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1.
R I Med J (2013) ; 104(9): 24-28, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705903

RESUMO

BACKGROUND: Increasing temperatures negatively impact health and increases demands on healthcare systems. However, this has been poorly studied in Rhode Island (RI). Here we characterize the impact of heat on emergency medical services (EMS) utilization in RI. METHODS: The Rhode Island National Emergency Services Information System V3 dataset was merged with data from the National Center for Environmental Information of the National Oceanic and Atmospheric Administration from the summers of 2018 and 2019. The outcome of daily mean EMS runs were compared against the exposure increasing daily temperatures, measured as daily maximum, minimum and daily average °F, using Poisson regressions. Patient characteristics were included across temperature models. RESULTS: Increasing daily temperatures were associated with increasing EMS encounters. The adjusted incident rate ratio (IRR) for mean daily EMS encounters by increasing maximum daily temperature was 1.006 (95% CI 1.004-1.007, Table 3). This resulted in a projected 17.2% increase in EMS runs on days with a maximum temperature of 65°F compared to days with a maximum temperature of 95°F. The adjusted IRR for mean daily EMS encounters by the daily minimum temperature was 1.004 (1.003-1.006) and the adjusted IRR for the mean daily EMS encounters by the daily average temperature was 1.006 (1.005-1.008). CONCLUSIONS: Increasing minimum, maximum, and average daily temperatures were associated with increasing EMS utilization across Rhode Island in the summers of 2018 and 2019. Further research into these trends may help with planning and resource allocation as summer temperatures continue to rise.


Assuntos
Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Temperatura Alta , Humanos , Rhode Island/epidemiologia , Temperatura
2.
R I Med J (2013) ; 104(9): 29-33, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705904

RESUMO

Human cases of tick-borne diseases have been increasing in the United States. In particular, the incidence of Lyme disease, the major vector-borne disease in Rhode Island, has risen, along with cases of babesiosis and anaplasmosis, all vectored by the blacklegged tick. These increases might relate, in part, to climate change, although other environmental changes in the northeastern U.S. (land use as it relates to habitat; vertebrate host populations for tick reproduction and enzootic cycling) also contribute. Lone star ticks, formerly southern in distribution, have been spreading northward, including expanded distributions in Rhode Island. Illnesses associated with this species include ehrlichiosis and alpha-gal syndrome, which are expected to increase. Ranges of other tick species have also been expanding in southern New England, including the Gulf Coast tick and the introduced Asian longhorned tick. These ticks can carry human pathogens, but the implications for human disease in Rhode Island are unclear.


Assuntos
Doenças Transmitidas por Carrapatos , Anaplasmose/epidemiologia , Animais , Babesiose/epidemiologia , Mudança Climática , Hipersensibilidade Alimentar/epidemiologia , Humanos , Doença de Lyme/epidemiologia , Rhode Island/epidemiologia , Doenças Transmitidas por Carrapatos/epidemiologia , Estados Unidos
3.
MMWR Morb Mortal Wkly Rep ; 70(43): 1501-1504, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34710080

RESUMO

During 2018-2019, the Rhode Island Department of Health (RIDOH) and the Missouri Department of Health and Senior Services (DHSS) investigated cases of metal poisonings associated with commercially and home-prepared cakes decorated with products referred to as luster dust. Several types of glitters and dusts, broadly known as luster dust,* for use on prepared foods can be purchased online and in craft and bakery supply stores (1). Decorating foods with luster dust and similar products is a current trend, popularized on television programs, instructional videos, blogs, and in magazine articles.† Some luster dusts are specifically produced with edible ingredients that can be safely consumed. Companies that make edible luster dust are required by law to include a list of ingredients on the label (2). Luster dusts that are safe for consumption are typically marked "edible" on the label. Some luster dusts used as cake decorations are not edible or food grade; labeled as "nontoxic" or "for decorative purposes only," these luster dusts are intended to be removed before consumption (3). RIDOH (2018) and Missouri DHSS (2019), investigated heavy metal poisonings associated with commercially and home-prepared cakes decorated with luster dust after receiving reports of children (aged 1-11 years) who became ill after consuming birthday cake. Cases in Rhode Island were associated with copper ingestion, and the case in Missouri was associated with a child's elevated blood lead level. In Rhode Island, luster dust products that had been used in cake frosting were found to contain high levels of multiple metals.§ These events indicate that increased vigilance by public health departments and further guidance to consumers and bakeries are needed to prevent unintentional poisonings. Labeling indicating that a product is nontoxic does not imply that the product is safe for consumption. Explicit labeling indicating that nonedible products are not safe for human consumption is needed to prevent illness from inappropriate use of inedible products on foods. Educating consumers, commercial bakers, and public health professionals about potential hazards of items used in food preparation is essential to preventing illness and unintentional poisoning from toxic metals and other nonedible ingredients.


Assuntos
Poeira , Contaminação de Alimentos , Intoxicação por Metais Pesados/epidemiologia , Criança , Pré-Escolar , Humanos , Lactente , Missouri/epidemiologia , Rhode Island/epidemiologia
4.
JAMA Netw Open ; 4(9): e2125538, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34533569

RESUMO

Importance: The rate of deaths from overdose has increased during the COVID-19 pandemic, and recent US overdose mortality rates have been markedly high. However, scant data are available on the causes of this increase or subpopulations at elevated risk. Objective: To evaluate the rates and characteristics of deaths from drug overdose before vs during the COVID-19 pandemic. Design, Setting, and Participants: This retrospective, population-based cohort study used data from 4 statewide databases linked at the person level via the Rhode Island Data Ecosystem on adults with deaths due to overdose in Rhode Island from January 1 to August 31, 2019, and January 1 to August 31, 2020. Main Outcomes and Measures: The rates of unintentional deaths from drug-related overdose during the 2019 and 2020 observation periods overall and by sociodemographic characteristics, drugs contributing to the cause of death, location of death, and socioeconomic factors were evaluated. In subgroup analyses restricted to Medicaid beneficiaries (n = 271), the proportions of deaths from overdose by behavioral health treatment and diagnosis claims in the year before death were also examined. Results: A total of 470 adults who died of drug overdose were included in the analysis (353 men [75%]; mean [SD] age, 43.5 [12.1] years). The rate of deaths from overdose in Rhode Island increased 28.1%, from 29.2 per 100 000 person-years in 2019 to 37.4 per 100 000 person-years in 2020 (P = .009). Compared with 2019, rates of deaths due to overdose during 2020 were higher among men (43.2 vs 59.2 per 100 000 person-years; P = .003), non-Hispanic White individuals (31.0 vs 42.0 per 100 000 person-years; P = .005), single individuals (54.8 vs 70.4 per 100 000 person-years; P = .04), deaths involving synthetic opioids (20.8 vs 28.3 per 100 000 person-years; P = .005), and deaths occurring in a personal residence (13.2 vs 19.7 per 100 000 person-years; P = .003). A decrease in the proportion of deaths from overdose involving heroin (11 of 206 [5%] vs <2% [exact value suppressed]; P = .02) and an increase among persons experiencing job loss (16 of 206 [8%] vs 41 of 264 [16%]; P = .01) from 2019 to 2020 were observed. Among individuals who died of overdose and were Medicaid beneficiaries, the proportions of those aged 50 to 59 years with anxiety (11 of 121 [9%] vs 29 of 150 [19%]; P = .03), men with depression (27 of 121 [22%] vs 57 of 150 [38%]; P = .008), and men with anxiety (28 of 121 [23%] vs 55 of 150 [37%]; P = .02) increased during 2020 compared with 2019. Conclusions and Relevance: In this cohort study, during the first 8 months of 2020, the rate of deaths from overdose increased in Rhode Island compared with the same period in 2019, and several emerging characteristics of deaths from drug overdose during the first year of the COVID-19 pandemic were identified. These findings may inform interventions that address macroenvironmental changes associated with the pandemic.


Assuntos
COVID-19 , Overdose de Drogas/mortalidade , Adulto , Estudos de Coortes , Overdose de Drogas/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Quarentena/psicologia , Quarentena/estatística & dados numéricos , Estudos Retrospectivos , Rhode Island/epidemiologia
6.
Child Obes ; 17(S1): S11-S21, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34569839

RESUMO

Background: Overweight and obesity in children is a public health crisis in the United States. Although evidence-based interventions have been developed, such programs are difficult to access. Dissemination of evidence-based pediatric weight management interventions (PWMIs) to families from diverse low-income communities is the primary objective of the CDC Childhood Obesity Research Demonstration (CORD) projects. Methods: The goal of the Rhode Island CORD 3.0 project is to adapt the evidence-based PWMI, JOIN for ME, for delivery among diverse families from low-income backgrounds and to test it in a hybrid effectiveness-implementation trial design in which the aims are to examine implementation and patient-centered outcomes. Children between the ages of 6 and 12 years with BMI ≥85th percentile and a caregiver will be recruited through two settings, a federally qualified health center, which serves as a patient-centered medical home, or low-income housing. Dyads will receive a remotely delivered group-based intervention that is 10 months in duration and includes 16 weekly sessions, followed by 4 biweekly and 4 monthly meetings. Assessments of child and caregiver weight status and child health-related quality of life will be conducted at baseline, and at 4 and 10 months after the start of intervention. Implementation outcomes assessing intervention acceptability, adoption, feasibility, fidelity, and penetration/reach will be collected to inform subsequent dissemination. Conclusions: If the adapted version of the JOIN for ME intervention can be successfully implemented and is shown to be effective, this project will provide a model for a scalable PWMI for families from low-income backgrounds. ClinicalTrials.gov no. NCT04647760.


Assuntos
Obesidade Pediátrica , Centers for Disease Control and Prevention, U.S. , Criança , Promoção da Saúde , Humanos , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/prevenção & controle , Qualidade de Vida , Rhode Island/epidemiologia , Estados Unidos
7.
Child Obes ; 17(S1): S22-S29, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34569847

RESUMO

Advances have been made in the development of effective interventions to address pediatric obesity; however, research findings often do not translate into clinical practice and a limited number of programs have been designed toward wide-spread dissemination and implementation. The Rhode Island (RI)-Childhood Obesity Research Demonstration (CORD) 3.0 Project involves adapting and testing an evidence-based pediatric weight management intervention (PWMI), JOIN for ME, for wide-scale dissemination and implementation in communities with a high proportion of families from low-income backgrounds. In this article, we describe the robust developmental formative evaluation (FE) process employed by RI-CORD as a model for the use of FE to drive dissemination of evidence-based PWMIs. The current project was guided by the Consolidated Framework for Implementation Research and Proctor Implementation Outcomes. This article also showcases examples of how the use of key informant interviews from engaged stakeholders in the community during a developmental FE process can drive selection of implementation strategies. The use of FE, driven by evidence-based theory, can help provide a roadmap to successful implementation of a pediatric weight management program, such as JOIN for ME.


Assuntos
Obesidade Pediátrica , Criança , Humanos , Obesidade Pediátrica/prevenção & controle , Pobreza , Avaliação de Programas e Projetos de Saúde , Rhode Island/epidemiologia
9.
Emerg Infect Dis ; 27(9): 2445-2449, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34424174

RESUMO

We developed a testing program for severe acute respiratory syndrome coronavirus 2 in an urban Latinx neighborhood in Providence, Rhode Island, USA. Approximately 11% of Latinx participants (n = 180) tested positive. Culturally tailored, community-based programs that reduce barriers to testing help identify persons at highest risk for coronavirus disease.


Assuntos
COVID-19 , SARS-CoV-2 , Teste para COVID-19 , Humanos , Área Carente de Assistência Médica , Rhode Island/epidemiologia
10.
BMC Infect Dis ; 21(1): 871, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433423

RESUMO

BACKGROUND: Epidemic projections and public health policies addressing Coronavirus disease (COVID)-19 have been implemented without data reporting on the seroconversion of the population since scalable antibody testing has only recently become available. METHODS: We measured the percentage of severe acute respiratory syndrome- Coronavirus-2 (SARS-CoV-2) seropositive individuals from 2008 blood donors drawn in the state of Rhode Island (RI). We utilized multiple antibody testing platforms, including lateral flow immunoassays (LFAs), enzyme-linked immunosorbent assays (ELISAs) and high throughput serological assays (HTSAs). To estimate seroprevalence, we utilized the Bayesian statistical method to adjust for sensitivity and specificity of the commercial tests used. RESULTS: We report than an estimated seropositive rate of RI blood donors of approximately 0.6% existed in April-May of 2020. Daily new case rates peaked in RI in late April 2020. We found HTSAs and LFAs were positively correlated with ELISA assays to detect antibodies specific to SARS-CoV-2 in blood donors. CONCLUSIONS: These data imply that seroconversion, and thus infection, is likely not widespread within this population. We conclude that IgG LFAs and HTSAs are suitable to conduct seroprevalence assays in random populations. More studies will be needed using validated serological tests to improve the precision and report the kinetic progression of seroprevalence estimates.


Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue , COVID-19/epidemiologia , SARS-CoV-2 , Teorema de Bayes , Humanos , Rhode Island/epidemiologia , Estudos Soroepidemiológicos
11.
Parasit Vectors ; 14(1): 394, 2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34376221

RESUMO

BACKGROUND: Invasive arthropod vectors and the range expansions of native vectors can lead to public and veterinary health concerns, as these vectors may introduce novel pathogens or spread endemic pathogens to new locations. Recent tick invasions and range expansion in the USA has been attributed to climate and land use change, an increase in global travel, and importations of exotic animals. METHODS: A 10-year surveillance study was conducted on Block Island, Rhode Island, from 2010 to 2020 including sampling ticks from small mammal and avian hosts. RESULTS: We report the discovery and establishment of the red sheep tick (Haemaphysalis punctata) for the first time in the western hemisphere and in the US. This invasive species was first collected in 2010 on Block Island, was collected continuously throughout the study, and was collected from an avian host. We document the first report of the invasive Asian longhorned tick (Haemaphysalis longicornis) in the state of Rhode Island, first observed at our sites in 2018. Finally, we present data on the range expansion and establishment of two native tick species, the lone star tick and the rabbit tick, on Block Island. CONCLUSION: This study emphasized the importance of long-term surveillance to detect changes in tick host communities, including invasive and expanding native vectors of potential significance to humans and wildlife.


Assuntos
Espécies Introduzidas , Ixodidae/genética , Mamíferos/parasitologia , Infestações por Carrapato/veterinária , Animais , Animais Selvagens/parasitologia , Vetores Artrópodes/parasitologia , Aves/parasitologia , Feminino , Ixodidae/classificação , Masculino , Ninfa , Rhode Island/epidemiologia , Ovinos/parasitologia , Infestações por Carrapato/epidemiologia
13.
R I Med J (2013) ; 104(6): 22-27, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34323875

RESUMO

BACKGROUND: In Rhode Island, malignant melanoma of skin causes about 30 deaths a year. Early detection has been shown to reduce mortality risk. METHODS: Dermatology volunteers and public health professionals convened 27 free skin cancer screenings at public beaches in 2015-2019 to raise skin cancer awareness and screen patients for malignancy. Participants with suspicious lesions were referred for follow-up and later telephoned to ascertain outcomes. RESULTS: Of 2354 people screened, 597 (25%) were referred. 319 of 597 (53%) were later reached by telephone. 196 of 319 (61%) who had kept appointments by the time of the telephone call reported the following diagnoses: 7 malignant melanomas, 32 keratinocyte carcinomas, and 34 actinic keratoses, yielding 3.0 as number needed to biopsy (NNB), and 18.3 as number needed to screen (NNS). CONCLUSIONS: Our results demonstrate the value of convenient skin cancer screening events, suggesting the desirability of additional interventions of this type.


Assuntos
Melanoma , Neoplasias Cutâneas , Biópsia , Detecção Precoce de Câncer , Humanos , Programas de Rastreamento , Melanoma/diagnóstico , Melanoma/epidemiologia , Rhode Island/epidemiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia
14.
BMC Med ; 19(1): 162, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-34253200

RESUMO

BACKGROUND: When three SARS-CoV-2 vaccines came to market in Europe and North America in the winter of 2020-2021, distribution networks were in a race against a major epidemiological wave of SARS-CoV-2 that began in autumn 2020. Rapid and optimized vaccine allocation was critical during this time. With 95% efficacy reported for two of the vaccines, near-term public health needs likely require that distribution is prioritized to the elderly, health care workers, teachers, essential workers, and individuals with comorbidities putting them at risk of severe clinical progression. METHODS: We evaluate various age-based vaccine distributions using a validated mathematical model based on current epidemic trends in Rhode Island and Massachusetts. We allow for varying waning efficacy of vaccine-induced immunity, as this has not yet been measured. We account for the fact that known COVID-positive cases may not have been included in the first round of vaccination. And, we account for age-specific immune patterns in both states at the time of the start of the vaccination program. Our analysis assumes that health systems during winter 2020-2021 had equal staffing and capacity to previous phases of the SARS-CoV-2 epidemic; we do not consider the effects of understaffed hospitals or unvaccinated medical staff. RESULTS: We find that allocating a substantial proportion (>75%) of vaccine supply to individuals over the age of 70 is optimal in terms of reducing total cumulative deaths through mid-2021. This result is robust to different profiles of waning vaccine efficacy and several different assumptions on age mixing during and after lockdown periods. As we do not explicitly model other high-mortality groups, our results on vaccine allocation apply to all groups at high risk of mortality if infected. A median of 327 to 340 deaths can be avoided in Rhode Island (3444 to 3647 in Massachusetts) by optimizing vaccine allocation and vaccinating the elderly first. The vaccination campaigns are expected to save a median of 639 to 664 lives in Rhode Island and 6278 to 6618 lives in Massachusetts in the first half of 2021 when compared to a scenario with no vaccine. A policy of vaccinating only seronegative individuals avoids redundancy in vaccine use on individuals that may already be immune, and would result in 0.5% to 1% reductions in cumulative hospitalizations and deaths by mid-2021. CONCLUSIONS: Assuming high vaccination coverage (>28%) and no major changes in distancing, masking, gathering size, hygiene guidelines, and virus transmissibility between 1 January 2021 and 1 July 2021 a combination of vaccination and population immunity may lead to low or near-zero transmission levels by the second quarter of 2021.


Assuntos
Vacinas contra COVID-19/provisão & distribuição , COVID-19 , Controle de Doenças Transmissíveis/organização & administração , Alocação de Recursos para a Atenção à Saúde/organização & administração , Alocação de Recursos/organização & administração , Cobertura Vacinal , Vacinação , Fatores Etários , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Incidência , Massachusetts/epidemiologia , Modelos Teóricos , Saúde Pública/métodos , Saúde Pública/normas , Rhode Island/epidemiologia , SARS-CoV-2 , Vacinação/métodos , Vacinação/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Cobertura Vacinal/provisão & distribuição
16.
R I Med J (2013) ; 104(7): 16-20, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34279520

RESUMO

COVID-19 is a worldwide public health emergency caused by SARS-CoV-2. Genomic surveillance of SARS-CoV-2 emerging variants is important for pandemic monitoring and informing public health responses. Through an interstate academic-public health partnership, we established Rhode Island's capacity to sequence SARS-CoV-2 genomes and created a systematic surveillance program to monitor the prevalence of SARS-CoV-2 variants in the state. We describe circulating SARS-CoV-2 lineages in Rhode Island; provide a timeline for the emerging and expanding contribution of variants of concern (VOC) and variants of interest (VOI), from their first introduction to their eventual predominance over other lineages; and outline the frequent identification of known adaptively beneficial spike protein mutations that appear to have independently arisen in non-VOC/non-VOI lineages. Overall, the described Rhode Island- centric genomic surveillance initiative provides a valuable perspective on SARS-CoV-2 in the state and contributes data of interest for future epidemiological studies and state-to-state comparisons.


Assuntos
COVID-19/virologia , SARS-CoV-2/genética , COVID-19/epidemiologia , Monitoramento Epidemiológico , Variação Genética , Genômica , Humanos , Pandemias , Vigilância da População , Rhode Island/epidemiologia , SARS-CoV-2/isolamento & purificação
17.
PLoS One ; 16(6): e0252411, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34143791

RESUMO

BACKGROUND: In order for healthcare systems to prepare for future waves of COVID-19, an in-depth understanding of clinical predictors is essential for efficient triage of hospitalized patients. METHODS: We performed a retrospective cohort study of 259 patients admitted to our hospitals in Rhode Island to examine differences in baseline characteristics (demographics and comorbidities) as well as presenting symptoms, signs, labs, and imaging findings that predicted disease progression and in-hospital mortality. RESULTS: Patients with severe COVID-19 were more likely to be older (p = 0.02), Black (47.2% vs. 32.0%, p = 0.04), admitted from a nursing facility (33.0% vs. 17.9%, p = 0.006), have diabetes (53.9% vs. 30.4%, p<0.001), or have COPD (15.4% vs. 6.6%, p = 0.02). In multivariate regression, Black race (adjusted odds ratio [aOR] 2.0, 95% confidence interval [CI]: 1.1-3.9) and diabetes (aOR 2.2, 95%CI: 1.3-3.9) were independent predictors of severe disease, while older age (aOR 1.04, 95% CI: 1.01-1.07), admission from a nursing facility (aOR 2.7, 95% CI 1.1-6.7), and hematological co-morbidities predicted mortality (aOR 3.4, 95% CI 1.1-10.0). In the first 24 hours, respiratory symptoms (aOR 7.0, 95% CI: 1.4-34.1), hypoxia (aOR 19.9, 95% CI: 2.6-152.5), and hypotension (aOR 2.7, 95% CI) predicted progression to severe disease, while tachypnea (aOR 8.7, 95% CI: 1.1-71.7) and hypotension (aOR 9.0, 95% CI: 3.1-26.1) were associated with increased in-hospital mortality. CONCLUSIONS: Certain patient characteristics and clinical features can help clinicians with early identification and triage of high-risk patients during subsequent waves of COVID-19.


Assuntos
COVID-19/epidemiologia , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Idoso , COVID-19/mortalidade , COVID-19/virologia , Comorbidade , Diabetes Mellitus/epidemiologia , Epidemias , Feminino , Humanos , Hipotensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rhode Island/epidemiologia , Fatores de Risco , SARS-CoV-2/fisiologia , Taquipneia/epidemiologia , Triagem/métodos
18.
R I Med J (2013) ; 104(5): 8-13, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34044430

RESUMO

Forty-one (41) patients admitted to Rhode Island hospitals with COVID-19 from April to November 2020 were identified to have severe cardiac complications. Clinical presentations of cardiovascular system toxicity in COVID-19 included myocarditis, pericarditis, cardiomyopathy, ACS and cardiac arrhythmia. Clinical features, hospital outcomes and post-discharge outcomes were characterized. Acute myocarditis (46.3%) and cardiomyopathy (29.3%) were the most common findings followed by cardiac arrhythmia, acute coronary syndrome, and pericardial disease. Pulmonary involvement of COVID-19 was absent in 41.5% of patients. Comorbid cardiovascular conditions were absent in 29.3% of patients. Severe cardiac complications in COVID-19 were associated with an in-hospital mortality rate of 61%. Among survivors with COVID-19-related cardiomyopathy, only 20% demonstrated recovery of LV function on follow-up echocardiography done within 12 weeks after initial diagnosis. Identification, diagnosis and management of severe cardiac complications in COVID-19 are discussed.


Assuntos
COVID-19/complicações , Cardiopatias/diagnóstico , Cardiopatias/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/mortalidade , COVID-19/terapia , Feminino , Seguimentos , Cardiopatias/mortalidade , Cardiopatias/terapia , Mortalidade Hospitalar , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rhode Island/epidemiologia , Índice de Gravidade de Doença , Análise de Sobrevida , Resultado do Tratamento
19.
R I Med J (2013) ; 104(5): 20-23, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34044432

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease (COVID-19) are a significant cause of morbidity and mortality across the United States. Internal medicine (IM) residents are a critical component of the healthcare workforce yet their seroprevalence of SARS-CoV-2 antibodies is largely unknown. The aim of this research was to ascertain the seroprevalences of SARS-CoV-2 among internal medicine residents during the first peak of COVID-19. METHODS: IM residents were enrolled in a surveillance program that included PCR and antibody testing for SARS-CoV-2 in June 2020. Residents also completed a short questionnaire to obtain sociodemographic information and characterize potential workplace exposure to COVID-19. RESULTS: A total of 101 IM residents participated in the study (out of N=162). Of the 101 samples, three (2.9%) tested positive for SARS-CoV-2 antibodies. No residents tested PCR positive for SARS-CoV-2. DISCUSSION: The implementation of COVID-19 patient cohorting and the incorporation of telemedicine to communicate with hospitalized patients into clinical practice early in the pandemic may have prevented the spread of the virus among the surveyed clinical trainees. CONCLUSION: Despite significant engagement with COVID-19 patients, IM residents demonstrated a low rate of SARS-CoV-2 seroprevalence.


Assuntos
COVID-19/epidemiologia , Medicina Interna/educação , Internato e Residência , Adulto , Anticorpos Antivirais/sangue , Biomarcadores/sangue , COVID-19/sangue , COVID-19/diagnóstico , COVID-19/transmissão , Teste para COVID-19 , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Masculino , Exposição Ocupacional , Prevalência , Rhode Island/epidemiologia , Fatores de Risco , SARS-CoV-2/imunologia , Estudos Soroepidemiológicos
20.
R I Med J (2013) ; 104(5): 24-29, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34044433

RESUMO

BACKGROUND: Rhode Island (RI) has been severely impacted by the COVID-19 pandemic. This study aims to describe emergency department (ED) patients with COVID-19 within the largest healthcare system in RI. METHODS: A retrospective electronic medical record review of 1,209 adult patients evaluated and diagnosed with COVID-19 in 4 EDs during the first peak (March 15, 2020 to May 16, 2020) was conducted. Sociodemographic, clinical, management, and ED disposition information were summarized. RESULTS: Median age of patients was 55 years (IQR 40-69), 55.2% were male, and 47.8% were Hispanic/Latinx. Over half of the patients (60.5%) were admitted to the hospital. Supplemental oxygen was used by 32.2%. CONCLUSION: This study presents the clinical and sociodemographic characteristics of ED patients with COVID-19 presenting to the largest healthcare system in Rhode Island. Continued analysis is warranted to provide further insight into the trends in this pandemic.


Assuntos
Teste Sorológico para COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiologia , Serviço Hospitalar de Emergência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , COVID-19/sangue , COVID-19/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Rhode Island/epidemiologia , SARS-CoV-2/imunologia , Estudos Soroepidemiológicos , Adulto Jovem
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