scholarly journals A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wil Lieberman-Cribbin ◽  
Naomi Alpert ◽  
Raja Flores ◽  
Emanuela Taioli

Abstract Background New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. Methods A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. Results The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p <  0.001) were statistically significantly positively associated with death rates. Conclusions Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wil Lieberman-Cribbin ◽  
Naomi Alpert ◽  
Raja Flores ◽  
Emanuela Taioli

Abstract Background Given the interplay between race and comorbidities on COVID-19 morbidity and mortality, it is vital that testing be performed in areas of greatest need, where more severe cases are expected. The goal of this analysis is to evaluate COVID-19 testing data in NYC relative to risk factors for COVID-19 disease severity and demographic characteristics of NYC neighborhoods. Methods COVID-19 testing and the racial/ethnic composition of NYC Zip Code Tabulation Areas (ZCTA) were obtained from the NYC Coronavirus data repository and the American Community Survey, respectively. The prevalence of neighborhood-level risk factors for COVID-19 severity according to the Centers for Disease Control and Prevention criteria for risk of severe illness and complications from COVID-19 were used to create a ZCTA-level risk index. Poisson regressions were performed to study the ratio of total tests relative to the total ZCTA population and the proportion of positive tests relative to the total tests performed over time. Results From March 2nd-April 6th, the total tests/population (%) was positively associated with the proportion of white residents (IRRadj: 1.0003, 95% CI: 1.0003–1.0004) and the COVID risk index (IRRadj: 1.038, 95% CI: 1.029–1.046). The risk index (IRRadj: 1.017, 95% CI: 0.939–1.101) was not associated with total tests performed from April 6th-May 12th, and inversely associated from May 12th-July 6th (IRRadj: 0.862, 95% CI: 0.814–0.913). From March 2nd-April 6th the COVID risk index was not statistically associated (IRRadj: 1.010, 95% CI: 0.987–1.034) with positive tests/total tests. From April 6th-May 12th, the COVID risk index was positively associated (IRRadj: 1.031, 95% CI: 1.002–1.060), while from May 12th-July 6th, the risk index was inversely associated (IRRadj: 1.135, 95% CI: 1.042–1.237) with positivity. Conclusions Testing in NYC has suffered from the lack of availability in high-risk populations, and was initially limited as a diagnostic tool for those with severe symptoms, which were mostly concentrated in areas where vulnerable residents live. Subsequent time periods of testing were not targeted in areas according to COVID-19 disease risk, as these areas still experience more positive tests.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emily DiMango ◽  
Kaitlyn Simpson ◽  
Elizabeth Menten ◽  
Claire Keating ◽  
Weijia Fan ◽  
...  

Abstract Background Evidence is conflicting regarding differential health outcomes in racial and ethnic minorities with cystic fibrosis (CF), a rare genetic disease affecting approximately 28,000 Americans. We performed a cross-sectional analysis of health outcomes in Black/Latinx patients compared with non-Hispanic Caucasian patients cared for in a CF center in New York City. Adult patients enrolled in the CF Foundation Patient Registry at the Columbia University Adult CF Program and seen at least once during 2019 were included. Health metrics were compared between Black/Latinx and non-Hispanic Caucasian patients. Results 262 patients were eligible. 39 patients (15%) identified as Black/Latinx or non-Hispanic Caucasian. Descriptive statistics are reported with mean (standard deviation). Current age was 35.9 (13.3) years for non-Hispanic Caucasian and 32.0 (9.3) years for Black/Latinx patients (p = 0.087). Age of diagnosis did not differ between groups; 9.56 (15.96) years versus 11.59 (15.8) years for non-Hispanic Caucasian versus Black/Latinx respectively (p = 0.464). Pulmonary function, measured as mean forced expiratory volume in one second (FEV1) was 70.6 (22.5) percent predicted in non-Hispanic Caucasian versus 59.50 (27.9) percent predicted in Black/Latinx patients (p = 0.010). Number of visits to the CF clinic were similar between groups. When controlled for age, gender, co-morbidities, median income, and insurance status, there was a continued association between minority status and lower FEV1. Conclusions Minorities with CF have significantly lower pulmonary function, the major marker of survival, than non-Hispanic Caucasians, even when controlled for a variety of demographic and socioeconomic factors that are known to affect health status in CF. Significant health disparities based on race and ethnicity exist at a single CF center in New York City, despite apparent similarities in access to guideline based care at an accredited CF Center. This data confirms the importance of design of culturally appropriate preventative and management strategies to better understand how to direct interventions to this vulnerable population with a rare disease.


Author(s):  
Desmond Sutton ◽  
Timothy Wen ◽  
Anna P. Staniczenko ◽  
Yongmei Huang ◽  
Maria Andrikopoulou ◽  
...  

Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p < 0.01). COVID-19 was associated with higher risk for diagnoses of chorioamnionitis and pneumonia and fevers without a focal diagnosis. In adjusted analyses, including demographic factors, logistic regression demonstrated a c-statistic of 0.71 (95% confidence interval [CI]: 0.69, 0.80). Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points


2007 ◽  
Vol 84 (2) ◽  
pp. 212-225 ◽  
Author(s):  
Susan E. Manning ◽  
Lorna E. Thorpe ◽  
Chitra Ramaswamy ◽  
Anjum Hajat ◽  
Melissa A. Marx ◽  
...  

2021 ◽  
Vol 56 (S2) ◽  
pp. 41-42
Author(s):  
Sanjay Pinto ◽  
Madeline Sterling ◽  
Faith Wiggins ◽  
Rebecca Hall ◽  
Chenjuan Ma

2021 ◽  
pp. 003335492110075
Author(s):  
Claudia Chernov ◽  
Lisa Wang ◽  
Lorna E. Thorpe ◽  
Nadia Islam ◽  
Amy Freeman ◽  
...  

Objectives Immigrant adults tend to have better health than native-born adults despite lower incomes, but the health advantage decreases with length of residence. To determine whether immigrant adults have a health advantage over US-born adults in New York City, we compared cardiovascular disease (CVD) risk factors among both groups. Methods Using data from the New York City Health and Nutrition Examination Survey 2013-2014, we assessed health insurance coverage, health behaviors, and health conditions, comparing adults ages ≥20 born in the 50 states or the District of Columbia (US-born) with adults born in a US territory or outside the United States (immigrants, following the National Health and Nutrition Examination Survey) and comparing US-born adults with (1) adults who immigrated recently (≤10 years) and (2) adults who immigrated earlier (>10 years). Results For immigrant adults, the mean time since arrival in the United States was 21.8 years. Immigrant adults were significantly more likely than US-born adults to lack health insurance (22% vs 12%), report fair or poor health (26% vs 17%), have hypertension (30% vs 23%), and have diabetes (20% vs 11%) but significantly less likely to smoke (18% vs 27%) (all P < .05). Comparable proportions of immigrant adults and US-born adults were overweight or obese (67% vs 63%) and reported CVD (both 7%). Immigrant adults who arrived recently were less likely than immigrant adults who arrived earlier to have diabetes or high cholesterol but did not differ overall from US-born adults. Conclusions Our findings may help guide prevention programs and policy efforts to ensure that immigrant adults remain healthy.


2021 ◽  
Author(s):  
Kiran Thakur ◽  
Victoria T. Chu ◽  
Christine Hughes ◽  
Carla Y. Kim ◽  
Shannon Fleck-Dardarian ◽  
...  

2020 ◽  
Vol 55 (4) ◽  
pp. 448-454
Author(s):  
Daniel Weisz ◽  
Michael Kelley Gusmano

Abstract Aims The aim of this study is to assess risk factors for alcohol misuse among older New York City residents and examine the effect of local public health efforts to address alcohol misuse. Methods The Community Health Survey, a cross-sectional telephone survey of 8500 randomly selected adult New Yorkers, records the frequency of alcohol use. We examine these results among 65 and older subjects by sociodemographic status using logistic regression modeling and compare trends in smoking and alcohol consumption between 2002 and 2016. Results Those with unhealthy drinking habits, combining binge drinking and excessive consumption, constituted 5.7% of 65 plus population and were more likely to be White, US born, healthy, better educated and wealthier. The percentage of older smokers in New York City has decreased while unhealthy drinking is nearly flat since 2002. Conclusions Our findings reinforce the importance of screening geriatric populations for alcohol use disorders and support the development of new public health efforts to address alcohol misuse if the city is to achieve results similar to those obtained in decreasing tobacco consumption.


2021 ◽  
pp. 1-19
Author(s):  
Casey J. Kelley ◽  
Karla L. Hanson ◽  
Grace A. Marshall ◽  
Leah C. Volpe ◽  
Stephanie Jilcott Pitts ◽  
...  

Abstract Objective: To examine cross-sectional associations between farmers’ market shopping behaviors and objectively measured and self-reported fruit and vegetable (FV) intake among rural North Carolina (NC) and New York City (NYC) shoppers. Design: Cross-sectional intercept surveys were used to assess self-reported FV intake and three measures of farmers’ market shopping behavior: (1) frequency of purchasing FV, (2) variety of FV purchased, and (3) dollars spent on FV. Skin carotenoids, a non-invasive biomarker for FV intake, were objectively measured using pressure-mediated reflection spectroscopy. Associations between farmers’ market shopping behaviors and FV intake were examined using regression models that controlled for demographic variables (e.g., age, sex, race, smoking status, education, income, and state). Setting: Farmers’ markets (n=17 markets) in rural NC and NYC. Participants: A convenience sample of 645 farmers’ market shoppers. Results: Farmers’ market shoppers in NYC purchased a greater variety of FV and had higher skin carotenoid scores compared to shoppers in rural NC. Among all shoppers, there was a positive, statistically significant association between self-reported frequency of shopping at farmers’ markets and self-reported as well as objectively assessed FV intake. The variety of FV purchased and farmers’ market spending on FV also were positively associated with self-reported FV intake, but not skin carotenoids. Conclusion: Those who shop for FV more frequently at a farmers’ markets, purchase a greater variety of FV, and spend more money on FV have higher self-reported, and in some cases higher objectively measured FV intake. Further research is needed to understand these associations and test causality.


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