RESUMEN
Context: A lack of consensus in the literature examining reproductive health experiences of women with disability prevails, in part, due to various operational definitions of disability. Methods: Results from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) were utilized to assess reproductive health, disability, and demographic variables among women aged 20-44. Disability was assessed using the six functional limitation subgroups. Analyses included modified Poisson regression and negative binomial regression. Results: One hundred eighty-two (14%) women reported having any functional limitation. Women with at least one functional limitation (WWFL) were significantly more likely than women without a functional limitation (WWOFL) to have had a hysterectomy and had more cesarean deliveries. WWFL did not differ significantly from WWOFL in key pregnancy outcomes (ever been pregnant, number of pregnancies, or number of unsuccessful pregnancies). A high degree of overlap between mobility and self-care (66.1%), cognitive and independent living (61%), and mobility and independent living (37.4%) limitations was found. Conclusions: This work summarizes key reproductive health variables among US women of reproductive age and contextualizes disability experiences through subgroup and overlap analysis. Subgroup analysis results demonstrate the need for detailed operational definitions of disability to accurately capture experiences of women with different limitations, and overlap analysis indicates the interconnectedness of limitations among this group. Findings call for future exploration of reproductive health-related similarities and differences between WWD and women without disability, and employment of detailed operational definitions of disability.
RESUMEN
INTRODUCTION: Obesity has been declared a major risk factor for morbidity and mortality in COVID-19 patients. In this rapid review, we provide an overview of recently-published papers with clinical and epidemiological relevance on this topic. METHODS: As part of a weekly COVID-19 data mining meeting, we conducted a literature review regarding the role of obesity in COVID-19 outcomes, particularly in young patients with COVID-19. We utilized the PubMed, Upstate Medical University Health Sciences Library, Google Scholar, and LitCovid databases to identify the articles. RESULTS: Our group identified seven relevant publications (four retrospective case series and three reviews). CONCLUSION: Our group's review of this topic illustrates that obesity is a common comorbidity in hospitalized COVID-19 patients. Obesity is associated with an increased likelihood of intermittent mandatory ventilation within the first 10 days of hospitalization and a higher risk of admission to acute or critical hospital care, including in patients aged less than 60 years, with one study showing it to be a greater risk factor than cardiovascular or pulmonary conditions for critical COVID-19 illness. There are some indications that moderate-intensity exercise may be beneficial for promoting a healthy immune system in patients with and without obesity. Given these findings, hospitals should ensure their staff are prepared and their facilities are adequately equipped to provide high-quality care to patients with obesity (PWO) hospitalized with COVID-19. Family medicine and primary care physicians are encouraged to counsel their PWO about their increased risk for morbidity and mortality during this pandemic.
