scholarly journals The Correlation between Racial/Ethnic Groups, Thrombosis, and Mortality in Hospitalized Patients with COVID-19

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3224-3224
Author(s):  
Maya Rodriguez ◽  
Wen Dai ◽  
Hayley Lund ◽  
Kristen Osinski ◽  
Ziyu Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Body Mass Index ◽  
Pulmonary Embolism ◽  
Ethnic Groups ◽  
Body Mass ◽  
Blood Clotting ◽  
Hospitalized Patients ◽  
The Other ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract The SARS-CoV-2 virus has infected hundreds of millions of people and caused millions of deaths worldwide. Reports of racial and ethnic disparities regarding both rates of infection of the SARS-CoV-2 virus and morbidity of the coronavirus disease-19 (COVID-19) contain profound differences depending on the population. A previous study found an independent and positive association between the Black/African American race and positive COVID-19 testing results in Milwaukee County, WI, while adjusting for age, sex, socioeconomic status, and comorbidities (Munoz-Price. et al, 2020, JAMA Network). Our previous study revealed that patients with COVID-19 who developed hypertriglyceridemia during their hospitalization were associated with a 2.3 times higher mortality rate, after adjusting for age, gender, body mass index, history of hypertension and diabetes (Dai. et al, 2021, manuscript accepted by Journal of Clinical Lipidology). Additionally, adverse blood clotting events is one of the major causes of death for patients with COVID-19. In this study, we investigated the correlation between racial/ethnic groups and mortality, along with potential correlations between hypertriglyceridemia and adverse blood clotting events in hospitalized patients with COVID-19 (ICD10CM:U07.1). De-identified data from 1,441 hospitalized patients diagnosed with COVID-19 between March 2020 and June 2021 were extracted using the Medical College of Wisconsin Clinical Research Data Warehouse. Vital, demographic, and diagnostic information were used for the statistical analysis, specifically: age, gender, body mass index (BMI), race/ethnicity, thrombosis diagnosis and laboratory test results for triglyceride. The thrombotic events included were presence of disseminated intravascular coagulopathy, deep vein thrombosis, myocardial infarction, pulmonary embolism, and stroke diagnosed during their hospitalization. Hypertriglyceridemia was characterized as triglyceride levels greater than 150 mg/dL, with a baseline variable being the first occurrence of hypertriglyceridemia (baseline), and the peak variable being the highest manifestation of hypertriglyceridemia during hospitalization (peak). A binary logistic regression model showed that non-white Hispanic and Asian patients both had a higher correlation with mortality than white patients, with odds ratios (OR) of 4.1 [95% CI (2.2-7.9), p < 0.001] and 4.2 [95% CI (1.8-9.8), p < 0.001], respectively, after adjusting for age, BMI, and sex (Figure A). Additionally, the regression analysis showed that peak hypertriglyceridemia developed during hospitalization was correlated with a 1.8 times higher mortality in the entire inpatient cohort [95% CI (1.2-2.9), p < 0.01], after adjusting for age, sex, and BMI and independent of obesity. Furthermore, myocardial infarction [OR = 1.5, 95% CI (1.-2.5), p < 0.05] and pulmonary embolism [OR = 2.0, 95% CI (1.1-4.1), p < 0.05] were also correlated with a higher mortality, after adjusting for age, BMI, and sex (Figure B). The peak hypertriglyceridemia developed during hospitalization correlates with the incidence of thrombotic events with a borderline significance [OR= 1.5, 95% CI (0.9-2.1), p = 0.05] after adjusting for BMI, age, and sex. Further analysis revealed that non-white Hispanic patients had the highest frequencies of peak hypertriglyceridemia (triglyceride > 150 mg/dL) occurrence during hospitalization than the other race/ethnicity groups (Figure C). On the other hand, 22% of non-white Hispanics had at least one diagnosis of thrombotic event during hospitalization, which was the lowest incidence of thrombosis among all race/ethnicity groups (Figure D). In our current retrospective study of inpatients with COVID-19, race/ethnicity, peak hypertriglyceridemia developed during hospitalization, and thrombosis are independently associated with mortality. The peak hypertriglyceridemia developed during hospitalization is positively correlated with the incidence of thrombosis. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Association between body mass index and 1-year outcome after acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D.W Kim
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Body Mass ◽  
Cardiac Death ◽  
Funding Source ◽  
Group Iii ◽  
End Point ◽  
Group I

Abstract Background Beneficial effects of overweight and obesity on mortality after acute myocardial infarction (AMI) have been described as “Body Mass Index (BMI) paradox”. However, the effects of BMI is still on debate. We analyzed the association between BMI and 1-year major cardiocerebrovascular events (MACCE) after AMI. Methods and findings Among 13,104 AMI patients registered in an Institute of Health in Korea between November 2011 and December 2015, 10,568 patients who eligible for this study were classified into 3 groups according to BMI (Group I; <22 kg/m2, 22 ≤ Group II <26 kg/m2, Group III; ≥26 kg/m2). The primary end point was a composite of cardiac death (CD), myocardial infarction (MI), target vessel revascularization (TVR), and cerebrovascular events at 1 year. Over the median follow-up of 12 months, the composite of primary end point occurred more frequently in the Group I patients than in the Group III patients (primary endpoint: adjusted hazard ratio [aHR], 1.290; 95% confidence interval [CI] 1.024 to 1.625, p=0.031). Especially, cardiac death in MACCE components played a major role in this effect (aHR, 1.548; 95% confidence interval [CI] 1.128 to 2.124, p=0.007). Conclusions Higher BMI appeared to be good prognostic factor on 1-year MACCE after AMI. This result suggests that higher BMI or obesity might confer a protective advantage over the life-quality after AMI. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Research of Korea Centers for Disease Control and Prevention and the Korea Health Technology R&D Project, Ministry of Health & Welfare (HI13C1527), Republic of Korea.

scholarly journals Trends in obesity and adiposity measures by race or ethnicity among adults in the United States 2011-18: population based study

BMJ ◽  
2021 ◽  
pp. n365
Author(s):  
Buyun Liu ◽  
Yang Du ◽  
Yuxiao Wu ◽  
Linda G Snetselaar ◽  
Robert B Wallace ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Waist Circumference ◽  
Ethnic Groups ◽  
Body Mass ◽  
Body Fat ◽  
Lean Mass ◽  
The United States ◽  
Population Based ◽  
Body Fat Percentage ◽  
Fat Percentage

AbstractObjectiveTo examine the trends in obesity and adiposity measures, including body mass index, waist circumference, body fat percentage, and lean mass, by race or ethnicity among adults in the United States from 2011 to 2018.DesignPopulation based study.SettingNational Health and Nutrition Examination Survey (NHANES), 2011-18.ParticipantsA nationally representative sample of US adults aged 20 years or older.Main outcome measuresWeight, height, and waist circumference among adults aged 20 years or older were measured by trained technicians using standardized protocols. Obesity was defined as body mass index of 30 or higher for non-Asians and 27.5 or higher for Asians. Abdominal obesity was defined as a waist circumference of 102 cm or larger for men and 88 cm or larger for women. Body fat percentage and lean mass were measured among adults aged 20-59 years by using dual energy x ray absorptiometry.ResultsThis study included 21 399 adults from NHANES 2011-18. Body mass index was measured for 21 093 adults, waist circumference for 20 080 adults, and body fat percentage for 10 864 adults. For the overall population, age adjusted prevalence of general obesity increased from 35.4% (95% confidence interval 32.5% to 38.3%) in 2011-12 to 43.4% (39.8% to 47.0%) in 2017-18 (P for trend<0.001), and age adjusted prevalence of abdominal obesity increased from 54.5% (51.2% to 57.8%) in 2011-12 to 59.1% (55.6% to 62.7%) in 2017-18 (P for trend=0.02). Age adjusted mean body mass index increased from 28.7 (28.2 to 29.1) in 2011-12 to 29.8 (29.2 to 30.4) in 2017-18 (P for trend=0.001), and age adjusted mean waist circumference increased from 98.4 cm (97.4 to 99.5 cm) in 2011-12 to 100.5 cm (98.9 to 102.1 cm) in 2017-18 (P for trend=0.01). Significant increases were observed in body mass index and waist circumference among the Hispanic, non-Hispanic white, and non-Hispanic Asian groups (all P for trend<0.05), but not for the non-Hispanic black group. For body fat percentage, a significant increase was observed among non-Hispanic Asians (30.6%, 29.8% to 31.4% in 2011-12; 32.7%, 32.0% to 33.4% in 2017-18; P for trend=0.001), but not among other racial or ethnic groups. The age adjusted mean lean mass decreased in the non-Hispanic black group and increased in the non-Hispanic Asian group, but no statistically significant changes were found in other racial or ethnic groups.ConclusionsAmong US adults, an increasing trend was found in obesity and adiposity measures from 2011 to 2018, although disparities exist among racial or ethnic groups.

scholarly journals Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Priya Bhagwat ◽  
Shashi N Kapadia ◽  
Heather J Ribaudo ◽  
Roy M Gulick ◽  
Judith S Currier
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Socioeconomic Factors ◽  
Ethnic Groups ◽  
Virologic Failure ◽  
Virologic Suppression ◽  
Factors Associated ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

Applying the Health Belief Model to Characterize Racial/Ethnic Differences in Digital Conversations Related to Depression Pre– and Mid–COVID-19 (Preprint)

2021 ◽  
Author(s):  
Ruby Castilla-Puentes ◽  
Jacqueline Pesa ◽  
Caroline Brethenoux ◽  
Patrick Furey ◽  
Liliana Gil Valletta ◽  
...  
Keyword(s):  
Health Belief Model ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Health Belief ◽  
Depression Symptoms ◽  
Seeking Help ◽  
Key Drivers ◽  
Race Ethnicity ◽  
Belief Model ◽  
Racial Ethnic

BACKGROUND The prevalence of depression symptoms in the United States is >3 times higher mid–COVID-19 versus pre-pandemic. Racial/ethnic differences in mindsets around depression and the potential impact of the COVID-19 pandemic are not well characterized. OBJECTIVE To describe attitudes, mindsets, key drivers, and barriers related to depression pre– and mid–COVID-19 by race/ethnicity using digital conversations about depression mapped to health belief model (HBM) concepts. METHODS Advanced search, data extraction, and AI-powered tools were used to harvest, mine, and structure open-source digital conversations of US adults who engaged in conversations about depression pre– (February 1, 2019-February 29, 2020) and mid–COVID-19 pandemic (March 1, 2020-November 1, 2020) across the internet. Natural language processing, text analytics, and social data mining were used to categorize conversations that included a self-identifier into racial/ethnic groups. Conversations were mapped to HBM concepts (ie, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy). Results are descriptive in nature. RESULTS Of 2.9 and 1.3 million relevant digital conversations pre– and mid–COVID-19, race/ethnicity was determined among 1.8 million (62%) and 979,000 (75%) conversations pre– and mid–COVID-19, respectively. Pre–COVID-19, 1.3 million conversations about depression occurred among non-Hispanic Whites (NHW), 227,200 among Black Americans (BA), 189,200 among Hispanics, and 86,800 among Asian Americans (AS). Mid–COVID-19, 736,100 conversations about depression occurred among NHW, 131,800 among BA, 78,300 among Hispanics, and 32,800 among AS. Conversations among all racial/ethnic groups had a negative tone, which increased pre– to mid–COVID-19; finding support from others was seen as a benefit among most groups. Hispanics had the highest rate of any racial/ethnic group of conversations showing an avoidant mindset toward their depression. Conversations related to external barriers to seeking treatment (eg, stigma, lack of support, and lack of resources) were generally more prevalent among Hispanics, BA, and AS than among NHW. Being able to benefit others and building a support system were key drivers to seeking help or treatment for all racial/ethnic groups. CONCLUSIONS Applying concepts of the HBM to data on digital conversation about depression allowed organization of the most frequent themes by race/ethnicity. Individuals of all groups came online to discuss their depression. There were considerable racial/ethnic differences in drivers and barriers to seeking help and treatment for depression pre– and mid–COVID-19. Generally, COVID-19 has made conversations about depression more negative, and with frequent discussions of barriers to seeking care. These data highlight opportunities for culturally competent and targeted approaches to address areas amenable to change that might impact the ability of people to ask for or receive mental health help, such as the constructs that comprise the HBM.

scholarly journals Impact of hypoalbuminemia, frailty, and body mass index on early prognosis in older patients (≥85 years) with ST-elevation myocardial infarction

2015 ◽  
Vol 66 (3) ◽  
pp. 263-268 ◽  
Author(s):  
Yasumori Sujino ◽  
Jun Tanno ◽  
Shintaro Nakano ◽  
Shuhei Funada ◽  
Yoshie Hosoi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Body Mass Index ◽  
Body Mass ◽  
Older Patients ◽  
St Elevation Myocardial Infarction ◽  
St Elevation
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