Health Status, Persistent Symptoms, and Effort Intolerance One Year After Acute COVID-19 Infection.

BACKGROUND: The long-term prevalence and risk factors for post-acute COVID-19 sequelae (PASC) are not well described and may have important implications for unvaccinated populations and policy makers. OBJECTIVE: To assess health status, persistent symptoms, and effort tolerance approximately 1 year after COVID-19 infection DESIGN: Retrospective observational cohort study using surveys and clinical data PARTICIPANTS: Survey respondents who were survivors of acute COVID-19 infection requiring Emergency Department presentation or hospitalization between March 3 and May 15, 2020. MAIN MEASURE(S): Self-reported health status, persistent symptoms, and effort tolerance KEY RESULTS: The 530 respondents (median time between hospital presentation and survey 332 days [IQR 325-344]) had mean age 59.2±16.3 years, 44.5% were female and 70.8% were non-White. Of these, 41.5% reported worse health compared to a year prior, 44.2% reported persistent symptoms, 36.2% reported limitations in lifting/carrying groceries, 35.5% reported limitations climbing one flight of stairs, 38.1% reported limitations bending/kneeling/stooping, and 22.1% reported limitations walking one block. Even those without high-risk comorbid conditions and those seen only in the Emergency Department (but not hospitalized) experienced significant deterioration in health, persistent symptoms, and limitations in effort tolerance. Women (adjusted relative risk ratio [aRRR] 1.26, 95% CI 1.01-1.56), those requiring mechanical ventilation (aRRR 1.48, 1.02-2.14), and people with HIV (aRRR 1.75, 1.14-2.69) were significantly more likely to report persistent symptoms. Age and other risk factors for more severe COVID-19 illness were not associated with increased risk of PASC. CONCLUSIONS: PASC may be extraordinarily common 1 year after COVID-19, and these symptoms are sufficiently severe to impact the daily exercise tolerance of patients. PASC symptoms are broadly distributed, are not limited to one specific patient group, and appear to be unrelated to age. These data have implications for vaccine hesitant individuals, policy makers, and physicians managing the emerging longer-term yet unknown impact of the COVID-19 pandemic.

The Gender Gap in Interventional Radiology: Barriers, Opportunities, and the Role of the Integrated IR Residency.

RATIONALE AND OBJECTIVES: To review the gender gap in Interventional Radiology (IR) and explore the role of the Integrated IR residency. MATERIALS AND METHODS: A retrospective review of gender demographic data of medical school applicants to Integrated IR residency from 2016-2021, and active residents/fellows ("trainees") in IR and peer specialties from 2007 to 2021. RESULTS: Women comprised 21.0% of medical student applicants to the Integrated IR residency in the 2020-21 academic year, versus 12.9% of Diagnostic Radiology (DR) resident applicants to the Independent IR residency; these figures have stayed relatively constant since 2016-17 and represent a statistically significantly difference (p=0.000044). The Integrated pathway has become the dominant source of IR trainees, growing from 4.4% in 2016-17 to 76.3% in 2020-21 (p=0.0013). From 2007 to 2021, the percentage of all IR trainees who were female grew from 10.5% to 20.3% (p=0.005). From 2017 to 2021, the percentage of Integrated IR residents who were female grew from 13.3% to 22.0% (p=0.053, 19.1% year-over-year growth), and has been higher than the percentage of female Independent IR residents (p=0.048). CONCLUSION: Women continue to be underrepresented in IR, though this gender gap is improving. The Integrated IR residency appears to have majorly contributed to this improvement, consistently supplying more women into the IR pipeline than through the fellowship/Independent IR residency. Women are significantly better represented among current Integrated IR residents than Independent residents. The now-dominant Integrated IR pathway must increase women recruitment for continued gender gap improvement.