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Association of SARS-CoV-2 genomic load trends with clinical status in COVID-19: A retrospective analysis from an academic hospital center in New York City.

ABSTRACT: The Infectious Diseases Society of America has identified the use of SARS-CoV-2 genomic load for prognostication purposes as a key research question. We designed a retrospective cohort study that included adult patients with COVID-19 pneumonia who had at least 2 positive nasopharyngeal tests at least 24 hours apart to study the correlation between the change in the genomic load of SARS-CoV-2, as reflected by the Cycle threshold (Ct) value of the RT-PCR, with change in clinical status. The Sequential Organ Failure Assessment (SOFA) score was used as a surrogate for patients' clinical status. Among 457 patients with COVID-19 pneumonia between 3/31/2020-4/10/2020, we identified 42 patients who met the inclusion criteria. The median initial SOFA score was 2 (IQR 2-3). 20 out of 42 patients had a lower SOFA score on their subsequent tests. We identified a statistically significant inverse correlation between the change in SOFA score and change in the Ct value with a decrease in SOFA score by 0.05 (SE 0.02; p<0.05) for an increase in Ct values by 1. This correlation was independent of the duration of symptoms. Our findings suggest that an increasing Ct value in sequential tests may be of prognostic value for patients diagnosed with COVID-19 pneumonia.

SUBMITTER: Zacharioudakis IM

PROVIDER: S-EPMC7671536 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Pulmonary Embolism Response Team activation during the COVID-19 pandemic in a New York City Academic Hospital: a retrospective cohort analysis.

Project description:Coronavirus disease 2019 (COVID-19) is associated with increased rates of deep vein thrombosis (DVT) and pulmonary embolism (PE). Pulmonary Embolism Response Teams (PERT) have previously been associated with improved outcomes. We aimed to investigate whether PERT utilization, recommendations, and outcomes for patients diagnosed with acute PE changed during the COVID-19 pandemic. This is a retrospective cohort study of all adult patients with acute PE who received care at an academic hospital system in New York City between March 1st and April 30th, 2020. These patients were compared against historic controls between March 1st and April 30th, 2019. PE severity, PERT utilization, initial management, PERT recommendations, and outcomes were compared. There were more cases of PE during the pandemic (82 vs. 59), but less PERT activations (26.8% vs. 64.4%, p < 0.001) despite similar markers of PE severity. PERT recommendations were similar before and during the pandemic; anticoagulation was most recommended (89.5% vs. 86.4%, p = 0.70). During the pandemic, those with PERT activations were more likely to be female (63.6% vs. 31.7%, p = 0.01), have a history of DVT/PE (22.7% vs. 1.7%, p = 0.01), and to be SARS-CoV-2 PCR negative (68.2% vs. 38.3% p = 0.02). PERT activation during the pandemic is associated with decreased length of stay (7.7 ± 7.7 vs. 13.2 ± 12.7 days, p = 0.02). PERT utilization decreased during the COVID-19 pandemic and its activation was associated with different biases. PERT recommendations and outcomes were similar before and during the pandemic, and led to decreased length of stay during the pandemic.

| S-EPMC7482370 | biostudies-literature

Impact of socioeconomic status measures on hospital profiling in New York City.

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| S-EPMC4072036 | biostudies-literature

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| S-EPMC6090544 | biostudies-literature

Internal Medicine Resident Work Absence During the COVID-19 Pandemic at a Large Academic Medical Center in New York City.

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| S-EPMC7771614 | biostudies-literature

Patient and provider experiences of telemental health during the COVID-19 pandemic in a New York City academic medical center.

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| S-EPMC8898588 | biostudies-literature

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| S-EPMC8425077 | biostudies-literature

Metabolomics of World Trade Center Exposed New York City Firefighters

Project description:Particulate matter (PM) exposure and metabolic syndrome (MetSyn) coexist in both industrialized and developing nations. PM and MetSyn are strong risk factors for chronic obstructive pulmonary disease (COPD) and asthma. After the World Trade Center collapse in 9/11/2001, PM-exposed individuals from the Fire Department of New York City (FDNY) developed a progressively lung disease. This nested case-cohort study is composed of never smoking, WTC exposed firefighters with normal pre-9/11 lung function presenting for subspecialty pulmonary evaluation (SPE) before March 2008. Representative cohort controls with serum drawn within six months of 9/11 (n=100). FEV1 at subspecialty exam defined cases: susceptible World Trade Center Lung Injury (WTC-LI) cases (n=50) had FEV1< lower limit of normal (LLN) and resistant WTC-LI cases with FEV1 ≥107% predicted (n=50). This study will determine the metabolomics profile that differentiates firefighters with WTC-LI, firefighters resistant to WTC-LI, and similarly exposed cohort controls.

2019-02-22 | ST001171 | MetabolomicsWorkbench

Characteristics and Outcomes of In-Hospital Cardiac Arrest Events During the COVID-19 Pandemic: A Single-Center Experience From a New York City Public Hospital.

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| S-EPMC7673640 | biostudies-literature

Risk Factors and Temporal Trends of Hospital-Acquired Infections (HAIs) Among HIV Positive Patients in Urban New York City Hospitals: 2006 to 2014.

Project description:HIV-infected patients may be at a greater risk of Hospital-Acquired Infections (HAIs) but risks factors for HAIs have not been well described in this population.The aim of this study was to examine the incidence, temporal trends and risk factors of HAIs among adult HIV positive patients.This was a retrospective cohort study carried out in an academic health system in New York City which included four hospitals over a 9-year period from 2006 to 2014. Simple and multiple logistic regression models were built to determine risk factors associated with site-specific HAIs such as Urinary Tract Infections (UTIs), Pneumonia (PNUs) and Bloodstream Infections (BSIs).There were 10,575 HIV positive discharges and 1,328 had HAIs: 697 UTIs, 555 BSIs and 192 PNUs. The incidence rate of HAIs decreased from 19.8 to 15.1 new infections per 1000 persondays between 2006 and 2014 (p value<0.001). In addition to the expected risk factors of urinary catheter use for UTI and central venous line use for BSI, symptomatic HIV and renal failure were significant risk factors for both UTIs (95% CI OR: (1.24, 2.27) and (1.46, 2.11) respectively) and BSIs (95% CIs OR: (2.28, 4.18) and (1.81, 2.71) respectively).HIV-infected patients had similar risk factors for HAIs as HIV-uninfected patients. Further research is required to address how patients' CD4 counts and viral loads affect their susceptibility to HAIs.

| S-EPMC5337446 | biostudies-other

The effects of changes in physical fitness on academic performance among New York City youth.

Project description:PurposeTo evaluate whether a change in fitness is associated with academic outcomes in New York City (NYC) middle-school students using longitudinal data and to evaluate whether this relationship is modified by student household poverty.MethodsThis was a longitudinal study of 83,111 New York City middle-school students enrolled between 2006-2007 and 2011-2012. Fitness was measured as a composite percentile based on three fitness tests and categorized based on change from the previous year. The effect of the fitness change level on academic outcomes, measured as a composite percentile based on state standardized mathematics and English Language Arts test scores, was estimated using a multilevel growth model. Models were stratified by sex, and additional models were tested stratified by student household poverty.ResultsFor both girls and boys, a substantial increase in fitness from the previous year resulted in a greater improvement in academic ranking than was seen in the reference group (girls: .36 greater percentile point improvement, 95% confidence interval: .09-.63; boys: .38 greater percentile point improvement, 95% confidence interval: .09-.66). A substantial decrease in fitness was associated with a decrease in academics in both boys and girls. Effects of fitness on academics were stronger in high-poverty boys and girls than in low-poverty boys and girls.ConclusionsAcademic rankings improved for boys and girls who increased their fitness level by >20 percentile points compared to other students. Opportunities for increased physical fitness may be important to support academic performance.

| S-EPMC5421374 | biostudies-literature

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