the term Immunity (vs Antibody) to describe antibody tests for SARS-CoV-2 increases the proportion of people believing that an antibody-positive result means they have no risk of catching coronavirus in the future, a perception that may be associated with less frequent hand washing.Trial registration numberOpen Science Framework: https://osf.io/tjwz8/files/

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Clinical predictors of a positive test result in patients undergoing genetic evaluation for a hereditary kidney cancer syndrome

Canadian Urological Association Journal ◽

10.5489/cuaj.6264 ◽

2019 ◽

Vol 14 (8) ◽

Author(s):

Andrea Kokorovic ◽

Aidan Thomas ◽

Jesus Serrano-Lomelin ◽

Meghan Ferguson ◽

Ricardo A. Rendon

Keyword(s):

High Risk ◽

Kidney Cancer ◽

Genetic Counselling ◽

Real Life ◽

Medical Genetics ◽

Positive Test ◽

Positive Test Result ◽

Clinical Implementation ◽

Cancer Syndrome ◽

Test Result

Introduction: Guidelines are available to assist providers in identifying patients with renal cell carcinoma (RCC) that may benefit from genetic counselling, however, the evidence for these recommendations lacks support from the literature and controversy remains as to who should be referred. We aimed to delineate risk factors associated with a positive genetic test in a real-life cohort of patients with RCC referred to a regional medical genetics unit for evaluation of a hereditary kidney cancer syndrome. Methods: Patients with a diagnosis of RCC referred to Maritime Medical Genetics Service (Nova Scotia, Canada) from 2006–2017 were reviewed using retrospective data. The primary outcome was identification of clinical features that were associated with a positive test result. Logistic regression models were used for analysis. Results: A total of 135 patients were referred to medical genetics for evaluation; 102 patients were evaluated, 75 underwent testing, and 74 were included in the final analysis. Five patients tested positive: three Birt Hogg Dube, one Cowden syndrome, and one Von Hippel Lindau. Presence of dermatological lesions (specifically fibrofolliculomas) and more than two high-risk features were the only predictors of a positive test result. Conclusions: The presence of dermatological lesions and more than two high-risk features are the only predictors of a positive test result in patients with a suspected hereditary kidney cancer syndrome. These findings are not reflected in current guidelines, and the clinical implementation of our results may improve the identification of high-risk patients for genetic counselling.

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