scholarly journals Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Koen F. Tieskens ◽  
Prasad Patil ◽  
Jonathan I. Levy ◽  
Paige Brochu ◽  
Kevin J. Lane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Mitigation ◽  
Ethnic Disparities ◽  
Care Facility ◽  
Community Level ◽  
Multiple Time ◽  
Term Care ◽  
Mixed Effect ◽  
Time Periods ◽  
Over Time

Abstract Background Associations between community-level risk factors and COVID-19 incidence have been used to identify vulnerable subpopulations and target interventions, but the variability of these associations over time remains largely unknown. We evaluated variability in the associations between community-level predictors and COVID-19 case incidence in 351 cities and towns in Massachusetts from March to October 2020. Methods Using publicly available sociodemographic, occupational, environmental, and mobility datasets, we developed mixed-effect, adjusted Poisson regression models to depict associations between these variables and town-level COVID-19 case incidence data across five distinct time periods from March to October 2020. We examined town-level demographic variables, including population proportions by race, ethnicity, and age, as well as factors related to occupation, housing density, economic vulnerability, air pollution (PM2.5), and institutional facilities. We calculated incidence rate ratios (IRR) associated with these predictors and compared these values across the multiple time periods to assess variability in the observed associations over time. Results Associations between key predictor variables and town-level incidence varied across the five time periods. We observed reductions over time in the association with percentage of Black residents (IRR = 1.12 [95%CI: 1.12–1.13]) in early spring, IRR = 1.01 [95%CI: 1.00–1.01] in early fall) and COVID-19 incidence. The association with number of long-term care facility beds per capita also decreased over time (IRR = 1.28 [95%CI: 1.26–1.31] in spring, IRR = 1.07 [95%CI: 1.05–1.09] in fall). Controlling for other factors, towns with higher percentages of essential workers experienced elevated incidences of COVID-19 throughout the pandemic (e.g., IRR = 1.30 [95%CI: 1.27–1.33] in spring, IRR = 1.20 [95%CI: 1.17–1.22] in fall). Towns with higher proportions of Latinx residents also had sustained elevated incidence over time (IRR = 1.19 [95%CI: 1.18–1.21] in spring, IRR = 1.14 [95%CI: 1.13–1.15] in fall). Conclusions Town-level COVID-19 risk factors varied with time in this study. In Massachusetts, racial (but not ethnic) disparities in COVID-19 incidence may have decreased across the first 8 months of the pandemic, perhaps indicating greater success in risk mitigation in selected communities. Our approach can be used to evaluate effectiveness of public health interventions and target specific mitigation efforts on the community level.

scholarly journals Time-varying associations between COVID-19 case incidence and community-level sociodemographic, occupational, environmental, and mobility risk factors in Massachusetts

2021 ◽  
Author(s):  
Koen Tieskens ◽  
Prasad Patil ◽  
Jonathan I. Levy ◽  
Paige Brochu ◽  
Kevin J. Lane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Undergraduate Students ◽  
Risk Mitigation ◽  
Ethnic Disparities ◽  
Care Facility ◽  
Community Level ◽  
Term Care ◽  
Mixed Effect ◽  
Time Periods ◽  
Over Time

Abstract Background: Associations between community-level risk factors and COVID-19 incidence are used to identify vulnerable subpopulations and target interventions, but the variability of these associations over time remains largely unknown. We evaluated variability in the associations between community-level predictors and COVID-19 case incidence in 351 cities and towns in Massachusetts from March to October 2020. Methods: Using publicly available sociodemographic, occupational, environmental, and mobility datasets, we developed mixed-effect, adjusted Poisson regression models to depict associations between these variables and town-level COVID-19 case incidence data across five distinct time periods. We examined town-level demographic variables, including z-scores of percent Black, Latinx, over 80 years and undergraduate students, as well as factors related to occupation, housing density, economic vulnerability, air pollution (PM2.5), and institutional facilities.Results: Associations between key predictor variables and town-level incidence varied across the five time periods. We observed reductions over time in the association with percentage Black residents (IRR=1.12 CI=(1.12-1.13) in spring, IRR=1.01 CI=(1.00-1.01) in fall). The association with number of long-term care facility beds per capita also decreased over time (IRR=1.28 CI=(1.26-1.31) in spring, IRR=1.07 CI=(1.05-1.09)in fall). Controlling for other factors, towns with higher percentages of essential workers experienced elevated incidence of COVID-19 throughout the pandemic (e.g., IRR=1.30 CI=(1.27-1.33) in spring, IRR=1.20, CI=(1.17-1.22) in fall). Towns with higher percentages of Latinx residents also had sustained elevated incidence over time (e.g., IRR=1.19 CI=(1.18-1.21) in spring, IRR=1.14 CI=(1.13-1.15) in fall). Conclusions: Town-level COVID-19 risk factors vary with time. In Massachusetts, racial (but not ethnic) disparities in COVID-19 incidence have decreased over time, perhaps indicating greater success in risk mitigation in selected communities. Our approach can be used to evaluate effectiveness of public health interventions and target specific mitigation efforts on the community level.

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

scholarly journals Evolution of anatomical concept usage over time: Mining 200 years of biodiversity literature

2017 ◽  
Author(s):  
Prashanti Manda ◽  
Todd J Vision
Keyword(s):  
Scientific Literature ◽  
Concept Drift ◽  
Multiple Time ◽  
Temporal Data Mining ◽  
Temporal Data ◽  
Initial State ◽  
Time Periods ◽  
Historic Record ◽  
Concept Usage ◽  
Over Time

The scientific literature contains an historic record of the changing ways in which we describe the world. Shifts in understanding of scientific concepts are reflected in the introduction of new terms and the changing usage and context of existing ones. We conducted an ontology-based temporal data mining analysis of biodiversity literature from the 1700s to 2000s to quantitatively measure how the context of usage for vertebrate anatomical concepts has changed over time. The corpus of literature was divided into nine non-overlapping time periods with comparable amounts of data and context vectors of anatomical concepts were compared to measure the magnitude of concept drift both between adjacent time periods and cumulatively relative to the initial state. Surprisingly, we found that while anatomical concept drift between adjacent time periods was substantial (55% to 68%), it was of the same magnitude as cumulative concept drift across multiple time periods. Such a process, bound by an overall mean drift, fits the expectations of a mean-reverting process.

scholarly journals Risk factors for pneumonia and influenza hospitalizations in long-term care facility residents: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Patience Moyo ◽  
Andrew R. Zullo ◽  
Kevin W. McConeghy ◽  
Elliott Bosco ◽  
Robertus van Aalst ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Importance of Bacterial Burden Among Methicillin-Resistant Staphylococcus aureus Carriers in a Long-Term Care Facility

2008 ◽  
Vol 29 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Nimalie D. Stone ◽  
Donna R. Lewis ◽  
H. K. Lowery ◽  
Lyndsey A. Darrow ◽  
Catherine M. Kroll ◽  
...  
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Nasal Swab ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Culture Positive ◽  
Epidemiologic Characteristics

Objective.To evaluate the prevalence and transmission of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization, as well as risk factors associated with MRSA carriage, among residents of a long-term care facility (LTCF).Design.Prospective, longitudinal cohort study.Setting.A 100-bed Veterans Administration LTCFParticipants.All current and newly admitted residents of the LTCF during an 8-week study period.Methods.Nasal swab samples were obtained weekly and cultured on MRSA-selective media, and the cultures were graded for growth on a semiquantitative scale from 0 (no growth) to 6 (heavy growth). Epidemiologic data for the periods before and during the study were collected to assess risk factors for MRSA carriage.Results.Of 83 LTCF residents, 49 (59%) had 1 or more nasal swab cultures that were positive for MRSA; 34 (41%) were consistently culture-negative (designated “noncarriers”). Of the 49 culture-positive residents, 30 (36% of the total of 83 residents) had all cultures positive for MRSA (designated “persistent carriers”), and 19 (23% of the 83 residents) had at least 1 culture, but not all cultures, positive for MRSA (designated “intermittent carriers”). Multivariate analysis showed that participants with at least 1 nasal swab culture positive for MRSA were likely to have had previous hospitalization (odds ratio, 3.9) or wounds (odds ratio, 8.2). Persistent carriers and intermittent carriers did not differ in epidemiologic characteristics but did differ in mean MRSA growth score (3.7 vs 0.7; P < .001).Conclusions.Epidemiologic characteristics differed between noncarriers and subjects with at least 1 nasal swab culture positive for MRSA. However, in this LTCF population, only the degree of bacterial colonization (as reflected by mean MRSA growth score) distinguished persistent carriers from intermittent carriers. Understanding the burden of colonization may be important when determining future surveillance and control strategies.

scholarly journals Risk factors for development of aminoglycoside resistance among gram-negative rods

2019 ◽  
Vol 76 (22) ◽  
pp. 1838-1847
Author(s):  
Stefan E Richter ◽  
Loren Miller ◽  
Jack Needleman ◽  
Daniel Z Uslan ◽  
Douglas Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Aminoglycoside Resistance ◽  
Term Care ◽  
Gram Negative ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
C Statistic

Abstract Purpose Development of scoring systems to predict the risk of aminoglycoside resistance and to guide therapy is described. Methods Infections due to aminoglycoside-resistant gram-negative rods (AR-GNRs) are increasingly common and associated with adverse outcomes; selection of effective initial antibiotic therapy is necessary to reduce adverse consequences and shorten length of stay. To determine risk factors for AR-GNR recovery from culture, cases of GNR infection among patients admitted to 2 institutions in a major academic hospital system during the period 2011–2016 were retrospectively analyzed. Gentamicin and tobramycin resistance (GTR-GNR) and amikacin resistance (AmR-GNR) patterns were analyzed separately. A total of 26,154 GNR isolates from 12,516 patients were analyzed, 6,699 of which were GTR, and 2,467 of which were AmR. Results In multivariate analysis, risk factors for GTR-GNR were presence of weight loss, admission from another medical or long-term care facility, a hemoglobin level of &lt;11 g/dL, receipt of any carbapenem in the prior 30 days, and receipt of any fluoroquinolone in the prior 30 days (C statistic, 0.63). Risk factors for AmR-GNR were diagnosis of cystic fibrosis, male gender, admission from another medical or long-term care facility, ventilation at any point prior to culture during the index hospitalization, receipt of any carbapenem in the prior 30 days, and receipt of any anti-MRSA agent in the prior 30 days (C statistic, 0.74). Multinomial and ordinal models demonstrated that the risk factors for the 2 resistance patterns differed significantly. Conclusion A scoring system derived from the developed risk prediction models can be applied by providers to guide empirical antimicrobial therapy for treatment of GNR infections.

A Norovirus Outbreak at a Long-Term-Care Facility: The Role of Environmental Surface Contamination

2005 ◽  
Vol 26 (10) ◽  
pp. 802-810 ◽  
Author(s):  
Henry M. Wu ◽  
Mary Fornek ◽  
Kellogg J. Schwab ◽  
Amy R. Chapin ◽  
Kristen Gibson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Rt Pcr ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Environmental Surface

AbstractBackground:The role of environmental surface contamination in the propagation of norovirus outbreaks is unclear. An outbreak of acute gastroenteritis was reported among residents of a 240-bed veterans long-term-care facility.Objectives:To identify the likely mode of transmission, to characterize risk factors for illness, and to evaluate for environmental contamination in this norovirus outbreak.Methods:An outbreak investigation was conducted to identify risk factors for illness among residents and employees. Stool and vomitus samples were tested for norovirus by reverse transcription polymerase chain reaction (RT-PCR). Fourteen days after outbreak detection, ongoing cases among the residents prompted environmental surface testing for norovirus by RT-PCR.Results:One hundred twenty-seven (52%) of 246 residents and 84 (46%) of 181 surveyed employees had gastroenteritis. Case-residents did not differ from non-case-residents by comorbidities, diet, room type, or level of mobility. Index cases were among the nursing staff. Eight of 11 resident stool or vomitus samples tested positive for genogroup II norovirus. The all-cause mortality rate during the month of the outbreak peak was significantly higher than the expected rate. Environmental surface swabs from case-resident rooms, a dining room table, and an elevator button used only by employees were positive for norovirus. Environmental and clinical norovirus sequences were identical.Conclusion:Extensive contamination of environmental surfaces may play a role in prolonged norovirus outbreaks and should be addressed in control interventions.

scholarly journals Risks and Prognoses of Alzheimer's Disease and Vascular Dementia in Patients With Insomnia: A Nationwide Population-Based Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Min Seok Baek ◽  
Kyungdo Han ◽  
Hyuk-Sung Kwon ◽  
Yong-ho Lee ◽  
Hanna Cho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Vascular Dementia ◽  
Cardiovascular Risk Factors ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

This study aimed to investigate the risk and prognosis of Alzheimer's disease (AD) and vascular dementia (VaD) in patients with insomnia using the National Health Insurance Service database covering the entire population of the Republic of Korea from 2007 to 2014. In total, 2,796,871 patients aged 40 years or older with insomnia were enrolled, and 5,593,742 controls were matched using a Greedy digit match algorithm. Mortality and the rate of admission to a long-term care facility were estimated using multivariable Cox analysis. Of all patients with insomnia, 138,270 (4.94%) and 26,706 (0.96%) were newly diagnosed with AD and VaD, respectively. The incidence rate ratios for AD and VaD were 1.73 and 2.10, respectively, in patients with insomnia compared with those without. Higher mortality rates and long-term care facility admission rates were also observed in patients with dementia in the insomnia group. Known cardiovascular risk factors showed interactions with the effects of insomnia on the risk of AD and VaD. However, the effects of insomnia on the incidence of AD and VaD were consistent between the groups with and without cardiovascular risk factors. Insomnia is a medically modifiable and policy-accessible risk factor and prognostic marker of AD and VaD.

scholarly journals Clinical features and risk factors for mortality among long-term care facility residents hospitalized due to COVID-19 in Spain

2021 ◽  
Author(s):  
José-Manuel Ramos-Rincón ◽  
Máximo Bernabeu-Whittel ◽  
Isabel Fiteni-Mera ◽  
Almudena López-Sampalo ◽  
Carmen López-Ríos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Long Term Care ◽  
Functional Dependence ◽  
Care Facility ◽  
Community Dwelling ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Abstract Background COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. Methods This is a cross-sectional analysis within a retrospective cohort of hospitalized patients≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Results Of 6,189 patients≥75 years, 1,185 (19.1%) were LTCF residents and 4,548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs. 82.1 years), mostly female (61.6% vs. 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs. 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p&lt;.001). Mortality risk factors in LTCF residents were severe functional dependence (aOR:1.79;95%CI:1.13-2.83;p=.012), dyspnea (1.66;1.16-2.39;p=.004), SatO2&lt;94% (1.73;1.27-2.37;p=.001), temperature≥37.8ºC (1.62;1.11-2.38; p=.013); qSOFA index≥2 (1.62;1.11-2.38;p=.013), bilateral infiltrates (1.98;1.24-2.98;p&lt;.001), and high C-reactive protein (1.005;1.003-1.007;p&lt;.001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR:0.74,95%CI:0.62-0.87;p&lt;.001). Conclusion Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.

Sign in / Sign up

Export Citation Format

Share Document