Association between overcrowded households, multigenerational households, and COVID-19: a cohort study

OBJECTIVES

The role of overcrowded and multigenerational households as a risk factor for COVID-19 remains unmeasured. The objective of this study is to examine and quantify the association between overcrowded and multigenerational households and COVID-19 in New York City (NYC).

STUDY DESIGN

Cohort study.

METHODS

We conducted a Bayesian ecological time series analysis at the ZIP Code Tabulation Area (ZCTA) level in NYC to assess whether ZCTAs with higher proportions of overcrowded (defined as the proportion of the estimated number of housing units with more than one occupant per room) and multigenerational households (defined as the estimated percentage of residences occupied by a grandparent and a grandchild less than 18 years of age) were independently associated with higher suspected COVID-19 case rates (from NYC Department of Health Syndromic Surveillance data for March 1 to 30, 2020). Our main measure was an adjusted incidence rate ratio (IRR) of suspected COVID-19 cases per 10,000 population. Our final model controlled for ZCTA-level sociodemographic factors (median income, poverty status, White race, essential workers), the prevalence of clinical conditions related to COVID-19 severity (obesity, hypertension, coronary heart disease, diabetes, asthma, smoking status, and chronic obstructive pulmonary disease), and spatial clustering.

RESULTS

39,923 suspected COVID-19 cases were presented to emergency departments across 173 ZCTAs in NYC. Adjusted COVID-19 case rates increased by 67% (IRR 1.67, 95% CI = 1.12, 2.52) in ZCTAs in quartile four (versus one) for percent overcrowdedness and increased by 77% (IRR 1.77, 95% CI = 1.11, 2.79) in quartile four (versus one) for percent living in multigenerational housing. Interaction between both exposures was not significant (β_interaction = 0.99, 95% CI: 0.99-1.00).

CONCLUSIONS

Overcrowdedness and multigenerational housing are independent risk factors for suspected COVID-19. In the early phase of the surge in COVID cases, social distancing measures that increase house-bound populations may inadvertently but temporarily increase SARS-CoV-2 transmission risk and COVID-19 disease in these populations.

Identification and control of specific aflatoxin-producing fungi in stored maize seeds in awka using azadirachta indica (neem) and garcinia kola seeds

Four fungal isolates were identified in this study of which three were Aspergillus species with Aspergillus flavus having the highest frequency followed by A. parasiticus. The result of high frequency of Aspergillus flavus and Aspergillus parasiticus in the Zea mays sample revealed production of aflatoxins. Maize sample in Awka was found to contain aflatoxin B1 (9.60ppb) and B2 (13.3ppb). Inhibition of A. flavus and A. parasiticus with Azadirachta indica and Garcinia kola seed extracts showed that the test plant extracts were effective for reducing mycelial growth on the test organism. Methanolic extract of G. kola showed antifungal inhibitory activity on the test organisms and the highest at 10% concentration. With ethanol extracts of G. kola, the antifungal activity was effective i.e. for inhibition of A. flavus and A. parasiticus, with A. parasiticus having the higher percentage inhibition at 10%. Inhibiting growth of Aspergillus flavus and Aspergillus parasiticus using methanolic and ethanolic extracts of neem seeds was effective in the inhibition of the test organism at 10%. The methanolic and ethanolic extracts of combined Garcinia kola and neem seeds revealed effective inhibition of A. flavus and A. parasiticus with ethanolic extracts of the combined test plants exerting the highest inhibition against A. flavus (80.43±3.62). The extracts from this plant show the ability to suppress growth of toxigenic A. flavus and A. parasiticus. Phytochemical analysis showed that the methanolic and ethanolic extracts of G. kola and neem seeds showed the presence of secondary metabolites and this may be a reason for the inhibitory activity on A. flavus and A. parasiticus. Results from this study will be important in planning a management strategy against aflatoxin-producing fungi and other fungi associated with spoilage of stored food products.

Barbiturate anticonvulsants: a neuropsychological and quantitative electroencephalographic study

We studied 11 epileptic children aged 7 to 14 years with quantitative electroencephalographic (EEG) and neuropsychological tests, both on and off the barbiturate anticonvulsants phenobarbital and mephobarbital, comparing them to 13 controls matched for age and IQ who received testing at similar intervals. Neuropsychological tests employed were the Wechsler Intelligence Scale for Children-Revised (WISC-R), Bender-Gestalt, controlled oral word association test (COWAT), selected subtests of the Wechsler Memory Scale-Revised, Purdue Peg Board, Stroop Test, Trail Making Test, Wide Range Achievement Test-Revised, and Achenbach Behavior Rating Scale. There was no difference between on- and off-drug quantitative EEG in percentage power of any frequency band between 0.6 and 32 Hz. Neuropsychological data from all 11 subjects were analyzed with a two-factor analysis of variance with repeated measures on the time factor. The only difference from controls was on the Stroop Test. Parents reported clear behavioral changes in 6 of 11 subjects, but in 4 of these children the behavioral changes were sufficiently mild that parents chose to continue the barbiturate anticonvulsants: irritability, oppositional attitude, and overactivity were described. Mephobarbital was reported by parents to cause less severe problems than phenobarbital in subjects who had taken both barbiturate anticonvulsants. Barbiturate anticonvulsants have no effect on quantitative EEG and limited effects on neuropsychological tests in school-aged children.

Opioid receptor changes in weaver mouse striatum

The dopaminergic projection from the substantia nigra to the patch and matrix compartments of the caudate-putamen undergoes a spontaneous, early postnatal degeneration in mice which carry the weaver gene. The projection to nucleus accumbens is relatively spared. Dopaminergic afferents have been shown to be important modulators of striatal opioid receptor expression. In the present study, opioid receptor localization in the caudate-putamen and nucleus accumbens of control and weaver mice was examined by quantitative autoradiography. Mu, delta and kappa opioid receptors were differentially distributed in nucleus accumbens and in patch and matrix compartments of the caudate-putamen. In animals which were homozygous for the weaver gene, the density of mu opioid receptors in both patch and matrix compartments was unchanged with respect to control mice. In contrast, the density of delta and kappa opioid receptors was significantly decreased in weaver caudate-putamen and nucleus accumbens. The significance of these results with respect to opioid receptor expression and Parkinson's disease is discussed.