Background: With the coronavirus outbreak of 2019 (COVID-19) came many changes in how health care is accessed and delivered. Perhaps most notable is the massive expansion of telemedicine, especially in the developed world. With pandemic-induced economic and health care system disruptions, it is reasonable to expect changes in how health care services are utilized by different patients. We examined how health care service usage trends changed for various patient demographics from the pre-COVID-19 era to the COVID-19 era. Design and methods: De-identified patient demographics and telemedicine, in-patient, in-person out-patient, radiology/procedures, and emergency department visit data ( N = 1,164,719) between January 1st, 2019 and May 31st, 2021 were obtained from UHealth in Miami, Florida, USA. This cross-sectional study employed descriptive statistics and other tools to determine relationships between patient demographics and health system usage. Results: There were significant changes in health care usage and demographics for UHealth services from the pre-COVID-19 era to the COVID-19 era. There was an increase in telehealth visits and a corollary decrease of in-person out-patient visits ( p < 0.001) along with increased health care utilization by those with commercial insurance ( p < 0.001) during COVID-19. Lower-income patients had increased use of in-person out-patient services ( p < 0.001). Non-Hispanic, English-speaking patients and those with higher median incomes had higher telemedicine usage. Conclusions: COVID-19 revealed differences in health care access, particularly telemedicine access, and highlighted differences in vulnerability among patient demographics. These trends are likely multifactorial and reflect changes in patients’ preferences and disparities in care access.

The gut microbiota, composed of numerous species of microbes, works in synergy with the various organ systems in the body to bolster our overall health and well-being. The most well-known function of the gut microbiome is to facilitate the metabolism and absorption of crucial nutrients, such as complex carbohydrates, while also generating vitamins. In addition, the gut microbiome plays a crucial role in regulating the functioning of the central nervous system (CNS). Host genetics, including specific genes and single nucleotide polymorphisms (SNPs), have been implicated in the pathophysiology of neurological disorders, including Parkinson’s disease (PD), Alzheimer’s disease (AD), and autism spectrum disorder (ASD). The gut microbiome dysbiosis also plays a role in the pathogenesis of these neurodegenerative disorders, thus perturbing the gut-brain axis. Overproduction of certain metabolites synthesized by the gut microbiome, such as short-chain fatty acids (SCFAs) and p-cresyl sulfate, are known to interfere with microglial function and trigger misfolding of alpha-synuclein protein, which can build up inside neurons and cause damage. By determining the association of the gut microbiome and its metabolites with various diseases, such as neurological disorders, future research will pave the way for the development of effective preventive and treatment modalities.

Deciphering the inner ear transcriptome has allowed major breakthroughs in therapeutic development for auditory disorders. Single-cell sequencing (SCS) technologies, through the analysis of cellular heterogeneity and the identification of novel gene markers, can significantly enhance our understanding about auditory disorders. The application of SCS has allowed the identification of gene targets specific to the inner ear cellular subtypes such as supporting cells, hair cells, stria vascularis cells, and spiral ganglion neuron cells. SCS has provided new insights into the molecular mechanisms underlying the pathophysiology of auditory disorders such as noise-trauma induced hearing loss, ototoxicity, sudden sensorineural hearing loss (SSNHL), vestibular schwannomas and acute otitis media, leading to the discovery of novel therapeutic targets. The objective of this perspective article is to discuss recent advancements regarding the utilization of SCS for inner ear research. With global initiatives striving to overcome the increasing burden of hearing loss, the SCS technique holds a great potential in revolutionizing the management of auditory disorders, paving the way to develop effective treatment modalities.

BACKGROUND With the coronavirus outbreak of 2019 (COVID-19) escalating in early 2020 came many changes in how health care is accessed and delivered. Perhaps most notable is the massive expansion of telemedicine usage, especially in the developed world. With pandemic-induced economic and health care system disruptions, it is reasonable to expect changes in how health care services are utilized by different patients. OBJECTIVE To examine how health care usage trends changed for various patient demographics from the pre-COVID-19 era to the COVID-19 era. METHODS De-identified patient demographics and telemedicine, inpatient, in-person outpatient, radiology/procedures, and emergency department visit data (N = 1,164,719) between January 1st, 2019 and May 31st, 2021 were obtained from the UHealth database. Descriptive statistics and other tools were used to determine relationships between patient demographics and health system usage. RESULTS There were insignificant changes in health care usage and demographics for UHealth services from the pre-COVID-19 era to the COVID-19 era. There was an increase in telehealth visits and a corollary decrease of in-person outpatient visits (P < .001) along with increased health care utilization by those with commercial insurance (P < .001) during COVID-19. Lower income patients had increased use of in-person outpatient services (P < .001). Non-Hispanic, English-speaking patients and those with higher median incomes had higher telemedicine usage. CONCLUSIONS COVID-19 emphasizes differences in health care access, particularly telemedicine access, and vulnerability among certain patient demographics. Telehealth usage expanded dramatically, particularly among non-Hispanic and English-speaking populations. During the COVID-19 era, those with lower median incomes and those with commercial insurance used health care resources at higher rates compared to other patient populations. The trends we see are likely multifactorial and reflect changes in patients’ preferences and disparities in care access.