Disease and healthcare burden of COVID-19 in the United States

Miller, Ian F.; Becker, Alexander D.; Grenfell, Bryan T.; Metcalf, C. Jessica E.

doi:10.1038/s41591-020-0952-y

Cited by 414 publications

(365 citation statements)

References 13 publications

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“…In the United States, during the time when this survey was fielded, cases of COVID-19 were more common in urban areas (Frey 2020), which aligns with our finding that living in urban areas was associated with significantly higher odds of delayed dental care. However, as the pandemic has spread in the United States, there is growing concern about the disease burden and health care system demands faced outside of urban population centers (Miller et al 2020), particularly for Black Americans (Sood and Sood 2020). In addition, we failed to find evidence that reports of delaying dental care differed by race and ethnicity.…”

Section: Discussionmentioning

confidence: 72%

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic

Kranz

Gahlon

Dick

et al. 2020

JDR Clinical & Translational Research

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Background: Coronavirus disease 2019 (COVID-19) has disrupted the delivery of health care services, including dental care. The objective of this study was to quantify and describe US adults who delayed dental care due to the COVID-19 pandemic. Methods: We analyzed cross-sectional responses collected from a nationally representative and long-running panel survey of US adults conducted in late May and early June 2020 (response rate = 70%). The survey included questions about dental care delayed due to the COVID-19 pandemic, purpose of the delayed dental visits, timing of future dental visits, and demographic information. Pearson’s chi-square tests were used to determine if rates of delayed dental care varied by subgroup. A multivariable regression model, adjusted for age, race, Hispanic ethnicity, census division, and rurality, was estimated to predict the odds of reporting delayed dental care. Results: Nearly half of respondents (46.7%) reported delaying going to the dentist or receiving dental care due to the COVID-19 pandemic. Among adults who reported delaying dental care due to the pandemic, 74.7% reported delaying a checkup, 12.4% reported delaying care to address something that was bothering them, and 10.5% reported delaying care to get planned treatment. About 44.4% of adults reported that they planned to visit the dentist within the next 3 mo. In the multivariable regression model, only living in an urban (vs. rural) area was associated with significantly higher odds of delayed dental care due to the pandemic (odds ratio: 1.5; 95% confidence interval: 1.1, 2.1). Conclusions: Nearly half of US adults reported delaying dental care due to the COVID-19 pandemic during the spring of 2020. Our results offer insight into the experiences of patients seeking dental care this spring and the economic challenges faced by dental providers due to the pandemic. Knowledge Transfer Statement: This article describes US adults who delayed dental care due to the COVID-19 pandemic. Results can be used by clinicians and policymakers to understand delayed care during the pandemic.

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Section: Discussionmentioning

confidence: 72%

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic

Kranz

Gahlon

Dick

et al. 2020

JDR Clinical & Translational Research

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“…Since the advent of the Coronavirus Disease 2019 (COVID-19) pandemic, dominated by respiratory disease and evolution of acute respiratory distress syndrome (ARDS), cardiovascular compromise, excessive systemic inflammation and coagulopathy in adults [ 1 , 2 , 3 ], several countries affected by the coronavirus disease [ 4 ] pandemic have reported an unusually high number of cases of children hospitalized due to a multisystem inflammatory condition, at times requiring intensive care ( Table S1 ) [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The Royal College of Paediatrics and Child Health (RCPCH) defined a paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) [ 34 ], and the Centers for Disease Control and Prevention (CDC) defined a multisystem inflammatory syndrome in children (MIS-C) [ 35 ], detailed in Table S2 .…”

Section: Introductionmentioning

confidence: 99%

Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS)

Felsenstein

Willis

Lythgoe

et al. 2020

JCM

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The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the pathogen responsible for Coronavirus Disease 2019 (COVID-19). Whilst most children and young people develop mild symptoms, recent reports suggest a novel paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Case definition and classification are preliminary, treatment is empiric and disease-associated outcomes are unclear. Here, we report 29 patients with PIMS-TS who were diagnosed, admitted and treated in the English North West between March and June 2020. Consistent with patterns observed internationally, cases peaked approximately 4 weeks after the initial surge of COVID-19-like symptoms in the UK population. Clinical symptoms included fever (100%), skin rashes (72%), cardiovascular involvement (86%), conjunctivitis (62%) and respiratory involvement (21%). Some patients had clinical features partially resembling Kawasaki disease (KD), toxic shock syndrome and cytokine storm syndrome. Male gender (69%), black, Asian and other minority ethnicities (BAME, 59%) were over-represented. Immune modulating treatment was used in all, including intravenous immunoglobulin (IVIG), corticosteroids and cytokine blockers. Notably, 32% of patients treated with IVIG alone went into remission. The rest required additional treatment, usually corticosteroids, with the exception of two patients who were treated with TNF inhibition and IL-1 blockade, respectively. Another patient received IL-1 inhibition as primary therapy, with associated rapid and sustained remission. Randomized and prospective studies are needed to investigate efficacy and safety of treatment, especially as resources of IVIG may be depleted secondary to high demand during future waves of COVID-19.

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“…Researchers have noted significant disparities in the availability of critical medical resources that impact COVID-19 survival, such as ventilators, hospital beds and intensive care unit (ICU) beds. [1][2][3][4] However, a range of individual, household and community characteristics also influence risk of COVID-19 infection and its lethality. Preliminary data from the epidemic demonstrate a convergence of Strengths and limitations of this study ► By demonstrating the high intercounty variation in a range of risk factors across US counties, including their intersection with communities of colour, this study highlights the need for policy-makers to consider their local context when addressing the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

US-county level variation in intersecting individual, household and community characteristics relevant to COVID-19 and planning an equitable response: a cross-sectional analysis

Chin

Kahn

et al. 2020

BMJ Open

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ObjectivesTo illustrate the intersections of, and intercounty variation in, individual, household and community factors that influence the impact of COVID-19 on US counties and their ability to respond.DesignWe identified key individual, household and community characteristics influencing COVID-19 risks of infection and survival, guided by international experiences and consideration of epidemiological parameters of importance. Using publicly available data, we developed an open-access online tool that allows county-specific querying and mapping of risk factors. As an illustrative example, we assess the pairwise intersections of age (individual level), poverty (household level) and prevalence of group homes (community-level) in US counties. We also examine how these factors intersect with the proportion of the population that is people of colour (ie, not non-Hispanic white), a metric that reflects histories of US race relations. We defined ‘high’ risk counties as those above the 75th percentile. This threshold can be changed using the online tool.SettingUS counties.ParticipantsAnalyses are based on publicly available county-level data from the Area Health Resources Files, American Community Survey, Centers for Disease Control and Prevention Atlas file, National Center for Health Statistic and RWJF Community Health Rankings.ResultsOur findings demonstrate significant intercounty variation in the distribution of individual, household and community characteristics that affect risks of infection, severe disease or mortality from COVID-19. About 9% of counties, affecting 10 million residents, are in higher risk categories for both age and group quarters. About 14% of counties, affecting 31 million residents, have both high levels of poverty and a high proportion of people of colour.ConclusionFederal and state governments will benefit from recognising high intrastate, intercounty variation in population risks and response capacity. Equitable responses to the pandemic require strategies to protect those in counties at highest risk of adverse COVID-19 outcomes and their social and economic impacts.

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Disease and healthcare burden of COVID-19 in the United States

Cited by 414 publications

References 13 publications

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic

Characteristics of US Adults Delaying Dental Care Due to the COVID-19 Pandemic

Presentation, Treatment Response and Short-Term Outcomes in Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS)

US-county level variation in intersecting individual, household and community characteristics relevant to COVID-19 and planning an equitable response: a cross-sectional analysis

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