Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series — 465 Health Care Facilities, United States, December 2020–October 2021

Yek, Christina; Warner, Sarah; Wiltz, Jennifer L.; Sun, Junfeng; Adjei, Stacey; Mancera, Alex; Silk, Benjamin J.; Gundlapalli, Adi V.; Harris, Aaron M.; Boehmer, Tegan K.; Kadri, Sameer S

doi:10.15585/mmwr.mm7101a4

Cited by 161 publications

(140 citation statements)

References 9 publications

Supporting

Mentioning

130

Contrasting

Unclassified

Order By: Relevance

“…Direct medical costs incurred for secondary infections were $1436 on average; this accounted for varying costs for different disease severity levels (e.g., $0 if asymptomatic or no healthcare is sought vs. $61,000 if ICU admission is required; see S1 Appendix). [25, 27] We assumed all medical costs were incurred in year one and did not require discounting.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of antigen testing for ending COVID-19 isolation

Maya

Kahn

2022

Preprint

View full text Add to dashboard Cite

BackgroundThe Omicron variant of SARS-CoV-2 led to a steep rise in transmissions. Recently, as public tolerance for isolation abated, CDC guidance on duration of at-home isolation of COVID-19 cases was shortened to five days if no symptoms, with no lab test requirement, despite more cautious approaches advocated by other federal experts.MethodsWe conducted a decision tree analysis of alternative protocols for ending COVID-19 isolation, estimating net costs (direct and productivity), secondary infections, and incremental cost-effectiveness ratios. Sensitivity analyses assessed the impact of input uncertainty.ResultsPer 100 individuals, five-day isolation had 23 predicted secondary infections and a net cost of $33,000. Symptom check on day five (CDC guidance) yielded a 23% decrease in secondary infections (to 17.8), with a net cost of $45,000. Antigen testing on day six yielded 2.9 secondary infections and $63,000 in net costs. This protocol, compared to the next best protocol of antigen testing on day five of a maximum eight-day isolation, cost an additional $1,300 per secondary infection averted. Antigen or polymerase chain reaction testing on day five were dominated (more expensive and less effective) versus antigen testing on day six. Results were qualitatively robust to uncertainty in key inputs.ConclusionsA six-day isolation with antigen testing to confirm the absence of contagious virus appears the most effective and cost-effective de-isolation protocol to shorten at-home isolation of individuals with COVID-19.

show abstract

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of antigen testing for ending COVID-19 isolation

Maya

Kahn

2022

Preprint

View full text Add to dashboard Cite

show abstract

“… 14–16 Persons with immunosuppressed and underlying conditions are often at a high risk of severe COVID-19 outcome despite vaccinations. 17 However, the severity of COVID-19 outcomes varied among different age, sex, race, gender and other subgroups. Besides biological factors, social determinants such as income, education, social class, etc., are found to be associated with COVID-19 outcomes.…”

Section: Introductionmentioning

confidence: 99%

Association Between Symptoms and Severity of Disease in Hospitalised Novel Coronavirus (COVID-19) Patients: A Systematic Review and Meta-Analysis

Talukder¹,

Razu²,

Alif³

et al. 2022

JMDH

View full text Add to dashboard Cite

Background Symptoms of the novel coronavirus disease (COVD-19) are well known, although asymptomatic cases were also reported due to this rapidly evolving viral disease. However, there has been limited research with inconsistent findings on symptoms of COVID-19 and disease severity. We aimed to evaluate the association between symptoms and severity of disease in adult patients with confirmed COVID-19 by performing a meta-analysis. Methods We conducted this study by searching four online databases (Medline, Web of Science, EMBASE and Cochrane library) of published studies that included symptoms of COVID-19 cases and severity of the disease between January 1, 2020, and October 31, 2021. PRISMA and MOOSE guidelines were followed, and only articles published in English were selected. We performed meta-analysis using Mantel-Haenszel random-effects model. Note that we included peer-reviewed studies conducted in Wuhan and published in the English language that reported the clinical characteristics of COVID-19, particularly the symptoms of novel coronavirus patients with their prevalence and distribution of patients based on the severity of the disease. Results Out of 255 articles identified, a total of twenty articles, including 5390 participants, met the inclusion criteria and were included. Among the participants, 2997 (55.60%) were males, and 974 (18.07%) reported severe conditions. Fever was the most commonly reported symptom in the reported COVID-19 confirmed cases (88.47%, 95% CI: 80.74–93.35%), which was followed by cough, fatigue, and less proportionally dyspnea and myalgia. Dyspnea was the only symptom, which was associated with severity of COVID-19 (OR 2.43, 95% CI: 1.52–3.89). Conclusion Dyspnoea was found to be associated with severity of COVID-19. People with existing respiratory illnesses, such as chronic obstructive pulmonary diseases need to be careful about the onset of such symptom and should seek medical attention.

show abstract

“…The present reality of the pandemic sits somewhere between these two hypothetical extremes, but closer to the latter, given evidence for decreased immunogenicity among SOT recipients and uncertainty about optimal timing for vaccination of SOT candidates. 20 , 21 , 22 Potential harm from COVID‐19 may also vary by specific organ transplanted: lung transplant recipients have worse outcomes from COVID‐19 compared to other SOT recipients. 23 The level of community spread is likewise important in determining the benefit a caregiver vaccine mandate confers through decreased transmission to the SOT recipient and others: in a setting with little to no baseline risk of infection, such as New Zealand prior to the Delta variant, 24 a caregiver mandate provides relatively little added utility.…”

Section: Introductionmentioning

confidence: 99%

Caregiver COVID-19 vaccination for solid organ transplant candidates

Sun

Wightman

Diekema

2022

American Journal of Transplantation

View full text Add to dashboard Cite

An increasing proportion of transplant centers have implemented a mandate for vaccination against COVID‐19 for solid organ transplant candidates. There has been comparatively little exploration of the ethical considerations of mandating vaccination of a candidate's primary caregiver, despite a high risk of transmission given the close nature of contact between the candidate and caregiver. We examine how a caregiver mandate can improve overall utility in organ allocation, particularly in circumstances where vaccine effectiveness at preventing transmission and serious disease is low among recipients but high in caregivers. Our analysis reveals how sensitive such mandates must be to the evolving circumstances of disease severity, transmissibility, and vaccine effectiveness: as the facts change, the degree of benefit gained and therefore the degree of infringement on access to transplant and caregiver choice that is tolerated will likewise change.

show abstract

Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series — 465 Health Care Facilities, United States, December 2020–October 2021

Cited by 161 publications

References 9 publications

Cost-effectiveness of antigen testing for ending COVID-19 isolation

Cost-effectiveness of antigen testing for ending COVID-19 isolation

Association Between Symptoms and Severity of Disease in Hospitalised Novel Coronavirus (COVID-19) Patients: A Systematic Review and Meta-Analysis

Caregiver COVID-19 vaccination for solid organ transplant candidates

Contact Info

Product

Resources

About