Association of comorbidities with COVID-19 infection rate and severity: a nationwide cohort study with propensity score matching (Preprint)

2021 ◽  
Author(s):  
Jiyong Kim ◽  
Seong Hun Park ◽  
Jong Moon Kim
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Infection Rate ◽  
Patient Demographics ◽  
Propensity Matching ◽  
The Disabled ◽  
Severe Group ◽  
Lower Infection ◽  
The Impact

BACKGROUND Confirming the relationship between comorbidities and coronavirus infection-19 (COVID-19) is important for efficient use of medical facilities. OBJECTIVE This study investigated the impact of patient demographics and comorbidities on the infection rate and severity of COVID-19. METHODS Data were derived from a Korean nationwide cohort study with propensity score matching. We included 8070 individuals with positive covid-19 test and 12015 controls between January 1, 2020, and May 30, 2020. Outcomes were confirmation of the comorbidities affecting the infection rate and the severity of COVID-19. Endpoints were COVID-19 positivity and severe clinical outcomes of COVID-19 (tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, or death). RESULTS In people aged 60 or older, in those insured with Medicaid, and in the disabled, the proportion corresponding to the severe group of patients showed a tendency to increase. The infection rate of COVID-19 was highest in pulmonary disease (adjusted odds ratio 1.88, 95% confidence interval 1.70 to 2.03), and hyperlipidemia (0.73, 0.67 to 0.80) had a lower infection rate. Disease severity was highest in kidney disease (5.59, 2.48 to 12.63), and lower in hyperlipidemia (0.78, 0.60 to 1.00). CONCLUSIONS Using propensity matching to reduce statistical bias, we found that most comorbidities increased the infection rate and severity of COVID-19, whereas hyperlipidemia reduced the rate and severity of infection. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1101/2021.09.22.21263946

scholarly journals Association of comorbidities with COVID-19 infection rate and severity: nationwide cohort study with propensity score matching

2021 ◽  
Author(s):  
Jiyong Kim ◽  
Seong Hun Park ◽  
Jong Moon Kim
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Infection Rate ◽  
Severe Infection ◽  
Population Based ◽  
The Disabled ◽  
Severe Group ◽  
Korean National Health Insurance ◽  
The Government

OBJECTIVE: To describe the association of comorbidities with coronavirus infection-19 (COVID-19) infection rates and severity of infection through Korean nationwide medical system. DESIGN: Nationwide population-based retrospective cohort study. SETTING: Korean national health insurance claims database between January 1, 2020, and May 30, 2020. PARTICIPANTS: Patients with positive COVID-19 test and 12 folded controls matched by age, sex and region. MAIN OUTCOMES MEASURES: Outcomes were confirmation of the comorbidities affecting the infection rate and the severity of COVID-19. Patients and outcomes were propensity score matching of factors which may affect COVID-19 infection rate and severity was performed. COVID-19 infections were confirmed through laboratory testing. Severe infection was defined as those who underwent tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, or died. RESULTS: A total of 8070 individuals with positive covid-19 test and 12015 controls were identified. In people aged 60 or older, in those insured with Medicaid, and in the disabled, the proportion corresponding to the severe group of patients showed a tendency to increase. The infection rate of COVID-19 was highest in pulmonary disease (adjusted odds ratio 1.88, 95% confidence interval 1.70 to 2.03), and hyperlipidemia (0.73, 0.67 to 0.80) had a lower infection rate. Disease severity was highest in kidney disease (5.59, 2.48 to 12.63), and lower in hyperlipidemia (0.78, 0.60 to 1.00). CONCLUSIONS: There is less bias as the government pays for all tests and treatments related to COVID-19 included in the data used in this study. Using propensity matching to reduce statistical bias, we found that most comorbidities increased the infection rate and severity of COVID-19, whereas hyperlipidemia reduced the rate and severity of infection. These results can be utilized to effectively manage COVID-19 infections.

scholarly journals Impact of Influenza Vaccination on Mortality in the Oldest Old: A Propensity Score-Matched Cohort Study

Vaccines ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 356
Author(s):  
Pauline Walzer ◽  
Clémentine Estève ◽  
Jeremy Barben ◽  
Didier Menu ◽  
Christine Cuenot ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Propensity Score Matching ◽  
Oldest Old ◽  
Immunization Coverage ◽  
All Cause Mortality ◽  
Comorbidity Index ◽  
The Impact

Influenza remains a major cause of illness and death in geriatric populations. While the influenza vaccine has successfully reduced morbidity and mortality, its effectiveness is suspected to decrease with age. The aim of this study was to assess the impact of influenza vaccination on all-cause mortality in very old ambulatory subjects. We conducted a prospective cohort study from 1 July 2016 to 31 June 2017 in a large unselected ambulatory population aged over 80 years. We compared all-cause mortality in vaccinated versus unvaccinated subjects after propensity-score matching, to control for age, sex and comorbidities. Among the 9149 patients included, with mean age 86 years, 4380 (47.9%) were vaccinated against influenza. In total, 5253 (57.4%) had at least one chronic disease. The most commonly vaccinated patients were those with chronic respiratory failure (76.3%) and the least commonly vaccinated were those suffering from Parkinson’s disease (28.5%). Overall, 2084 patients (22.8%) died during the study. After propensity score matching, the mortality was evaluated at 20.9% in the vaccinated group and 23.9% in the unvaccinated group (OR = 0.84 [0.75–0.93], p = 0.001). This decrease in mortality in the vaccinated group persisted whatever the age and Charlson Comorbidity index. In conclusion, nearly a half of this ambulatory elderly population received Influenza vaccine. After adjustment on comorbidities, influenza vaccination was associated with a significant decrease in all-cause mortality, even in the eldest multimorbid population. Improving immunization coverage in this frail older population is urgently needed.

scholarly journals The impact of quarantine on Covid-19 infections

2021 ◽  
Vol 10 (s1) ◽  
Author(s):  
Pablo Marshall
Keyword(s):  
Health System ◽  
Infection Rate ◽  
District Level ◽  
Infection Model ◽  
Social Distancing ◽  
Proposed Model ◽  
Lower Infection ◽  
The Impact ◽  
Lower Infection Rate ◽  
Over Time

Abstract Objectives: Coronavirushas had profound effects on people’s lives and the economy of many countries, generating controversy between the need to establish quarantines and other social distancing measures to protect people’s health and the need to reactivate the economy. This study proposes and applies a modification of the SIR infection model to describe the evolution of coronavirus infections and to measure the effect of quarantine on the number of people infected. Methods: Two hypotheses, not necessarily mutually exclusive, are proposed for the impact of quarantines. According to the first hypothesis, quarantine reduces the infection rate, delaying new infections over time without modifying the total number of people infected at the end of the wave. The second hypothesis establishes that quarantine reduces the population infected in the wave. The two hypotheses are tested with data for a sample of 10 districts in Santiago, Chile. Results: The results of applying the methodology show that the proposed model describes well the evolution of infections at the district level. The data shows evidence in favor of the first hypothesis, quarantine reduces the infection rate; and not in favor of the second hypothesis, that quarantine reduces the population infected. Districts of higher socio-economic levels have a lower infection rate, and quarantine is more effective. Conclusions: Quarantine, in most districts, does not reduce the total number of people infected in the wave; it only reduces the rate at which they are infected. The reduction in the infection rate avoids peaks that may collapse the health system.

scholarly journals Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching

2021 ◽  
Vol 11 (2) ◽  
pp. 161
Author(s):  
Chong-Chi Chiu ◽  
Jhi-Joung Wang ◽  
Chao-Ming Hung ◽  
Hsiu-Fen Lin ◽  
Hong-Hsi Hsien ◽  
...  
Keyword(s):  
Propensity Score ◽  
Functional Status ◽  
Propensity Score Matching ◽  
Acute Care ◽  
Medical Cost ◽  
Economic Burden ◽  
Stroke Rehabilitation ◽  
Stroke Patients ◽  
The Impact ◽  
Post Acute Care

Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (p < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (p < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.

scholarly journals Adoption of improved agricultural technology and its impact on household income: a propensity score matching estimation in eastern Ethiopia

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Muluken G. Wordofa ◽  
Jemal Y. Hassen ◽  
Getachew S. Endris ◽  
Chanyalew S. Aweke ◽  
Dereje K. Moges ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Technology Use ◽  
Household Income ◽  
Agricultural Technology ◽  
Primary Data ◽  
Farm Income ◽  
Agricultural Technologies ◽  
Eastern Ethiopia ◽  
The Impact

Abstract Background Adoption of improved agricultural technologies remains to be a promising strategy to achieve food security and poverty reduction in many developing countries. However, there are limited rigorous impact evaluations on the contributions of such technologies on household welfare. This paper investigates the impact of improved agricultural technology use on farm household income in eastern Ethiopia. Methods Primary data for the study was obtained from a random sample of 248 rural households, 119 of which are improved technology users and the rest are non-users. The research employed the Propensity Score Matching (PSM) procedure to establish the causal relationship between adoption of improved crop and livestock technologies and changes in farm income. Results Results from the econometric analysis show that households using improved agricultural technologies had, on average, 23,031.28 Birr (Birr is the official currency of Ethiopia. The exchange rate according to the National Bank of Ethiopia (NBE) was 1 USD = 27.6017 Birr on 04 October 2018.) higher annual farm income compared to those households not using such technologies. Our findings highlight the importance of promoting multiple and complementary agricultural technologies among rural smallholders. Conclusions We suggest that rural technology generation, dissemination and adoption interventions be strengthened. Moreover, the linkage among research, extension, universities and farmers needs to be enhanced through facilitating a multistakeholders innovation platforms.

Was it worth it? The impact of the German minimum wage on union membership of employees

2021 ◽  
pp. 0143831X2110358
Author(s):  
Simon Ress ◽  
Florian Spohr
Keyword(s):  
Propensity Score ◽  
Social Security ◽  
Labour Market ◽  
Propensity Score Matching ◽  
Minimum Wage ◽  
Trade Union ◽  
Union Membership ◽  
Difference In Differences ◽  
German Trade ◽  
The Impact

This contribution scrutinises how introducing a statutory minimum wage of EUR 8.50 per hour, in January 2015, impacted German employees’ decision with regard to union membership. Based on representative data from the Labour Market and Social Security panel, the study applies a logistic difference-in-differences propensity score matching approach on entries into and withdrawals from unions in the German Trade Union Confederation (Deutscher Gewerkschaftsbund, DGB). The results show no separate effect on withdrawals from or entries into unions after the minimum wage introduction for those employees who benefited financially from it, but a significant increase of entries overall. Thus, unions’ campaign for a minimum wage strengthened their position in total but did not reverse the segmentation of union membership patterns.

scholarly journals USING PROPENSITY SCORE MATCHING METHOD TO ESTIMATE THE IMPACT OF VIETGAP PROGRAM ON THE HEALTH OF FARMERS IN THUA THIEN HUE PROVINCE, VIETNAM

2017 ◽  
Vol 126 (5B) ◽  
pp. 17
Author(s):  
Trần Huỳnh Bảo Châu
Keyword(s):  
Health Status ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Pesticide Exposure ◽  
Agricultural Practices ◽  
Health Problems ◽  
Vegetable Production ◽  
Matching Method ◽  
Environment Friendly ◽  
The Impact

<p><strong>Abstract:</strong></p><p>This study estimates the impact value of the VietGAP program when applied to vegetable production on the health of farmers in Thua Thien Hue province. By employing the propensity score matching (PSM) method, our findings show that the VietGAP program has a significant impact on farmers’ health. In particular, the program reduces farmers’ health problems due to pesticide exposure by 15.6 %, 22.9 %, 25.5 %, and 23.6 %, respectively, from four types of matching. This study provides evidence of the positive impacts of the VietGAP program on the health status of farmers in Thua Thien Hue province. It is therefore hoped that the production, consumption, and management solutions provided by the VietGAP program can encourage farmers to use environment-friendly agricultural practices.</p><p><strong>Keywords: </strong>propensity score matching (PSM) method, VietGAP program, farmers’ health</p>

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