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Marriage and Divorce Decline during the COVID-19 Pandemic: A Case Study of Five States.

ABSTRACT: The decline in marriage and divorce was evident prior to the coronavirus disease 2019 pandemic, but it remains unknown whether these patterns have persisted during the pandemic. The authors compared monthly marriage and divorce counts for two years prior to the pandemic (2018 and 2019) and during the pandemic for the five states that published monthly vital statistics data for 2020 (Arizona, Florida, Missouri, New Hampshire, and Oregon). All five states witnessed initial declines in marriage. Counts of marriages in Arizona and New Hampshire rebounded. In contrast, marriage shortfalls occurred in Florida, Missouri, and Oregon. In the early pandemic months, divorces initially declined in all five states and rebounded in Arizona. In the remaining four states, divorce shortfalls have occurred. As more data become available, it will be important to acknowledge these state variations in response to the pandemic.

SUBMITTER: Manning WD

PROVIDER: S-EPMC8302068 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Rationale & objectiveThe direct and indirect effects of the coronavirus disease 2019 (COVID-19) pandemic on kidney function in the chronic kidney disease (CKD) population are not well understood.Study designCohort study.Setting & participantsRetrospective study of kidney function trajectories using deidentified administrative claims and laboratory data for Medicare Advantage and commercially insured enrollees with CKD stages G3-4 between 2018 and 2021.PredictorsCOVID-19 infection.OutcomeRapid kidney function decline defined as annual estimated glomerular filtration rate (eGFR) decline of ≥40%.Analytical approachPropensity score matching was used to identify individuals without COVID-19 infection matched 1:1 to a COVID-19 infected cohort and indexed on the date of diagnosing COVID-19 infection, age, sex, race or ethnicity, and Charlson comorbidity index score. Outpatient kidney function was compared during the prepandemic period (January 1, 2018, to February 29, 2020) with the pandemic period (March 1, 2020, to August 31, 2021). Two creatinine measurements, after the infection date and ≥60 days apart, were required to reduce correlation with acute infection.ResultsOf 97,203 enrollees with CKD G3-4, 9% experienced a COVID-19 infection. Characteristics of 8,901 propensity matched enrollees include mean age 74 years, 58% women, 67% White, and 63% CKD G3a, 28% CKD G3b, and 9% CKD G4. Median overall annual eGFR change was -2.65 ml/min/1.73m2, with 76% of the cohort experiencing worsened eGFR in the pandemic period. Rapid kidney function decline was observed in 1.9% and 2.0% of enrollees in the prepandemic and pandemic periods, respectively. Rapid kidney function decline was observed in 2.5% of those with COVID-19 infection and 1.5% of those without COVID-19 infection (P < 0.05). Factors associated with increased odds of rapid kidney function decline during pandemic included Asian race, higher Charlson comorbidity index, advancing CKD stage, prepandemic rapid kidney function decline, and COVID-19 infection.LimitationsRetrospective study design with potential bias.ConclusionsCOVID-19 infection increased odds of rapid kidney function decline during the pandemic. The downstream impact of pandemic-related eGFR decline on health outcomes, such as kidney failure or mortality, requires further study.Plain-language summaryWe used a cohort of insured individuals with moderate-to-severe chronic kidney disease (CKD) to compare the rates of rapid kidney function decline in prepandemic and pandemic periods and to evaluate the impact of the coronavirus disease 19 (COVID-19) on kidney function decline. We found that overall rates of rapid kidney function decline did not change during the prepandemic and pandemic periods but were significantly higher in both periods among individuals with a COVID-19 infection. As CKD severity increased, rates of both rapid kidney function decline and COVID-19 increased. Advancing CKD, higher comorbid condition, Asian race, prepandemic rapid kidney function decline, and COVID-19 were all associated with higher odds of rapid kidney function decline in the pandemic. These findings suggest close monitoring is warranted for individuals with CKD and COVID-19.

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Marriage and Divorce Decline during the COVID-19 Pandemic: A Case Study of Five States.

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