Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 21.167
Filtrar
1.
Sci Rep ; 11(1): 9089, 2021 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-33907222

RESUMEN

We propose a susceptible-exposed-infective-recovered-type (SEIR-type) meta-population model to simulate and monitor the (COVID-19) epidemic evolution. The basic model consists of seven categories, namely, susceptible (S), exposed (E), three infective classes, recovered (R), and deceased (D). We define these categories for n age and sex groups in m different spatial locations. Therefore, the resulting model contains all epidemiological classes for each age group, sex, and location. The mixing between them is accomplished by means of time-dependent infection rate matrices. The model is calibrated with the curve of daily new infections in New York City and its boroughs, including census data, and the proportions of infections, hospitalizations, and deaths for each age range. We finally obtain a model that matches the reported curves and predicts accurate infection information for different locations and age classes.


Asunto(s)
/epidemiología , Análisis Espacio-Temporal , /patología , Epidemias , Monitoreo Epidemiológico , Predicción , Humanos , Modelos Estadísticos , Ciudad de Nueva York/epidemiología , /aislamiento & purificación
3.
IEEE Pulse ; 12(2): 17-21, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33861695

RESUMEN

"I am now eight-and-a-half months into my journey with long COVID … My symptoms include diagnosed post-COVID tachycardia and acute fatigue. I also have chest tightness and breathlessness from time to time; anxiety; muscle aches and pains, especially in the evening; memory loss; and insomnia."-38-year-old female from the U.K.


Asunto(s)
/complicaciones , Pandemias , Adulto , Autoinmunidad , /etiología , /rehabilitación , Disfunción Cognitiva/etiología , Estudios de Cohortes , Fatiga/etiología , Femenino , Interacciones Microbiota-Huesped/inmunología , Interacciones Microbiota-Huesped/fisiología , Humanos , Masculino , Ciudad de Nueva York/epidemiología , Disautonomías Primarias/etiología , Factores de Tiempo
4.
Artículo en Inglés | MEDLINE | ID: mdl-33805614

RESUMEN

This study examined the life-motivating values of residents in underserved minority communities to inform the development of community engagement strategies. Semi-structured interviews were conducted to explore the main research questions: (1) what were the values of research participants, and (2) what did they consider important in their lives? The participants included twenty-seven ethnically diverse individuals living in low-income neighborhoods in New York City (NYC). Thematic analysis was performed to identify common themes and patterns related to the values that participants considered important in their lives. Three broad themes were identified: (1) benevolence; (2) universalism, and (3) self-direction. Benevolence implies a sense of belonging as the central meaning in life; community engagement strategies focused on this value emphasize concern for the welfare of loved ones. Community engagement strategies focused on universalism emphasize social justice and concern for the environment and the world. Finally, community engagement strategies focused on self-direction seek to satisfy participants' needs for control, autonomy, and mastery. This study introduces the Value-Based Framework for Community-Centered Research. It illustrates how value exploration is central to a community-centered approach to public health research and can be an important first step for designing studies that are better aligned with community needs and contexts. Such an approach can also help to co-create a "research identity" with community members and integrate their values into a project's purpose, thereby increasing community ownership and engagement in the study.


Asunto(s)
Comunicación , Salud Pública , Humanos , Ciudad de Nueva York , Pobreza , Características de la Residencia
5.
Artículo en Inglés | MEDLINE | ID: mdl-33800009

RESUMEN

The destruction of the World Trade Center (WTC) towers on 11 September 2001 resulted in acute and chronic dust and fume exposures to community members, including local workers and residents, with well-described aerodigestive adverse health effects. This study aimed to characterize lung cancer in the WTC Environmental Health Center (WTC EHC) focusing on gender and smoking history. WTC EHC patients undergo an initial evaluation that includes WTC exposure information, demographics, and tobacco use. Detailed cancer characteristics are recorded from pathology reports. As of 31 December 2019, 248 WTC EHC patients had a diagnosis of lung cancer. More patients with lung cancer were women (57%) compared to men (43%). Many cases (47% women, 51% men) reported acute dust cloud exposure. Thirty-seven percent of lung cancer cases with available smoking history were never-smokers (≤1 pack-years) and 42% had a ≤5 pack-year history. The median age of cancer diagnosis in never-smoking women was 61 years compared to 66 years in men. Adenocarcinoma was more common in never-smokers compared to ever-smokers (72% vs. 65%) and in women compared to men (70% vs. 65%). We provide an initial description of lung cancers in local community members with documented exposure to the WTC dust and fumes.


Asunto(s)
Enfermedades Pulmonares , Neoplasias Pulmonares , Ataques Terroristas del 11 de Septiembre , Polvo , Salud Ambiental , Femenino , Humanos , Neoplasias Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Ciudad de Nueva York
6.
Artículo en Inglés | MEDLINE | ID: mdl-33800881

RESUMEN

The World Trade Center Health Program (WTCHP) has a research mission to identify physical and mental health conditions that may be related to the 9/11 terrorist attacks as well as effective diagnostic procedures and treatments for WTC-related health conditions. The ability of the WTCHP to serve its members and realize positive impacts on all of its stakeholders depends on effective translation of research findings. As part of an ongoing assessment of the translational impact of World Trade Center (WTC)-related research, we applied the National Institute of Environmental Health Sciences (NIEHS) translational framework to two case studies: WTC-related research on post-traumatic stress disorder (PTSD) and cancer. We conducted a review of 9/11 health-related research in the peer-reviewed literature through October 2017, grey literature, and WTCHP program documentation. We mapped peer-reviewed studies in the literature to the NIEHS framework and used WTCHP program documentation and grey literature to find evidence of translation of research into clinical practice and policy. Using the NIEHS framework, we identified numerous translational milestones and bridges, as well as areas of opportunity, within each case study. This application demonstrates the utility of the NIEHS framework for documenting progress toward public health impact and for setting future research goals.


Asunto(s)
Ataques Terroristas del 11 de Septiembre , Trastornos por Estrés Postraumático , Humanos , Salud Mental , National Institute of Environmental Health Sciences (U.S.) , Ciudad de Nueva York , Salud Pública , Estados Unidos
7.
PLoS One ; 16(4): e0249768, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33826654

RESUMEN

In March 2020, New York City (NYC) experienced an outbreak of coronavirus disease 2019 (COVID-19) which resulted in a 78-day mass confinement of all residents other than essential workers. The aims of the current study were to (1) document the breadth of COVID-19 experiences and their impacts on college students of a minority-serving academic institution in NYC; (2) explore associations between patterns of COVID-19 experiences and psychosocial functioning during the prolonged lockdown, and (3) explore sex and racial/ethnic differences in COVID-19-related experiences and mental health correlates. A total of 909 ethnically and racially diverse students completed an online survey in May 2020. Findings highlight significant impediments to multiple areas of students' daily life during this period (i.e., home life, work life, social environment, and emotional and physical health) and a vast majority reported heightened symptoms of depression and generalized anxiety. These life disruptions were significantly related to poorer mental health. Moreover, those who reported the loss of a close friend or loved one from COVID-19 (17%) experienced significantly more psychological distress than counterparts with other types of infection-related histories. Nonetheless, the majority (96%) reported at least one positive experience since the pandemic began. Our findings add to a growing understanding of COVID-19 impacts on psychological health and contribute the important perspective of the North American epicenter of the pandemic during the time frame of this investigation. We discuss how the results may inform best practices to support students' well-being and serve as a benchmark for future studies of US student populations facing COVID-19 and its aftermath.


Asunto(s)
Ansiedad , Depresión , Salud Mental , Estrés Psicológico , Estudiantes , Universidades , Adolescente , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , /psicología , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Femenino , Humanos , Masculino , Ciudad de Nueva York , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología
8.
PLoS One ; 16(4): e0249349, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33831046

RESUMEN

BACKGROUND: Tocilizumab, an interleukin-6 receptor blocker, has been used in the inflammatory phase of COVID-19, but its impact independent of corticosteroids remains unclear in patients with severe disease. METHODS: In this retrospective analysis of patients with COVID-19 admitted between March 2 and April 14, 2020 to a large academic medical center in New York City, we describe outcomes associated with tocilizumab 400 mg (without methylprednisolone) compared to a propensity-matched control. The primary endpoints were change in a 7-point ordinal scale of oxygenation and ventilator free survival, both at days 14 and 28. Secondary endpoints include incidence of bacterial superinfections and gastrointestinal perforation. Primary outcomes were evaluated using t-test. RESULTS: We identified 33 patients who received tocilizumab and matched 74 controls based on demographics and health measures upon admission. After adjusting for illness severity and baseline ordinal scale, we failed to find evidence of an improvement in hypoxemia based on an ordinal scale at hospital day 14 in the tocilizumab group (OR 2.2; 95% CI, 0.7-6.5; p = 0.157) or day 28 (OR 1.1; 95% CI, 0.4-3.6; p = 0.82). There also was no evidence of an improvement in ventilator-free survival at day 14 (OR 0.8; 95% CI, 0.18-3.5; p = 0.75) or day 28 (OR 1.1; 95% CI, 0.1-1.8; p = 0.23). There was no increase in secondary bacterial infection rates in the tocilizumab group compared to controls (OR 0.37; 95% CI, 0.09-1.53; p = 0.168). CONCLUSIONS: There was no evidence to support an improvement in hypoxemia or ventilator-free survival with use of tocilizumab 400 mg in the absence of corticosteroids. No increase in secondary bacterial infections was observed in the group receiving tocilizumab.


Asunto(s)
Anticuerpos Monoclonales Humanizados/administración & dosificación , Infecciones Bacterianas , Brotes de Enfermedades , Hospitales de Enseñanza , Anticuerpos Monoclonales Humanizados/efectos adversos , Infecciones Bacterianas/etiología , Infecciones Bacterianas/mortalidad , /mortalidad , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Respiración Artificial , Estudios Retrospectivos , Tasa de Supervivencia
10.
BMJ Open Respir Res ; 8(1)2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33811098

RESUMEN

BACKGROUND: Corticosteroids are a potential therapeutic agent for patients with COVID-19 pneumonia. The RECOVERY (Randomised Trials in COVID-19 Therapy) trial provided data on the mortality benefits of corticosteroids. The study aimed to determine the association between corticosteroid use on mortality and infection rates and to define subgroups who may benefit from corticosteroids in a real-world setting. METHODS: Clinical data were extracted that included demographic, laboratory data and details of the therapy, including the administration of corticosteroids, azithromycin, hydroxychloroquine, tocilizumab and anticoagulation. The primary outcome was in-hospital mortality. Secondary outcomes included intensive care unit (ICU) admission and invasive mechanical ventilation. Outcomes were compared in patients who did and did not receive corticosteroids using the multivariate Cox regression model. RESULTS: 4313 patients were hospitalised with COVID-19 during the study period, of whom 1270 died (29.4%). When administered within the first 7 days after admission, corticosteroids were associated with reduced mortality (OR 0.73, 95% CI 0.55 to 0.97, p=0.03) and decreased transfers to the ICU (OR 0.72, 95% CI 0.47 to 1.11, p=0.02). This mortality benefit was particularly impressive in younger patients (<65 years of age), females and those with elevated inflammatory markers, defined as C reactive protein ≥150 mg/L (p≤0.05), interleukin-6 ≥20 pg/mL (p≤0.05) or D-dimer ≥2.0 µg/L (p≤0.05). Therapy was safe with similar rates of bacteraemia and fungaemia in corticosteroid-treated and non-corticosteroid-treated patients. CONCLUSION: In patients hospitalised with COVID-19 pneumonia, corticosteroid use within the first 7 days of admission decreased mortality and ICU admissions with no associated increase in bacteraemia or fungaemia.


Asunto(s)
Corticoesteroides/uso terapéutico , Hospitalización , Adulto , Anciano , Anciano de 80 o más Años , Antiinflamatorios/uso terapéutico , /mortalidad , Estudios de Cohortes , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York , Tasa de Supervivencia
11.
Clin Pediatr (Phila) ; 60(4-5): 247-251, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33853371

RESUMEN

The emergence of novel coronavirus disease-2019 poses an unprecedented challenge to pediatricians. While the majority of children experience mild disease, initial case reports on young infants are conflicting. We present a case series of 8 hospitalized infants 60 days of age or younger with coronavirus disease-2019. A quarter of these patients had coinfections (viral or bacterial). None of these infants had severe disease. Continued vigilance in testing this vulnerable group of infants is warranted.


Asunto(s)
/estadística & datos numéricos , Unidades de Cuidado Intensivo Neonatal , /aislamiento & purificación , Anticuerpos Antivirales/sangre , Servicio de Urgencia en Hospital , Femenino , Humanos , Lactante , Masculino , Ciudad de Nueva York , ARN Viral/análisis , Reacción en Cadena en Tiempo Real de la Polimerasa , Factores de Riesgo , Índice de Severidad de la Enfermedad
12.
PLoS One ; 16(3): e0243263, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33684104

RESUMEN

As mobile device location data become increasingly available, new analyses are revealing the significant changes of mobility pattern when an unplanned event happened. With different control policies from local and state government, the COVID-19 outbreak has dramatically changed mobility behavior in affected cities. This study has been investigating the impact of COVID-19 on the number of people involved in crashes accounting for the intensity of different control measures using Negative Binomial (NB) method. Based on a comprehensive dataset of people involved in crashes aggregated in New York City during January 1, 2020 to May 24, 2020, people involved in crashes with respect to travel behavior, traffic characteristics and socio-demographic characteristics are found. The results show that the average person miles traveled on the main traffic mode per person per day, percentage of work trip have positive effect on person involved in crashes. On the contrary, unemployment rate and inflation rate have negative effects on person involved in crashes. Interestingly, different level of control policies during COVID-19 outbreak are closely associated with safety awareness, driving and travel behavior, and thus has an indirect influence on the frequency of crashes. Comparing to other three control policies including emergence declare, limits on mass gatherings, and ban on all nonessential gathering, the negative relationship between stay-at-home policy implemented in New York City from March 20, 2020 and the number of people involved crashes is found in our study.


Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Conducción de Automóvil/estadística & datos numéricos , Seguridad/estadística & datos numéricos , Viaje/estadística & datos numéricos , Humanos , Ciudad de Nueva York , Política Pública , Asunción de Riesgos
13.
Undersea Hyperb Med ; 48(1): 89-96, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33648038

RESUMEN

The New York Bridge and Tunnel Commission began planning for a tunnel beneath the lower Hudson river to connect Manhattan to New Jersey in 1919. At 8,300 feet, it would be the longest tunnel for passenger vehicles in the world. A team of engineers and physiologists at the Yale University Bureau of Mines Experiment Station was tasked with calculating the ventilation requirements that would provide safety from exposure to automobile exhaust carbon monoxide (CO) while balancing the cost of providing ventilation. As the level of ambient CO which was comfortably tolerated was not precisely defined, they performed human exposures breathing from 100 to 1,000 ppm CO, first on themselves and subsequently on Yale medical students. Their findings continue to provide a basis for carbon monoxide alarm requirements a century later.


Asunto(s)
Intoxicación por Monóxido de Carbono/prevención & control , Arquitectura y Construcción de Instituciones de Salud/historia , Estaciones de Transporte/historia , Emisiones de Vehículos/envenenamiento , Monóxido de Carbono/análisis , Intoxicación por Monóxido de Carbono/historia , Carboxihemoglobina/análisis , Historia del Siglo XX , Humanos , New Jersey , Ciudad de Nueva York , Valores de Referencia , Ríos , Ventilación/economía , Ventilación/métodos
14.
J Urban Health ; 98(2): 197-204, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33649905

RESUMEN

There is growing evidence on the effect of face mask use in controlling the spread of COVID-19. However, few studies have examined the effect of local face mask policies on the pandemic. In this study, we developed a dynamic compartmental model of COVID-19 transmission in New York City (NYC), which was the epicenter of the COVID-19 pandemic in the USA. We used data on daily and cumulative COVID-19 infections and deaths from the NYC Department of Health and Mental Hygiene to calibrate and validate our model. We then used the model to assess the effect of the executive order on face mask use on infections and deaths due to COVID-19 in NYC. Our results showed that the executive order on face mask use was estimated to avert 99,517 (95% CIs 72,723-126,312) COVID-19 infections and 7978 (5692-10,265) deaths in NYC. If the executive order was implemented 1 week earlier (on April 10), the averted infections and deaths would be 111,475 (81,593-141,356) and 9017 (6446-11,589), respectively. If the executive order was implemented 2 weeks earlier (on April 3 when the Centers for Disease Control and Prevention recommended face mask use), the averted infections and deaths would be 128,598 (94,373-162,824) and 10,515 (7540-13,489), respectively. Our study provides public health practitioners and policymakers with evidence on the importance of implementing face mask policies in local areas as early as possible to control the spread of COVID-19 and reduce mortality.


Asunto(s)
Máscaras , Humanos , Ciudad de Nueva York/epidemiología , Pandemias
15.
Nat Commun ; 12(1): 1660, 2021 03 12.
Artículo en Inglés | MEDLINE | ID: mdl-33712587

RESUMEN

In less than nine months, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) killed over a million people, including >25,000 in New York City (NYC) alone. The COVID-19 pandemic caused by SARS-CoV-2 highlights clinical needs to detect infection, track strain evolution, and identify biomarkers of disease course. To address these challenges, we designed a fast (30-minute) colorimetric test (LAMP) for SARS-CoV-2 infection from naso/oropharyngeal swabs and a large-scale shotgun metatranscriptomics platform (total-RNA-seq) for host, viral, and microbial profiling. We applied these methods to clinical specimens gathered from 669 patients in New York City during the first two months of the outbreak, yielding a broad molecular portrait of the emerging COVID-19 disease. We find significant enrichment of a NYC-distinctive clade of the virus (20C), as well as host responses in interferon, ACE, hematological, and olfaction pathways. In addition, we use 50,821 patient records to find that renin-angiotensin-aldosterone system inhibitors have a protective effect for severe COVID-19 outcomes, unlike similar drugs. Finally, spatial transcriptomic data from COVID-19 patient autopsy tissues reveal distinct ACE2 expression loci, with macrophage and neutrophil infiltration in the lungs. These findings can inform public health and may help develop and drive SARS-CoV-2 diagnostic, prevention, and treatment strategies.


Asunto(s)
/genética , /genética , Adulto , Anciano , Antagonistas de Receptores de Angiotensina/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Antivirales/farmacología , /epidemiología , Interacciones Farmacológicas , Femenino , Perfilación de la Expresión Génica , Genoma Viral , Antígenos HLA/genética , Interacciones Microbiota-Huesped/efectos de los fármacos , Interacciones Microbiota-Huesped/genética , Humanos , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular , Ciudad de Nueva York/epidemiología , Técnicas de Amplificación de Ácido Nucleico , Pandemias , RNA-Seq , /efectos de los fármacos
16.
Environ Sci Technol ; 55(8): 4332-4343, 2021 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-33720711

RESUMEN

Despite decades of declining air pollution, urban U.S. areas are still affected by summertime ozone and wintertime particulate matter exceedance events. Volatile organic compounds (VOCs) are known precursors of secondary organic aerosol (SOA) and photochemically produced ozone. Urban VOC emission sources, including on-road transportation emissions, have decreased significantly over the past few decades through successful regulatory measures. These drastic reductions in VOC emissions have led to a change in the distribution of urban emissions and noncombustion sources of VOCs such as those from volatile chemical products (VCPs), which now account for a higher fraction of the urban VOC burden. Given this shift in emission sources, it is essential to quantify the relative contribution of VCP and mobile source emissions to urban pollution. Herein, ground site and mobile laboratory measurements of VOCs were performed. Two ground site locations with different population densities, Boulder, CO, and New York City (NYC), NY, were chosen in order to evaluate the influence of VCPs in cities with varying mixtures of VCPs and mobile source emissions. Positive matrix factorization was used to attribute hundreds of compounds to mobile- and VCP-dominated sources. VCP-dominated emissions contributed to 42 and 78% of anthropogenic VOC emissions for Boulder and NYC, respectively, while mobile source emissions contributed 58 and 22%. Apportioned VOC emissions were compared to those estimated from the Fuel-based Inventory of Vehicle Emissions and VCPs and agreed to within 25% for the bulk comparison and within 30% for more than half of individual compounds. The evaluated inventory was extended to other U.S. cities and it suggests that 50 to 80% of emissions, reactivity, and the SOA-forming potential of urban anthropogenic VOCs are associated with VCP-dominated sources, demonstrating their important role in urban U.S. air quality.


Asunto(s)
Contaminantes Atmosféricos , Ozono , Compuestos Orgánicos Volátiles , Contaminantes Atmosféricos/análisis , Ciudades , Monitoreo del Ambiente , Ciudad de Nueva York , Ozono/análisis , Material Particulado/análisis , Emisiones de Vehículos/análisis , Compuestos Orgánicos Volátiles/análisis
17.
Proc Natl Acad Sci U S A ; 118(13)2021 03 30.
Artículo en Inglés | MEDLINE | ID: mdl-33727410

RESUMEN

Although there is increasing awareness of disparities in COVID-19 infection risk among vulnerable communities, the effect of behavioral interventions at the scale of individual neighborhoods has not been fully studied. We develop a method to quantify neighborhood activity behaviors at high spatial and temporal resolutions and test whether, and to what extent, behavioral responses to social-distancing policies vary with socioeconomic and demographic characteristics. We define exposure density ([Formula: see text]) as a measure of both the localized volume of activity in a defined area and the proportion of activity occurring in distinct land-use types. Using detailed neighborhood data for New York City, we quantify neighborhood exposure density using anonymized smartphone geolocation data over a 3-mo period covering more than 12 million unique devices and rasterize granular land-use information to contextualize observed activity. Next, we analyze disparities in community social distancing by estimating variations in neighborhood activity by land-use type before and after a mandated stay-at-home order. Finally, we evaluate the effects of localized demographic, socioeconomic, and built-environment density characteristics on infection rates and deaths in order to identify disparities in health outcomes related to exposure risk. Our findings demonstrate distinct behavioral patterns across neighborhoods after the stay-at-home order and that these variations in exposure density had a direct and measurable impact on the risk of infection. Notably, we find that an additional 10% reduction in exposure density city-wide could have saved between 1,849 and 4,068 lives during the study period, predominantly in lower-income and minority communities.


Asunto(s)
/transmisión , Disparidades en el Estado de Salud , Características de la Residencia/estadística & datos numéricos , Entorno Construido , /prevención & control , Sistemas de Información Geográfica , Humanos , Ciudad de Nueva York/epidemiología , Factores de Riesgo , Factores Socioeconómicos , Análisis Espacio-Temporal
18.
Transfusion ; 61(4): 1064-1070, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33665881

RESUMEN

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variable clinical course with significant mortality. Early reports suggested higher rates of SARS-CoV-2 infection in patients with type A blood and enrichment of type A individuals among COVID-19 mortalities. STUDY DESIGN AND METHODS: The study includes all patients hospitalized or with an emergency department (ED) visit who were tested for SARS-CoV-2 between March 10, 2020 and June 8, 2020 and had a positive test result by nucleic acid test (NAT) performed on a nasopharyngeal swab specimen. A total of 4968 patients met the study inclusion criteria, with a subsequent 23.1% (n = 1146/4968) all-cause mortality rate in the study cohort. To estimate overall risk by ABO type and account for the competing risks of in-hospital mortality and discharge, we calculated the cumulative incidence function (CIF) for each event. Cause-specific hazard ratios (csHRs) for in-hospital mortality and discharge were analyzed using multivariable Cox proportional hazards models. RESULTS: Type A blood was associated with the increased cause-specific hazard of death among COVID-19 patients compared to type O (HR = 1.17, 1.02-1.33, p = .02) and type B (HR = 1.32,1.10-1.58, p = .003). CONCLUSIONS: Our study shows that ABO histo-blood group type is associated with the risk of in-hospital death in COVID-19 patients, warranting additional inquiry. Elucidating the mechanism behind this association may reveal insights into the susceptibility and/or immunity to SARS-CoV-2.


Asunto(s)
/sangre , Mortalidad Hospitalaria , Hospitales , /metabolismo , Sistema del Grupo Sanguíneo ABO , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Estudios Retrospectivos , Tasa de Supervivencia
19.
JAMA Netw Open ; 4(3): e214302, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33749770

RESUMEN

Importance: Accumulating evidence suggests that children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to manifest mild symptoms and are at a lower risk of developing severe respiratory disease compared with adults. It remains unknown how the immune response in children differs from that of adolescents and adults. Objective: To investigate the association of age with the quantity and quality of SARS-CoV-2 antibody responses. Design, Setting, and Participants: This cross-sectional study used 31 426 SARS-CoV-2 antibody test results from pediatric and adult patients. Data were collected from a New York City hospital from April 9 to August 31, 2020. The semiquantitative immunoglobin (Ig) G levels were compared between 85 pediatric and 3648 adult patients. Further analysis of SARS-CoV-2 antibody profiles was performed on sera from 126 patients aged 1 to 24 years. Main Outcomes and Measures: SARS-CoV-2 antibody positivity rates and IgG levels were evaluated in patients from a wide range of age groups (1-102 years). SARS-CoV-2 IgG level, total antibody (TAb) level, surrogate neutralizing antibody (SNAb) activity, and antibody binding avidity were compared between children (aged 1-10 years), adolescents (aged 11-18 years), and young adults (aged 19-24 years). Results: Among 31 426 antibody test results (19 797 [63.0%] female patients), with 1194 pediatric patients (mean [SD] age, 11.0 [5.3] years) and 30 232 adult patients (mean [SD] age, 49.2 [17.1] years), the seroprevalence in the pediatric (197 [16.5%; 95% CI, 14.4%-18.7%]) and adult (5630 [18.6%; 95% CI, 18.2%-19.1%]) patient populations was similar. The SARS-CoV-2 IgG level showed a negative correlation with age in the pediatric population (r = -0.45, P < .001) and a moderate but positive correlation with age in adults (r = 0.24, P < .001). Patients aged 19 to 30 years exhibited the lowest IgG levels (eg, aged 25-30 years vs 1-10 years: 99 [44-180] relative fluorescence units [RFU] vs 443 [188-851] RFU). In the subset cohort aged 1 to 24 years, IgG, TAb, SNAb and avidity were negatively correlated with age (eg, IgG: r = -0.51; P < .001). Children exhibited higher median (IQR) IgG levels, TAb levels, and SNAb activity compared with adolescents (eg, IgG levels: 473 [233-656] RFU vs 191 [82-349] RFU; P < .001) and young adults (eg, IgG levels: 473 [233-656] RFU vs 85 [38-150] RFU; P < .001). Adolescents also exhibited higher median (IQR) TAb levels, IgG levels, and SNAb activity than young adults (eg, TAb levels: 961 [290-2074] RFU vs 370 [125-697]; P = .006). In addition, children had higher antibody binding avidity compared with young adults, but the difference was not significant. Conclusions and Relevance: The results of this study suggest that SARS-CoV-2 viral specific antibody response profiles are distinct in different age groups. Age-targeted strategies for disease screening and management as well as vaccine development may be warranted.


Asunto(s)
Anticuerpos Neutralizantes/sangre , Anticuerpos Antivirales/sangre , Afinidad de Anticuerpos/inmunología , Formación de Anticuerpos/inmunología , Factores de Edad , /epidemiología , /métodos , Niño , Correlación de Datos , Estudios Transversales , Femenino , Humanos , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , /aislamiento & purificación
20.
World Neurosurg ; 148: 256-262, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33770848

RESUMEN

Coronavirus disease 2019 (COVID-19) has disrupted lives and indelibly impacted the practice of medicine since emerging as a pandemic in March 2020. For neurosurgery departments throughout the United States, the pandemic has created unique challenges across subspecialties in devising methods of triage, workflow, and operating room safety. Located in New York City, at the early epicenter of the COVID-19 crisis, the Weill Cornell Medicine Department of Neurological Surgery was disrupted and challenged in many ways, requiring adaptations in clinical operations, workforce management, research, and education. Through our department's collective experience, we offer a glimpse at how our faculty and administrators overcame obstacles, and transformed in the process, at the height of the COVID-19 pandemic.


Asunto(s)
Prestación de Atención de Salud , Educación a Distancia , Neurocirugia/organización & administración , Procedimientos Neuroquirúrgicos , Centros Médicos Académicos , Investigación Biomédica , Docentes Médicos , Personal de Salud , Departamentos de Hospitales , Humanos , Neurocirugia/educación , Neurocirugia/métodos , Ciudad de Nueva York , Quirófanos , Administración de Personal , Triaje , Difusión por la Web como Asunto , Flujo de Trabajo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...