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Ahmed SM, Shah RU, Fernandez V, Grineski S, Brintz B, Samore MH, Ferrari MJ, Leung DT, Keegan LT. Robust Testing in Outpatient Settings to Explore COVID-19 Epidemiology: Disparities in Race/Ethnicity and Age, Salt Lake County, Utah, 2020. Public Health Rep 2021; 136:345-353. [PMID: 33541222 PMCID: PMC8580386 DOI: 10.1177/0033354920988612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE US-based descriptions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have focused on patients with severe disease. Our objective was to describe characteristics of a predominantly outpatient population tested for SARS-CoV-2 in an area receiving comprehensive testing. METHODS We extracted data on demographic characteristics and clinical data for all patients (91% outpatient) tested for SARS-CoV-2 at University of Utah Health clinics in Salt Lake County, Utah, from March 10 through April 24, 2020. We manually extracted data on symptoms and exposures from a subset of patients, and we calculated the adjusted odds of receiving a positive test result by demographic characteristics and clinical risk factors. RESULTS Of 17 662 people tested, 1006 (5.7%) received a positive test result for SARS-CoV-2. Hispanic/Latinx people were twice as likely as non-Hispanic White people to receive a positive test result (adjusted odds ratio [aOR] = 2.0; 95% CI, 1.3-3.1), although the severity at presentation did not explain this discrepancy. Young people aged 0-19 years had the lowest rates of receiving a positive test result for SARS-CoV-2 (<4 cases per 10 000 population), and adults aged 70-79 and 40-49 had the highest rates of hospitalization per 100 000 population among people who received a positive test result (16 and 11, respectively). CONCLUSIONS We found disparities by race/ethnicity and age in access to testing and in receiving a positive test result among outpatients tested for SARS-CoV-2. Further research and public health outreach on addressing racial/ethnic and age disparities will be needed to effectively combat the coronavirus disease 2019 pandemic in the United States.
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Affiliation(s)
- Sharia M. Ahmed
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Rashmee U. Shah
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Valerie Fernandez
- College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, USA
| | - Sara Grineski
- Center for Natural & Technological Hazards, University of Utah, Salt Lake City, UT, USA
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Benjamin Brintz
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Matthew H. Samore
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Veterans Affairs, Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Matthew J. Ferrari
- Department of Biology, Pennsylvania State University, State College, PA, USA
| | - Daniel T. Leung
- Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Lindsay T. Keegan
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Veterans Affairs, Salt Lake City Health Care System, Salt Lake City, UT, USA
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Rehm HL, Hynes E, Funke BH. The Changing Landscape of Molecular Diagnostic Testing: Implications for Academic Medical Centers. J Pers Med 2016; 6:jpm6010008. [PMID: 26828522 PMCID: PMC4810387 DOI: 10.3390/jpm6010008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/18/2016] [Accepted: 01/21/2016] [Indexed: 12/21/2022] Open
Abstract
Over the last decade, the field of molecular diagnostics has undergone tremendous transformation, catalyzed by the clinical implementation of next generation sequencing (NGS). As technical capabilities are enhanced and current limitations are addressed, NGS is increasingly capable of detecting most variant types and will therefore continue to consolidate and simplify diagnostic testing. It is likely that genome sequencing will eventually serve as a universal first line test for disorders with a suspected genetic origin. Academic Medical Centers (AMCs), which have been at the forefront of this paradigm shift are now presented with challenges to keep up with increasing technical, bioinformatic and interpretive complexity of NGS-based tests in a highly competitive market. Additional complexity may arise from altered regulatory oversight, also triggered by the unprecedented scope of NGS-based testing, which requires new approaches. However, these challenges are balanced by unique opportunities, particularly at the interface between clinical and research operations, where AMCs can capitalize on access to cutting edge research environments and establish collaborations to facilitate rapid diagnostic innovation. This article reviews present and future challenges and opportunities for AMC associated molecular diagnostic laboratories from the perspective of the Partners HealthCare Laboratory for Molecular Medicine (LMM).
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Affiliation(s)
- Heidi L Rehm
- Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Boston, MA 02139, USA.
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
| | - Elizabeth Hynes
- Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Boston, MA 02139, USA.
| | - Birgit H Funke
- Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Boston, MA 02139, USA.
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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