scholarly journals Understanding the Patterns of Serological Testing for COVID-19 Pre- and Post-Vaccination Rollout in Michigan

2021 ◽  
Vol 10 (19) ◽  
pp. 4341
Author(s):  
Zhangchen Zhao ◽  
Stephen Salerno ◽  
Xu Shi ◽  
Seunggeun Lee ◽  
Bhramar Mukherjee ◽  
...  
Keyword(s):  
Circulatory Disease ◽  
Regional Health ◽  
Post Vaccination ◽  
Black Race ◽  
Factors Associated ◽  
Race Ethnicity ◽  
Testing Patterns ◽  
Induced Immunity ◽  
Antibody Tests ◽  
Roll Out

Testing for SARS-CoV-2 antibodies is commonly used to determine prior COVID-19 infections and to gauge levels of infection- or vaccine-induced immunity. Michigan Medicine, a primary regional health center, provided an ideal setting to understand serologic testing patterns over time. Between 27 April 2020 and 3 May 2021, characteristics for 10,416 individuals presenting for SARS-CoV-2 antibody tests (10,932 tests in total) were collected. Relative to the COVID-19 vaccine roll-out date, 14 December 2020, the data were split into a pre- (8026 individuals) and post-vaccine launch (2587 individuals) period and contrasted with untested individuals to identify factors associated with tested individuals and seropositivity. Exploratory analysis of vaccine-mediated seropositivity was performed in 347 fully vaccinated individuals. Predictors of tested individuals included age, sex, smoking, neighborhood variables, and pre-existing conditions. Seropositivity in the pre-vaccine launch period was 9.2% and increased to 46.7% in the post-vaccine launch period. In the pre-vaccine launch period, seropositivity was significantly associated with age (10 year; OR = 0.80 (0.73, 0.89)), ever-smoker status (0.49 (0.35, 0.67)), respiratory disease (4.38 (3.13, 6.12)), circulatory disease (2.09 (1.48, 2.96)), liver disease (2.06 (1.11, 3.84)), non-Hispanic Black race/ethnicity (2.18 (1.33, 3.58)), and population density (1.10 (1.03, 1.18)). Except for the latter two, these associations remained statistically significant in the post-vaccine launch period. The positivity rate of fully vaccinated individual was 296/347(85.3% (81.0%, 88.8%)).

scholarly journals COVID-19 Virus Infection and Transmission are Observably Less in Highly Dengue-Endemic Countries: Is Pre-Exposure to Dengue Virus Protective Against COVID-19 Severity and Mortality? Will the Reverse Scenario Be True?

2020 ◽  
pp. 1-5 ◽  
Author(s):  
Subhajit Biswas ◽  
Soumi Sukla ◽  
Subhajit Biswas
Keyword(s):  
Immune Response ◽  
North America ◽  
Virus Infection ◽  
Dengue Virus ◽  
Post Vaccination ◽  
Infection Transmission ◽  
Susceptible Populations ◽  
Induced Immunity ◽  
Antibody Tests ◽  
Dengue Epidemic

Global severity maps of ongoing dengue epidemic and COVID-19 pandemic do not tend to overlap. Countries with high dengue endemicity (>1.5 million cases/year) are observably less hit by COVID-19 in terms of infection, transmission and mortality. Based on non-overlap of dengue and COVID-19 severity maps in general and increasing evidences of SARS-CoV-2 false-positivity in dengue antibody tests, we wonder whether regular pre-exposure to dengue virus (DENV) in highly dengue endemic countries is providing some extent of protection against COVID-19 severity. We also wondered whether immunization of susceptible populations in dengue non-endemic countries (e.g. Europe and North America) with available live-attenuated dengue vaccines, will cue the anti-viral immune response to thwart COVID-19. Risk of developing post-vaccination antibody-dependent enhancement (ADE) is low as dengue is not endemic in the aforesaid regions. Understanding the consequences of dengue and COVID-19 co-endemicity in the upcoming days is another area of huge concern. Although, it appears that dengue-induced immunity is ‘thwarting’ COVID-19, it is not clear whether conversely, COVID-19 convalescent individuals will also be resistant to future dengue attacks. On the contrary, such individuals may show higher susceptibility to DENV due to ADE caused by cross-reactive COVID-19 antibodies. The latter may bind to DENV without neutralizing the virus; instead, such antibodies may facilitate cellular entry of DENV by means of their Fcregions attached to the susceptible cells. This possibility also cautions against complications that may arise on implementing SARS-CoV-2 vaccinations in highly dengue endemic countries.

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.

scholarly journals SARS-CoV-2 Convalescent Sera Binding and Neutralizing Antibody Concentrations Compared with COVID-19 Vaccine Efficacy Estimates Against Symptomatic Infection

2021 ◽  
Author(s):  
Amy J. Schuh ◽  
Panayampalli S. Satheshkumar ◽  
Stephanie Dietz ◽  
Lara Bull-Otterson ◽  
Myrna Charles ◽  
...  
Keyword(s):  
Vaccine Efficacy ◽  
Neutralizing Antibody ◽  
Published Data ◽  
Symptomatic Infection ◽  
Convenience Sample ◽  
Post Vaccination ◽  
Antibody Assays ◽  
Study Population ◽  
Binding Antibody ◽  
Induced Immunity

Previous vaccine efficacy (VE) studies have estimated neutralizing and binding antibody concentrations that correlate with protection from symptomatic infection; how these estimates compare to those generated in response to SARS-CoV-2 infection is unclear. Here, we assessed quantitative neutralizing and binding antibody concentrations using standardized SARS-CoV-2 assays on 3,067 serum specimens collected during July 27, 2020-August 27, 2020 from COVID-19 unvaccinated persons with detectable anti-SARS-CoV-2 antibodies using qualitative antibody assays. Quantitative neutralizing and binding antibody concentrations were strongly positively correlated (r=0.76, p<0.0001) and were noted to be several fold lower in the unvaccinated study population as compared to published data on concentrations noted 28 days post-vaccination. In this convenience sample, ~88% of neutralizing and ~63-86% of binding antibody concentrations met or exceeded concentrations associated with 70% COVID-19 VE against symptomatic infection from published VE studies; ~30% of neutralizing and 1-14% of binding antibody concentrations met or exceeded concentrations associated with 90% COVID-19 VE. These data support observations of infection-induced immunity and current recommendations for vaccination post infection to maximize protection against symptomatic COVID-19.

Patient factors associated with time to medication receipt of oral anti-cancer drugs.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1519-1519
Author(s):  
Morgan RL Lichtenstein ◽  
Melissa Beauchemin ◽  
Sahil Doshi ◽  
Rohit Raghunathan ◽  
Cynthia Law ◽  
...  
Keyword(s):  
Financial Assistance ◽  
Cancer Center ◽  
Prior Authorization ◽  
Cancer Drugs ◽  
Free Standing ◽  
Oncology Patients ◽  
Related Factors ◽  
Factors Associated ◽  
Anti Cancer ◽  
Race Ethnicity

1519 Background: The past decade has seen a dramatic increase in the number of Food and Drug Administration approvals of oral anti-cancer drugs (OACDs). Most OACD prescriptions require coordination between providers, payers, specialty pharmacists, and financial assistance organizations, which can delay drug receipt. We evaluated median time to OACD receipt (TTR) from initial OACD prescription submission and assessed clinical and process-related factors associated with TTR. Methods: We prospectively collected data on all new OACD prescriptions for adult oncology patients at a large, urban outpatient cancer center from 1/1/2018 to 12/31/2019. We collected patient demographic, medical, and insurance data; prescription submission and delivery dates; and interactions with payers and financial assistance groups. TTR was defined as the number of days from OACD initial prescription to patient receipt of the drug. We estimated the median TTR across all patients and used multivariable logistic regression to identify factors associated with TTR above the median. Results: The cohort included 1080 patients who were prescribed 1269 new OACDs. Of these prescriptions, 84% (N=1069) were received, and 71% (N=896) required prior authorization. The median patient age was 66, 44% identified as Non-Hispanic White (White), 25% of patients had commercial insurance, 16% had Medicaid alone, and 58% had Medicare alone or in combination with another plan. The median TTR per patient was 7 days (IQR 0 – 142; 25% ≥ 14 days and 5% ≥ 30 days). In unadjusted analyses, insurance and race/ethnicity were associated with TTR. Compared with patients covered by Medicaid, those with Medicare and supplemental insurance (a partial, not free-standing plan) had nearly 2.5 times the odds of TTR >7 days controlling for other factors. Race/ethnicity showed a trend toward longer TTR with Non-Hispanic Black (Black) patients having a longer TTR compared to White patients, controlling for other factors. We did not observe statistically significant effects of either comorbidity or prior authorization requirement on TTR. Conclusions: Though the majority of oncology patients prescribed OACDs receive the drug, 71% of prescriptions required prior authorization and a quarter of patients waited at least two weeks. Disparities in TTR are primarily driven by financial factors, specifically insurance type.[Table: see text]

25 Social Integration in the First 2 Years After Moderate to Severe Burn Injury: A Burn Model System National Database Study

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S19-S20
Author(s):  
Kara McMullen ◽  
Alyssa M Bamer ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
Jeffrey C Schneider ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Integration ◽  
Psychiatric Treatment ◽  
Community Integration ◽  
Total Body Surface Area ◽  
Factors Associated ◽  
Burn Survivors ◽  
Race Ethnicity ◽  
Total Body

Abstract Introduction Feeling a part of community and participating in social life are important aspects of overall quality of life. Burn survivors consider community reintegration one of the most important issues affecting their recovery. Integration, including social integration, has been studied in this population, but longitudinal analyses to examine factors associated with successful integration are lacking. The current study aims to assess variables associated with social integration during the first two years post-burn. Methods Adult (18+ years) burn survivors enrolled in the Burn Model System national longitudinal database responded to questionnaires at hospital discharge and 6-, 12-, and 24-months postburn. Social integration was assessed at all follow-up timepoints using the Community Integration Questionnaire Social Integration Component Scale, which has a possible range of scores from 0 (no community integration) to 12 (excellent community integration). To examine variables associated with social integration over time, linear mixed effect models utilizing generalized least squares with maximum likelihood and robust standard errors were used. Independent variables in the model included age, sex, % total body surface area (TBSA) burned, race/ethnicity, living status at time of injury, facial burn, history of psychiatric treatment preburn, employment at follow-up assessment, and SF-12 or VR-12 mental health component scores at the time of each follow-up assessment. Results Data from 1,848 adult burn survivors were included in the analyses. Average age of the survivors was 42.9 years, 74.0% were male, 77.7% were white, 47.0% were married or living common-law with a partner, and mean total body surface area burned was 18.2%. Factors associated with better social integration over time included younger age, female sex, lower TBSA (&lt; 40%) burn size, white/non-Hispanic race, no preburn psychiatric treatment, postburn employment, and better mental health. Time was not a significant predictor, indicating that social integration scores remain relatively stable over the 24-month follow-up period. Conclusions We identified several factors that contribute to greater social integration including age, gender, burn size, race/ethnicity, employment, and mental health, with the association between age, gender, and employment status and community integration a novel finding in this population. Applicability of Research to Practice This study suggests that while most factors associated with social integration are not modifiable, interventions aimed at improving mental health and helping burn survivors return to work could also improve self-reported social integration.

scholarly journals Factors Associated with E-Cigarette Use in U.S. Young Adult Never Smokers of Conventional Cigarettes: A Machine Learning Approach

2020 ◽  
Vol 17 (19) ◽  
pp. 7271
Author(s):  
Nkiruka C. Atuegwu ◽  
Cheryl Oncken ◽  
Reinhard C. Laubenbacher ◽  
Mario F. Perez ◽  
Eric M. Mortensen
Keyword(s):  
Machine Learning ◽  
Young Adult ◽  
Public Awareness ◽  
Behavioral Risk ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Factors Associated ◽  
History Of ◽  
Race Ethnicity ◽  
Never Smokers

E-cigarette use is increasing among young adult never smokers of conventional cigarettes, but the awareness of the factors associated with e-cigarette use in this population is limited. The goal of this work was to use machine learning (ML) algorithms to determine the factors associated with current e-cigarette use among US young adult never cigarette smokers. Young adult (18–34 years) never cigarette smokers from the 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) who reported current or never e-cigarette use were used for the analysis (n = 79,539). Variables associated with current e-cigarette use were selected by two ML algorithms (Boruta and Least absolute shrinkage and selection operator (LASSO)). Odds ratios were calculated to determine the association between e-cigarette use and the variables selected by the ML algorithms, after adjusting for age, gender and race/ethnicity and incorporating the BRFSS complex design. The prevalence of e-cigarette use varied across states. Factors previously reported in the literature, such as age, race/ethnicity, alcohol use, depression, as well as novel factors associated with e-cigarette use, such as disabilities, obesity, history of diabetes and history of arthritis were identified. These results can be used to generate further hypotheses for research, increase public awareness and help provide targeted e-cigarette education.

scholarly journals Compliance among infants exposed to hepatitis B virus in a post-vaccination serological testing program in four provinces in China

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Hui Zheng ◽  
Guo-Min Zhang ◽  
Po-Lin Chan ◽  
Fu-Zhen Wang ◽  
Lance Everett Rodewald ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Venous Blood ◽  
Serological Testing ◽  
Sample Collection ◽  
Post Vaccination ◽  
Loss To Follow Up ◽  
Factors Associated ◽  
B Virus

Abstract Background Mother to child transmission of hepatitis B virus (HBV) remains the most common form of HBV infection in China. Prevention of HBV vertical transmission involves timely administration of the complete hepatitis B vaccine (HepB) series and hepatitis B immunoglobulin. Post-vaccination serological testing (PVST) is utilized to determine an infant’s outcome after HBV exposure and completion of HepB series. We aim to determine the frequency of compliance with a PVST testing cascade for HBV infected mothers and analyze factors associated with infant lost to follow up (LTFU). Methods We conducted a retrospective cohort review of previously collected data in Fujian, Jiangxi, Zhejiang and Chongqing provinces in China from 1 June 2016–31 December 2017. The study population included all HBV-exposed infants and their mothers. SAS software was used for statistical analyses. Bivariate and multivariate regression analyses (presented in odds ratio [OR] with 95% confidence intervals [CI]) were used to compare the proportional differences of factors associated with PVST not being completed. Results Among enrolled 8474 target infants, 40% of them transferred out of the study provinces without further information and 4988 were eligible for PVST. We found 20% (994) of infants were not compliant with the testing cascade: 55% of LTFU occurred because parents refused venous blood sample collection or failure of sample collection in the field, 16% transferred out after 6 months of age, and 10% of families chose to have independent, confidential PVST completed without reporting results. High PVST noncompliance rates were more likely to be from Fujian (aOR = 17.0, 95% CI: 9.7–29.9), Zhejiang (aOR = 5.7, 95% CI: 3.2–10.1) and Jiangxi (aOR = 1.9, 95% CI: 1.0–3.4), and from HBV e antigen positive mother (aOR = 1.2, 95% CI: 1.1–1.4). Conclusions This study found that the LTFU rate reached 20% in PVST program, which was a significant problem. We recommend implementing a national electronic information system for tracking HBV at risk mother-infant pairs; encourage further research in developing a less invasive means of completing PVST, and take effective measures nationally to reduce HBV stigma. Without reducing the loss to follow up rate among infants eligible for PVST, elimination of vertical HBV transmission will be impossible.

scholarly journals S241. FACTORS ASSOCIATED WITH EARLY RISK OF DISENGAGEMENT FROM EARLY PSYCHOSIS INTERVENTION SERVICES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S130-S131
Author(s):  
Nicole Kozloff ◽  
Aristotle Voineskos ◽  
George Foussias ◽  
Alexia Polillo ◽  
Sean Kidd ◽  
...  
Keyword(s):  
At Risk ◽  
Substance Use ◽  
Logistic Regression ◽  
Young People ◽  
Family Involvement ◽  
The Body ◽  
Early Psychosis ◽  
First Episode ◽  
Factors Associated ◽  
Race Ethnicity

Abstract Background Despite the body of evidence supporting early psychosis intervention (EPI) programs for young people with psychotic disorders, approximately 30% of individuals with first-episode psychosis disengage from care. To date, two factors, lack of family involvement and presence of a substance use disorder, have emerged as robust predictors of EPI disengagement. Several factors associated with service disengagement in mental health care more broadly have not been well-studied in EPI; some of these, such as homelessness and ethnicity, may be of particular importance to urban, multicultural populations, and ethnicity in particular has been shown to affect pathways into EPI services. Early missed appointments may signal risk for subsequent service disengagement. We sought to identify early predictors of disengagement risk in an urban EPI program. Methods We conducted a prospective chart review of consecutive patients accepted for services in a large, urban EPI program in Toronto, Canada in a 3-month period from July 4-October 3, 2018. Patients were observed in their first 3 months of treatment. The primary outcome of interest was risk of disengagement, defined as having missed at least 1 appointment without cancellation. Extracted data included a variety of demographic and clinical information. The principal investigator trained 2 data abstractors on the first 50 charts; subsequent agreement on the next 5 charts was 88%. Based on previous literature, we hypothesized that risk of disengagement would be increased in individuals with problem substance use, experiences of homelessness, and nonwhite race/ethnicity and decreased in individuals with family involvement in their care. We used logistic regression to examine the odds of disengagement associated with univariate predictors individually, and then together in a multivariate model. Results Seventy-three patients were consecutively admitted to EPI services in the 3-month period. Of these individuals, 59% (N=43) were identified as being at risk of disengagement based on having missed at least 1 appointment without cancellation. In the full sample, 71% (N=52) identified as nonwhite, 23% (N=17) had a documented experience of homelessness, 52% (N=38) had problem substance use, and 73% (N=53) had family involved in their care. In univariate logistic regression, only problem substance use was associated with risk of disengagement (OR=2.91, 95% CI 1.11–7.66); no significant associations were identified with race/ethnicity, experience of homelessness, or family involvement. In multivariate logistic regression, once we controlled for these other factors, the association between risk of disengagement and problem substance use was attenuated and no longer statistically significant (OR=2.15, 95% CI 0.77–5.97). Discussion In this small study of early disengagement in an urban EPI program, only problem substance use was associated with increased odds of missing an appointment, but not when we controlled for other factors thought to be associated with disengagement. Larger studies may be required to identify factors with small but important effects. These factors may be used to identify young people at risk of disengagement from EPI services early in care in order to target them for increased engagement efforts.

scholarly journals Developing a Typology of HIV/STI Testing Patterns Among Gay, Bisexual, and Queer Men: A Framework to Guide Interventions

2019 ◽  
Vol 30 (4) ◽  
pp. 610-621 ◽  
Author(s):  
Rayner Kay Jin Tan ◽  
Nashwinder Kaur ◽  
Mark I-Cheng Chen ◽  
Chen Seong Wong
Keyword(s):  
Thematic Analysis ◽  
External Factors ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Sti Testing ◽  
Semistructured Interviews ◽  
Testing Patterns ◽  
Purposive Sample ◽  
Inductive Thematic Analysis

Although factors associated with HIV/sexually transmitted infection (STI) testing among gay, bisexual, and queer (GBQ) men are well-established in the literature, few studies have attempted to delineate the processes underlying different patterns of testing. We conducted a qualitative study involving 35 semistructured interviews with a purposive sample of GBQ men in Singapore from October 2017 to July 2018. Topics explored included formative sexual experiences, relationships, and experiences of HIV/STI testing. Interviews were audio-recorded, transcribed, coded, and analyzed through inductive thematic analysis. A typology comprising four distinct HIV/STI testing patterns was identified from the data, categorized based on the regularity of testing, relative to internal or external factors that motivate testing behaviors. These include triggered episodic testing, influenced episodic testing, institutionalized regular testing, and value-based regular testing. The typology highlights the preconditions that underlie different testing patterns and provides a framework for developing interventions that promote HIV/STI testing among GBQ men.

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