1
|
Sander B, Mishra S, Swayze S, Sahakyan Y, Duchen R, Quinn K, Janjua N, Sbihi H, Kwong J. Population-Based Matched Cohort Study of COVID-19 Healthcare Costs, Ontario, Canada. Emerg Infect Dis 2025; 31:710-719. [PMID: 40133039 PMCID: PMC11950279 DOI: 10.3201/eid3104.241463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2025] Open
Abstract
Estimates of COVID-19-related healthcare costs are key to health system planning, but attributable cost data remain limited. We characterized healthcare costs attributable to COVID-19 through a population-based matched cohort study in Ontario, Canada, by using health administrative data. We matched SARS-CoV-2-positive persons from 2020 to unexposed historical control persons from 2016-2018. We estimated phase-based and survival-adjusted COVID-19-attributable healthcare costs from the health system perspective. We matched 159,817 persons. Mean (95% CI) attributable 10-day costs per person were $1 ($-4 to $6) preindex, $240 ($231-$249) during acute care, $18 ($14-$21) in postacute phases, $3,928 ($3,471-$4,384) in the terminal phase for early deaths, and $1,781 ($1,182-$2,380) for late deaths. Mean cumulative survival-adjusted cost at 360 days was $2,553 ($2,348-$2,756) per person. SARS-CoV-2 infection is associated with substantial long-term healthcare costs, consistent with understanding of post-COVID condition. Determining phase-specific costs can inform budget and pandemic planning.
Collapse
|
2
|
Łukomska E, Kloc K, Kowalska M, Matjaszek A, Joshi K, Scholz S, Van de Velde N, Beck E. Healthcare Resource Utilization (HCRU) and Direct Medical Costs Associated with Long COVID or Post-COVID-19 Conditions: Findings from a Literature Review. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2025; 13:7. [PMID: 39990183 PMCID: PMC11843940 DOI: 10.3390/jmahp13010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 01/09/2025] [Accepted: 01/24/2025] [Indexed: 02/25/2025]
Abstract
Approximately 10-20% of individuals suffering from COVID-19 develop prolonged symptoms known as long COVID or post-COVID condition (LC). This review aimed to assess healthcare resource use (HCRU) and healthcare costs associated with LC. Because LC is not clearly defined and often remains undiagnosed, studies reporting on long-term follow-up of individuals with a COVID-19 diagnosis were also included. Among the 41 publications included, 36 reported on HCRU and 16 on costs. Individuals with LC had significantly elevated HCRU and healthcare costs vs. controls without a COVID-19 diagnosis over ≥15 months, with a 7.6-13.1% increase in total healthcare costs per person per month as assessed by difference-in-difference analysis. Among studies that did not specifically refer to LC, having a COVID-19 diagnosis was associated with a significant 4-10% increase in long-term total HCRU over 6-8 months and a 1.3- to 2.9-fold relative increase in total healthcare costs over 6 months. Due to the heterogeneity of the included studies, high-quality evidence is needed to better understand the economic burden of LC. In the absence of effective treatments, prioritizing the prevention of acute COVID-19, e.g., through vaccination, may be crucial for preventing LC and the associated long-term HCRU and medical spending.
Collapse
|
3
|
Hanage WP, Schaffner W. Burden of Acute Respiratory Infections Caused by Influenza Virus, Respiratory Syncytial Virus, and SARS-CoV-2 with Consideration of Older Adults: A Narrative Review. Infect Dis Ther 2025; 14:5-37. [PMID: 39739200 PMCID: PMC11724833 DOI: 10.1007/s40121-024-01080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 11/06/2024] [Indexed: 01/02/2025] Open
Abstract
Influenza virus, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are acute respiratory infections (ARIs) that can cause substantial morbidity and mortality among at-risk individuals, including older adults. In this narrative review, we summarize themes identified in the literature regarding the epidemiology, seasonality, immunity after infection, clinical presentation, and transmission for these ARIs, along with the impact of the COVID-19 pandemic on seasonal patterns of influenza and RSV infections, with consideration of data specific to older adults when available. As the older adult population increases globally, it is of paramount importance to fully characterize the true disease burden of ARIs in order to develop appropriate mitigation strategies to minimize their impact in vulnerable populations. Challenges associated with characterizing the burden of these diseases include the shared symptomology and clinical presentation of influenza virus, RSV, and SARS-CoV-2, which complicate accurate diagnosis and highlight the need for improved testing and surveillance practices. To this end, multiple regional, national, and global virologic and disease surveillance systems have been established to provide accurate knowledge of viral epidemiology, support appropriate preparedness and response to potential outbreaks, and help inform prevention strategies to reduce disease severity and transmission. Beyond the burden of acute illness, long-term health consequences can also result from influenza virus, RSV, and SARS-CoV-2 infection. These include cardiovascular and pulmonary complications, worsening of existing chronic conditions, increased frailty, and reduced life expectancy. ARIs among older adults can also place a substantial financial burden on society and healthcare systems. Collectively, the existing data indicate that influenza virus, RSV, and SARS-CoV-2 infections in older adults present a substantial global health challenge, underscoring the need for interventions to improve health outcomes and reduce the disease burden of respiratory illnesses.Graphical abstract and video abstract available for this article.
Collapse
Affiliation(s)
- William P Hanage
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - William Schaffner
- Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
| |
Collapse
|
4
|
Liu K, Rennert-May E, Zhang Z, D’Souza AG, Crocker A, Williamson T, Beall R, Leal J. Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study. Health Serv Insights 2024; 17:11786329241306390. [PMID: 39678311 PMCID: PMC11639006 DOI: 10.1177/11786329241306390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 11/22/2024] [Indexed: 12/17/2024] Open
Abstract
Background Assessing the financial burden of COVID-19 is important for planning health services and resource allocation to inform future pandemic response. Objectives This study examines the changing dynamics in healthcare utilization patterns and costs from a public healthcare perspective during the COVID-19 pandemic in Alberta, Canada. Design Population-based descriptive study. Methods All adult patients over the age of 18 years who had a laboratory-confirmed COVID-19 diagnosis in Alberta, Canada from March 1, 2020 to December 15, 2021. We described demographic information and community- and hospital-based healthcare utilization and costs. We compared changes in each outcome throughout the first four waves of the pandemic. Results Among 255,037 patients, hospitalization incurred significantly higher costs (N = 20,603; aRR = 755.51; marginal cost: $21,738.17 CAD; P < .01). Wave 2 recorded the highest cost for Emergency Department (ED) visits (aRR = 1.10; marginal cost: $79.19 CAD; P < .01). Compared to Wave 1, Waves 2-4 all recorded significantly lower costs for out-patient visits. Wave 2's in-patient cost for patients that required ICU admission was significantly lower than Wave 1 (aRR = 0.75; marginal cost: -$24,142.47 CAD; P = .02). Conclusion COVID-19 exerted a heavy toll on healthcare services, and the dynamics of this continue to evolve. Utilization of ED and in-patient services were particularly high. Severe infections requiring hospitalization and ICU admission are more expensive than non-hospitalized and non-ICU hospital admits. Future studies should clarify specific factors, such as sociodemographic determinants, that contribute to evolving patterns of health services consumption and changing trends in cost to holistically inform responses to future pandemics.
Collapse
Affiliation(s)
- Kathy Liu
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Elissa Rennert-May
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Zuying Zhang
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Adam G D’Souza
- Centre of Health Informatics, University of Calgary, Calgary, AB, Canada
- Analytics, Alberta Health Services, Calgary, AB, Canada
| | | | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Centre of Health Informatics, University of Calgary, Calgary, AB, Canada
- Infection Prevention and Control, Alberta Health Services, Calgary, AB, Canada
- Alberta Children’s Hospital Research Institute, Calgary, AB, Canada
- Libin Cardiovascular Institute, Calgary, AB, Canada
| | - Reed Beall
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jenine Leal
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
5
|
McNaughton CD, Austin PC, Li Z, Sivaswamy A, Fang J, Abdel-Qadir H, Udell JA, Wodchis WP, Lee DS, Mostarac I, Atzema CL. Higher Post-Acute Health Care Costs Following SARS-CoV-2 Infection Among Adults in Ontario, Canada. J Multidiscip Healthc 2024; 17:5749-5761. [PMID: 39659735 PMCID: PMC11628314 DOI: 10.2147/jmdh.s465154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 09/06/2024] [Indexed: 12/12/2024] Open
Abstract
Purpose and Introduction Growing evidence suggests SARS-CoV-2 infection increases the risk of long term cardiovascular, neurological, and other effects. However, post-acute health care costs following SARS-CoV-2 infection are not known. Patients and Statistical Methods Beginning 56 days following SARS-CoV-2 polymerase chain reaction (PCR) testing, we compared person-specific total and component health care costs (2020 CAD$) for the first year of follow-up at the mean and 99th percentiles of health care costs for matched test-positive and test-negative adults in Ontario, Canada, between January 1, 2020, and March 31, 2021. Matching included demographics, baseline clinical characteristics, and two-week time blocks. Results For 531,182 people, mean person-specific total health care costs were $513.83 (95% CI $387.37-$638.40) higher for test-positive females and $459.10 (95% CI $304.60-$615.32) higher for test-positive males, which were driven by hospitalization, long-term care, and complex continuing care costs. At the 99th percentile of each subgroup, person-specific health care costs were $12,533.00 (95% CI $9008.50-$16,473.00) higher for test-positive females and $14,604.00 (95% CI $9565.50-$19,506.50) for test-positive males, driven by hospitalization, specialist (males), and homecare costs (females). Cancer costs were lower. Six-month and 1-year cost differences were similar. Conclusion Post-acute health care costs after a positive SARS-CoV-2 PCR test were significantly higher than matched test-negative individuals, and these increased costs persisted for at least one year. The largest increases health care costs came from hospitalizations, long-term care, complex continuing care, followed by outpatient specialists (for males) and homecare costs (for women). Given the magnitude of ongoing viral spread, policymakers, clinicians, and patients should be aware of higher post-acute health care costs following SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Candace D McNaughton
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
| | - Peter C Austin
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
| | - Zhiyin Li
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
| | - Atul Sivaswamy
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
| | - Jiming Fang
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
| | - Husam Abdel-Qadir
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
- Division of Cardiology, Women’s College Hospital, Toronto, Ontario, Canada
| | - Jacob A Udell
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Division of Cardiology, Women’s College Hospital, Toronto, Ontario, Canada
| | - Walter P Wodchis
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Douglas S Lee
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
- Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada
| | | | - Clare L Atzema
- ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada
| |
Collapse
|
6
|
AlManie SA, AlHazami MS, Ebrahim A, Attique MS. Assessment of Direct Medical Cost of Hospitalized COVID-19 Adult Patients in Kuwait During the First Wave of the Pandemic. CLINICOECONOMICS AND OUTCOMES RESEARCH 2024; 16:509-522. [PMID: 39069972 PMCID: PMC11283802 DOI: 10.2147/ceor.s467543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/08/2024] [Indexed: 07/30/2024] Open
Abstract
Objective This study aims to estimate the direct medical cost of COVID-19 hospitalizations and to utilize prevalence estimates from Jaber Al-Ahmad Hospital to estimate the direct medical cost of all hospitalized adult patients in Kuwait using a decision tree analysis. Methods A cost-of-illness model was developed. The Ministry of Health perspective was considered, direct medical costs were estimated from July 1st to September 30th, using a bottom-up approach. The mean cost per hospitalized patient was estimated using a decision analysis model. Prevalence estimates of ambulance use, use of ER, ICU admission, and mortality were considered in the current study. Patients aged 18 years and above with a confirmed diagnosis of COVID-19 were included. One-way sensitivity analysis and probabilistic sensitivity analysis (PSA) were performed. Results Data for 2986 patients were analyzed. The mean age was 61 (SD= 11) years old. Most of the patients were Kuwaiti (2864, 95.91%), and more than half were females (1677, 56.16%). Of the total hospital admissions, 417 patients (14%) were admitted to the ICU. The average length of the hospital stay was 11 (SD= 9) days, and among all hospital admissions, 270 (9.04%) patients died. The total estimated direct medical cost of hospitalized patients at Jaber Al-Ahmad Hospital was $47,213,768 (14,283,203.6 KD). The average cost of hospital stay per patient was estimated at $15,498 (4,688.60 KD). The weighted average cost per hospitalized patient in Kuwait was estimated at $16,373 (4,953.08 KD). The total direct medical cost of hospitalized COVID-19 patients in Kuwait during the study period was estimated at $174,372,450 (52,751,502 KD). Conclusion The COVID-19 pandemic constituted a significant burden on the Kuwaiti healthcare system. The findings of this study urge the need for preventive care strategies to reduce adverse health outcomes and the economic impact of the pandemic.
Collapse
Affiliation(s)
- Sarah A AlManie
- Department of Pharmacy Practice, School of Pharmacy-Kuwait University, Kuwait City, Kuwait
| | - Mai S AlHazami
- Department of Pharmacy Practice, School of Pharmacy-Kuwait University, Kuwait City, Kuwait
| | - Alyah Ebrahim
- Respiratory Department- Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, Kuwait
| | - Muhammad S Attique
- Respiratory Department- Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, Kuwait
| |
Collapse
|
7
|
Sell H, Schaible K, Gouveia-Pisano JA, Yehoshua A, Malhotra D, Di Fusco M, Cha-Silva AS, Andersen KM, Nicholls L, Landi SN, Rolland C, Judy J. Economic burden of COVID-19 for employers and employees in the United States. J Med Econ 2024; 27:267-278. [PMID: 38294896 DOI: 10.1080/13696998.2024.2309835] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVE Describe the economic burden of COVID-19 on employers and employees in the United States (US). METHODS A targeted literature review was conducted to evaluate the impact of COVID-19 on US-based employers and employees in terms of healthcare resource utilization (HCRU), medical costs, and costs associated with work-loss. Searches were conducted in MEDLINE, Embase, and EconLit using a combination of disease terms, populations, and outcomes to identify articles published from January 2021 to November 4, 2022. As data from the employer perspective were lacking, additional literature related to influenza were included to contextualize the impact of COVID-19, as it shifts into an endemic state, within the existing respiratory illness landscape. RESULTS A total of 41 articles were included in the literature review. Employer and employee perspectives were not well represented in the literature, and very few articles overlapped on any given outcome. HCRU, costs, and work impairment vary by community transmission levels, industry type, population demographics, telework ability, mitigation implementation measures, and company policies. Work-loss among COVID-19 cases were higher among the unvaccinated and in the week following diagnosis and for some, these continued for 6 months. HCRU is increased in those with COVID-19 and COVID-19-related HCRU can also continue for 6 months. CONCLUSIONS COVID-19 continues to be a considerable burden to employers. The majority of COVID-19 cases impact working age adults. HCRU is mainly driven by outpatient visits, while direct costs are driven by hospitalization. Productivity loss is higher for unvaccinated individuals. An increased focus to support mitigation measures may minimize hospitalizations and work-loss. A data-driven approach to implementation of workplace policies, targeted communications, and access to timely and appropriate therapies for prevention and treatment may reduce health-related work-loss and associated cost burden.
Collapse
|
8
|
Sandin R, Veenstra DL, Vankelegom M, Dzingina M, Sullivan SD, Campbell D, Ma C, Harrison C, Draica F, Wiemken TL, Mugwagwa T. Budget impact of oral nirmatrelvir/ritonavir in adults at high risk for progression to severe COVID-19 in the United States. J Manag Care Spec Pharm 2023; 29:1290-1302. [PMID: 38058141 PMCID: PMC10776264 DOI: 10.18553/jmcp.2023.29.12.1290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND Nirmatrelvir/ritonavir (NMV/r) is indicated for the treatment of mild-to-moderate COVID-19 in adults who are at high risk for progression to severe COVID-19. NMV/r has also been authorized for emergency use by the US Food and Drug Administration for the treatment of mild-to-moderate COVID-19 in pediatric patients (aged 226512 years and weighing at least 40 kg) who are at high risk for progression to severe COVID-19. Understanding the budget impact of introducing NMV/r for the treatment of adults with COVID-19 is of key interest to US payers. OBJECTIVE To estimate the annual budget impact of introducing NMV/r in a US commercial health plan setting in the current Omicron COVID-19 era. METHODS A budget impact model was developed to assess the impact of NMV/r on health care costs in a hypothetical 1-million-member commercial health insurance plan over a 1-year period in the US population; clinical and cost inputs were derived from published literature with a focus on studies in the recent COVID-19 era that included vaccinated population and predominance of the Omicron variant. In the base-case analysis, it was assumed the only effect of NMV/r was a reduction in incidence (not severity) of hospitalization or death; its potential effect on post-COVID conditions was assessed in a scenario analysis. Outcomes included the number of hospitalizations, total cost, per patient per year (PPPY) costs, and per member per month (PMPM) costs. Sensitivity and scenario analyses were conducted to assess uncertainty around key model inputs. RESULTS An estimated 29,999 adults were eligible and sought treatment with oral antiviral for COVID-19 over 1 year. The availability of NMV/r was estimated to reduce the number of hospitalizations by 647 with a total budget impact of $2,733,745, $91 PPPY, and $0.23 PMPM. NMV/r was cost saving when including post-COVID conditions with a -$1,510,780 total budget impact, a PPPY cost of -$50, and a PMPM cost of -$0.13. Sensitivity analyses indicated results were most sensitive to the risk of hospitalization under supportive care, risk of hospitalization with NMV/r treatment and cost of NMV/r. CONCLUSIONS Treatment with NMV/r in the current COVID-19 era is estimated to result in substantial cost offsets because of reductions in hospitalization and modest budget impact to potential overall cost savings.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Cuiying Ma
- Health Economics & Outcomes Research Ltd, Cardiff, Wales, UK
| | - Cale Harrison
- Health Economics & Outcomes Research Ltd, Cardiff, Wales, UK
| | | | | | | |
Collapse
|
9
|
Al-Maweri SA, Alhajj MN, Halboub E, Tamimi F, Salleh NM, Al-Ak'hali MS, Kassim S, Abdulrab S, Anweigi L, Mohammed MMA. The impact of periodontal disease on the clinical outcomes of COVID-19: A systematic review and meta-analysis. BMC Oral Health 2023; 23:658. [PMID: 37689665 PMCID: PMC10493030 DOI: 10.1186/s12903-023-03378-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND A possible relationship between periodontitis (PD) and COVID-19 and its adverse outcomes has been suggested. Hence, the present systematic review and meta-analysis aimed to investigate the available evidence regarding the potential association between periodontitis (PD) and COVID-19 and its adverse outcomes. MATERIALS AND METHODS PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published up to April 15th, 2023. Studies that evaluated the association between PD and COVID-19 were included. Risk of bias was evaluated by two reviewers, and meta-analyses were performed using RevMan 5.3 software. RESULTS A total of 22 studies involving 92,535 patients from USA, Europe, Asia, the Middle East and South America were included; of these, 12 were pooled into the meta-analysis. Most of the studies (19 studies) reported a significant association between PD and COVID-19. The pooled data found a significant association between PD and COVID-19 outcomes: more severe symptoms (OR = 6.95, P = 0.0008), ICU admissions (OR = 3.15, P = 0.0001), and mortality (OR = 1.92, P = 0.21). Additionally, compared to mild PD, severe PD was significantly associated with higher risks of severe COVID-19 outcomes: severe symptoms (P = 0.02); ICU admission (P = 0.0001); and higher mortality rates (P = 0.0001). The results also revealed 58% higher risk for COVID-19 infection in patients with PD (P = 0.00001). CONCLUSIONS The present findings suggest a possible association between poor periodontal health and the risk of poor COVID-19 outcomes. However, owing to the observed methodological heterogeneity across the included studies, further prospective cohort studies with standardized methodologies are warranted to further unravel the potential association between periodontal disease and COVID-19 and its adverse outcomes.
Collapse
Affiliation(s)
| | - Mohammed Nasser Alhajj
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia
- Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Nosizana Mohd Salleh
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Federal Territory of Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Saba Kassim
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Saleem Abdulrab
- Al Khor Health Center, Primary Health Care Corporation, Doha, Qatar
| | - Lamyia Anweigi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Marwan Mansoor Ali Mohammed
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
10
|
Mishra T, Patel DA, Awadelkarim A, Sharma A, Patel N, Yadav N, Almas T, Sattar Y, Alraies MC. A National Perspective on the Impact of the COVID-19 Pandemic on Heart Failure Hospitalizations in the United States. Curr Probl Cardiol 2023; 48:101749. [PMID: 37087079 PMCID: PMC10121154 DOI: 10.1016/j.cpcardiol.2023.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 04/17/2023] [Indexed: 04/24/2023]
Abstract
Nationwide data of the COVID-19 pandemic's impact on heart failure (HF) hospitalizations is lacking. We conducted this study to elucidate the impact of the COVID-19 pandemic on HF hospitalizations. Additionally, we assessed the differences in hospitalization characteristics during the pandemic and the impact that a concurrent diagnosis of COVID-19 has on various outcomes and predictors of inpatient mortality among patients admitted for HF. The National Inpatient Sample (NIS) database was queried for all hospitalizations with a primary diagnosis of HF between 2017 and 2020. Monthly HF hospitalizations were trended longitudinally over this period. Beginning April 1, 2020, concurrent COVID-19 infections were identified. Subsequently, we stratified HF hospitalizations between April 2020 and December 2020 (HF-2020) based on if concomitant COVID-19 was diagnosed, forming the HF-COVID+ve and HF-COVID-ve groups respectively. HF-2020 was also compared with prepandemic HF hospitalizations between April 2019 and December 2019 (HF-2019). Baseline characteristics were compared, and adjusted outcomes were obtained. During the initial COVID-19 surge in April 2020, HF admissions were reduced by 47% compared to January 2020. Following this decline, HF hospitalizations increased but did not reach prepandemic levels. HF-2020 admissions had an increased complication burden compared to HF-2019, including acute myocardial infarction (8.9% vs 6.6%, P < 0.005) and pulmonary embolism (4.1% vs 3.4%, P < 0.005) indicating a sicker cohort of patients. HF-COVID+ve hospitalizations had 2.9 times higher odds of inpatient mortality compared to HF-COVID-ve and an increased adjusted length of stay by 2.16 days (P < 0.005). A pandemic of the same magnitude as COVID-19 can overwhelm even the most advanced health systems. Early resource mobilization and preparedness is essential to provide care to a sick cohort of patients like acute HF, who are directly and indirectly effected by the consequences of the pandemic which has worsened hospitalization outcomes.
Collapse
Affiliation(s)
- Tushar Mishra
- Division of Cardiovascular Medicine, Wayne State University/Detroit Medical Center, Detroit, MI
| | | | - Abdalaziz Awadelkarim
- Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI
| | - Aditi Sharma
- Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, MI
| | - Neel Patel
- Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI
| | - Narendra Yadav
- Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehdradun, Uttarakhand, India
| | - Talal Almas
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Yasar Sattar
- Department of Cardiology, West Virginia University, Morgantown, WV, USA
| | - M Chadi Alraies
- Division of Cardiovascular Medicine, Wayne State University/Detroit Medical Center, Detroit, MI.
| |
Collapse
|
11
|
Ketkar A, Willey V, Pollack M, Glasser L, Dobie C, Wenziger C, Teng CC, Dube C, Cunningham D, Verduzco-Gutierrez M. Assessing the risk and costs of COVID-19 in immunocompromised populations in a large United States commercial insurance health plan: the EPOCH-US Study. Curr Med Res Opin 2023; 39:1103-1118. [PMID: 37431293 DOI: 10.1080/03007995.2023.2233819] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE To estimate the prevalence of patients with an immunocompromising condition at risk for COVID-19, estimate COVID-19 prevalence rate (PR) and incidence rate (IR) by immunocompromising condition, and describe COVID-19-related healthcare resource utilization (HCRU) and costs. METHODS Using the Healthcare Integrated Research Database (HIRD), patients with ≥1 claim for an immunocompromising condition of interest or ≥2 claims for an immunosuppressive (IS) treatment and COVID-19 diagnosis during the infection period (1 April 2020-31 March 2022) and had ≥12 months baseline data were included. Cohorts (other than the composite cohort) were not mutually exclusive and were defined by each immunocompromising condition. Analyses were descriptive in nature. RESULTS Of the 16,873,161 patients in the source population, 2.7% (n = 458,049) were immunocompromised (IC). The COVID-19 IR for the composite IC cohort during the study period was 101.3 per 1000 person-years and the PR was 13.5%. The highest IR (195.0 per 1000 person-years) and PR (20.1%) were seen in the end-stage renal disease (ESRD) cohort; the lowest IR (68.3 per 1000 person-years) and PR (9.4%) were seen in the hematologic or solid tumor malignancy cohort. Mean costs for hospitalizations associated with the first COVID-19 diagnosis were estimated at nearly $1 billion (2021 United States dollars [USD]) for 14,516 IC patients, with a mean cost of $64,029 per patient. CONCLUSIONS Immunocompromised populations appear to be at substantial risk of severe COVID-19 outcomes, leading to increased costs and HCRU. Effective prophylactic options are still needed for these high-risk populations as the COVID-19 landscape evolves.
Collapse
Affiliation(s)
| | | | | | - Lisa Glasser
- AstraZeneca Biopharmaceuticals Medical, Wilmington, DE, USA
| | | | | | - Chia-Chen Teng
- AstraZeneca Biopharmaceuticals Medical, Wilmington, DE, USA
| | - Christine Dube
- AstraZeneca Biopharmaceuticals Medical, Wilmington, DE, USA
| | | | | |
Collapse
|
12
|
Álvarez-del Río B, Sánchez-de Prada L, Álvaro-Meca A, Martín-Fernández M, Álvarez FJ, Tamayo E, Gutiérrez-Abejón E. Prevalence and cost of hospitalized patients with asymptomatic COVID-19 in 2020 in Spain. Front Public Health 2023; 11:1229561. [PMID: 37588119 PMCID: PMC10427243 DOI: 10.3389/fpubh.2023.1229561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction COVID-19 transmission has been characterized by the presence of asymptomatic patients. Additionally, most studies evaluating costs focus on symptomatic COVID-19 cases. Objective To describe the prevalence, characteristics, and costs of asymptomatic COVID-19 cases at admission in Spanish hospitals in 2020. Methods A nationwide study was performed, and data of hospitalized patients were collected of the Minimum Basic Data Set in Spain during 2020. Patients with COVID-19 codes as a primary and as a secondary diagnosis at admission were selected. Variables collected included age, sex, length of stay, in-hospital death, admission, length of stay and death in intensive care unit, mechanical ventilation and ventilatory assistance. COVID-19 related hospital costs were calculated using diagnosis-related groups from the Minimum Basic Data Set. Patients and costs were disaggregated by sex, age group, intensive care unit admission and epidemic wave (first or second) and main diagnosis. Results A total of 14,742 patients were admitted with asymptomatic COVID-19 in Spanish hospitals representing 6.35% of all COVID-19 admitted patients. The total cost of admissions with asymptomatic COVID-19 was €105,933,677.6 with a mean cost per patient of €7,185.8 with higher mean cost in the first wave despite only 2.7% of cases were found during that time. Based on primary diagnosis, the higher number of cases of asymptomatic COVID-19 were found in "Pregnancy, childbirth and the puerperium" followed by "diseases of the circulatory system". Conclusions There was a high prevalence of asymptomatic cases during screening at admission process in Spanish hospitals in 2020. The highest number of cases was found among the group of "pregnancy, childbirth, and puerperium" followed by "diseases of the circulatory system." The higher costs might be due not only to the main pathology at admission but to the associated healthcare provisions needed in case of positive COVID-19 testing.
Collapse
Affiliation(s)
- Blanca Álvarez-del Río
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - Laura Sánchez-de Prada
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Departamento de Microbiología e Inmunología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro Nacional de Gripe de Valladolid, Valladolid, Spain
| | - Alejandro Álvaro-Meca
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, Spain
| | - Marta Martín-Fernández
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - F. Javier Álvarez
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Tamayo
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Gutiérrez-Abejón
- Departamento de Farmacología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
- BioCritic, Grupo de Investigación Biomédica en Cuidados Críticos, Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Dirección Técnica de Farmacia, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain
- Facultad de Empresa y Comunicación, Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| |
Collapse
|
13
|
Datta D, George Dalmida S, Martinez L, Newman D, Hashemi J, Khoshgoftaar TM, Shorten C, Sareli C, Eckardt P. Using machine learning to identify patient characteristics to predict mortality of in-patients with COVID-19 in south Florida. Front Digit Health 2023; 5:1193467. [PMID: 37588022 PMCID: PMC10426497 DOI: 10.3389/fdgth.2023.1193467] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/12/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction The SARS-CoV-2 (COVID-19) pandemic has created substantial health and economic burdens in the US and worldwide. As new variants continuously emerge, predicting critical clinical events in the context of relevant individual risks is a promising option for reducing the overall burden of COVID-19. This study aims to train an AI-driven decision support system that helps build a model to understand the most important features that predict the "mortality" of patients hospitalized with COVID-19. Methods We conducted a retrospective analysis of "5,371" patients hospitalized for COVID-19-related symptoms from the South Florida Memorial Health Care System between March 14th, 2020, and January 16th, 2021. A data set comprising patients' sociodemographic characteristics, pre-existing health information, and medication was analyzed. We trained Random Forest classifier to predict "mortality" for patients hospitalized with COVID-19. Results Based on the interpretability of the model, age emerged as the primary predictor of "mortality", followed by diarrhea, diabetes, hypertension, BMI, early stages of kidney disease, smoking status, sex, pneumonia, and race in descending order of importance. Notably, individuals aged over 65 years (referred to as "older adults"), males, Whites, Hispanics, and current smokers were identified as being at higher risk of death. Additionally, BMI, specifically in the overweight and obese categories, significantly predicted "mortality". These findings indicated that the model effectively learned from various categories, such as patients' sociodemographic characteristics, pre-hospital comorbidities, and medications, with a predominant focus on characterizing pre-hospital comorbidities. Consequently, the model demonstrated the ability to predict "mortality" with transparency and reliability. Conclusion AI can potentially provide healthcare workers with the ability to stratify patients and streamline optimal care solutions when time is of the essence and resources are limited. This work sets the platform for future work that forecasts patient responses to treatments at various levels of disease severity and assesses health disparities and patient conditions that promote improved health care in a broader context. This study contributed to one of the first predictive analyses applying AI/ML techniques to COVID-19 data using a vast sample from South Florida.
Collapse
Affiliation(s)
- Debarshi Datta
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - Safiya George Dalmida
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - Laurie Martinez
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - David Newman
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States
| | - Javad Hashemi
- College of Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Taghi M. Khoshgoftaar
- College of Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Connor Shorten
- College of Engineering & Computer Science, Florida Atlantic University, Boca Raton, FL, United States
| | - Candice Sareli
- Memorial Healthcare System, Hollywood, FL, United States
| | - Paula Eckardt
- Memorial Healthcare System, Hollywood, FL, United States
| |
Collapse
|
14
|
Impact of COVID-19 on Patients Hospitalized With Deep Vein Thrombosis and/or Pulmonary Embolism: A Nationwide Analysis. Curr Probl Cardiol 2023; 48:101553. [PMID: 36528208 PMCID: PMC9749377 DOI: 10.1016/j.cpcardiol.2022.101553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) infection predisposes patients to develop deep vein thrombosis (DVT) and pulmonary embolism (PE). In this study, we compared the in-hospital outcomes of patients with DVT and/or PE with concurrent COVID-19 infection vs those with concurrent flu infection. The National Inpatient Sample from 2019 to 2020 was analyzed to identify all adult admissions diagnosed with DVT and PE. These patients were then stratified based on whether they had concomitant COVID-19 or flu. We identified 62,895 hospitalizations with the diagnosis of DVT and/or PE with concomitant COVID-19, and 8155 hospitalizations with DVT and/or PE with concomitant flu infection. After 1:1 propensity score match, the incidence of cardiac arrest and inpatient mortality were higher in the COVID-19 group. The incidence of cardiogenic shock was higher in the flu group. Increased age, Hispanic race, diabetes, chronic kidney disease, arrhythmia, liver disease, coagulopathy, and rheumatologic diseases were the independent predictors of mortality in patients with DVT and/or PE with concomitant COVID-19.
Collapse
|
15
|
Di Fusco M, Marczell K, Thoburn E, Wiemken TL, Yang J, Yarnoff B. Public health impact and economic value of booster vaccination with Pfizer-BioNTech COVID-19 vaccine, bivalent (original and omicron BA.4/BA.5) in the United States. J Med Econ 2023; 26:509-524. [PMID: 36942976 DOI: 10.1080/13696998.2023.2193067] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To assess the public health impact and economic value of booster vaccination with the Pfizer-BioNTech COVID-19 Vaccine, Bivalent in the United States. METHODS A combined cohort Markov decision tree model estimated the cost-effectiveness and budget impact of booster vaccination compared to no booster vaccination in individuals aged ≥5 years. Analyses prospectively assessed three scenarios (base case, low, high) defined based upon the emergence (or not) of subvariants, using list prices. Age-stratified parameters were informed by literature. The cost-effectiveness analysis estimated cases, hospitalizations and deaths averted, Life Years (LYs) and Quality Adjusted Life Years (QALYs) gained, the incremental cost-effectiveness ratio (ICER), the net monetary benefit (NMB), and the Return on Investment (ROI). The budget impact analyses used the perspective of a hypothetical 1-million-member plan. Sensitivity analyses explored parameter uncertainty. Conservatively, indirect effects and broad societal benefits were not considered. RESULTS The base case predicted that, compared to no booster vaccination, the Pfizer-BioNTech COVID-19 Vaccine, Bivalent could result in ∼3.7 million fewer symptomatic cases, 162 thousand fewer hospitalizations, 45 thousand fewer deaths, 373 thousand fewer discounted QALYs lost, and was cost-saving. Using a conservative value of $50,000 for 1 LY, every $1 invested yielded estimated $4.67 benefits. Unit costs, health outcomes and effectiveness had the greatest impact on results. At $50,000 per QALY gained, the booster generated a 34.2 billion NMB and probabilistic sensitivity analyses indicated a 92% chance of being cost-saving and 98% of being cost-effective. The bivalent was cost-saving or highly cost-effective in high and low scenarios. In a hypothetical 1-million-member health plan population, the vaccine was predicted to be a budget-efficient solution for payers. CONCLUSIONS Booster vaccination with the Pfizer-BioNTech COVID-19 Vaccine, Bivalent for the US population aged ≥5 years could generate notable public health impact and be cost-saving based on the findings of our base case analyses.
Collapse
Affiliation(s)
| | - Kinga Marczell
- Evidera, Bocskai út 134-146, Dorottya Udvar, E épület 2. emelet, Budapest, Hungary
| | | | | | - Jingyan Yang
- Pfizer Inc., New York, NY USA
- Institute for Social and Economic Research and Policy, Columbia University, New York, NY, USA
| | | |
Collapse
|
16
|
Hernández-Aceituno A, García-Hernández A, Larumbe-Zabala E. COVID-19 long-term sequelae: Omicron versus Alpha and Delta variants. Infect Dis Now 2023; 53:104688. [PMID: 36858287 PMCID: PMC9970656 DOI: 10.1016/j.idnow.2023.104688] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND The study aimed to assess the association between three predominant SARS-CoV-2 variants (Alpha, Delta, and Omicron) and the risk of developing long COVID (persistence of physical, medical, and cognitive symptoms more than 4 weeks after infection), post-COVID-19 syndrome (symptoms extending beyond 12 weeks), and viral persistence (testing positive beyond 4 weeks despite clinical resolution). METHODS Retrospective study of 325 patients hospitalized for COVID-19 with genomic sequencing information. For each SARS-CoV-2 variant, sample characteristics, frequency of symptoms, and long-term sequelae were compared using Chi-squared test, Fisher's exact test, Kruskal-Wallis test, and Dunn's test as appropriate. Odds ratios (OR) were calculated using logistic regression models to assess the association of risk factors and sequelae. RESULTS The adjusted model showed that the Omicron (vs Alpha) variant (OR, 0.30; 95% CI0.16-0.56), admission to ICU (OR, 1.14; 95% CI 1.05-1.23), and being treated with antiviral or immunomodulatory drugs (OR, 2.01; 95% CI 1.23-3.27) predicted long COVID and post-COVID-19 syndrome. Viral persistence showed no difference between variants. CONCLUSIONS The Omicron variant was associated with significantly lower odds of developing long-term sequelae from COVID-19 compared with previous variants, while severity of illness indicators increased the risk. Vaccination status, age, sex, and comorbidities were not found to predict sequelae development. This information has implications for both health managers and clinicians when deciding on the appropriate clinical management and subsequent outpatient follow-up of these patients. More studies with non-hospitalized patients are still necessary.
Collapse
Affiliation(s)
- Ana Hernández-Aceituno
- Dirección General de Salud Pública, Canary Islands, Spain; Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
| | - Abigail García-Hernández
- Dirección General de Salud Pública, Canary Islands, Spain,Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Eneko Larumbe-Zabala
- Dirección General de Salud Pública, Canary Islands, Spain,Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Canary Islands, Spain
| |
Collapse
|
17
|
Cai J, Bidulescu A. The association between chronic conditions, COVID-19 infection, and food insecurity among the older US adults: findings from the 2020-2021 National Health Interview Survey. BMC Public Health 2023; 23:179. [PMID: 36703149 PMCID: PMC9880360 DOI: 10.1186/s12889-023-15061-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND This study aims to examine how the presence of chronic conditions or positive COVID-19 infection (as exposures) is related to food insecurity (as an outcome) in the older population and whether there is a dose-response relationship between the number of chronic conditions and the severity of food insecurity. METHODS Cross-sectional data of 17,977 older adults (≥ 65 years) from the 2020-2021 National Health Interview Survey were analyzed. Chronic conditions included physical health conditions (i.e., arthritis, coronary heart diseases, hypertension, stroke, prediabetes, diabetes, asthma, chronic obstructive pulmonary disease, and disability) and mental health conditions (i.e., anxiety and depression disorder). COVID-19 infection status was determined by a self-reported diagnosis of COVID-19. Household food insecurity was measured using the 10-item US Department of Agriculture (USDA) Food Security Survey Module with a 30-day look-back window. Multinomial logistic regression models were used to examine the association between health conditions and food insecurity controlling for socio-demographic factors. RESULTS Our results indicated that 4.0% of the older adults lived in food-insecure households. The presence of chronic conditions was significantly associated with higher odds of being food insecure independent of socio-demographic factors (AOR ranged from 1.17 to 3.58, all p < 0.0001). Compared with participants with 0-1 chronic condition, the odds of being (low or very low) food insecure was 1.09 to 4.07 times higher for those with 2, or ≥ 3 chronic conditions (all p < 0.0001). The severity of food insecurity significantly increased as the number of chronic conditions increased (p for trend < 0.0001). Besides, COVID-infected participants were 82% more likely to be very low food secure than the non-infected participants (AOR = 1.82, 95% CI: 1.80, 1.84). CONCLUSIONS The presence of chronic conditions or positive COVID-infection is independently associated with household food insecurity. Clinical health professionals may help identify and assist individuals at risk of food insecurity. Management and improvement of health conditions may help reduce the prevalence and severity of food insecurity in the older population.
Collapse
Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, USA.
| | - Aurelian Bidulescu
- grid.411377.70000 0001 0790 959XDepartment of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN USA
| |
Collapse
|