Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study

Background: There is limited clinical patient data comparing the first and second waves of the coronavirus disease 2019 (COVID-19) in the United States and the effects of a COVID-19 resurgence on different age, racial and ethnic groups. We compared the first and second COVID-19 waves in the Bronx, N...

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Autores principales:	Wouter S. Hoogenboom, Antoine Pham, Harnadar Anand, Roman Fleysher, Alexandra Buczek, Selvin Soby, Parsa Mirhaji, Judy Yee, Tim Q. Duong
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	COVID-19 SARS-CoV-2 Coronavirus Resurgence Race Ethnicity Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/fb19093f70574cb1b0ef97bea5e410e8
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spelling	oai:doaj.org-article:fb19093f70574cb1b0ef97bea5e410e82021-11-12T04:50:07ZClinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study2667-193X10.1016/j.lana.2021.100041https://doaj.org/article/fb19093f70574cb1b0ef97bea5e410e82021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667193X21000338https://doaj.org/toc/2667-193XBackground: There is limited clinical patient data comparing the first and second waves of the coronavirus disease 2019 (COVID-19) in the United States and the effects of a COVID-19 resurgence on different age, racial and ethnic groups. We compared the first and second COVID-19 waves in the Bronx, New York, among a racially and ethnically diverse population. Methods: Patients in this retrospective cohort study were included if they had a laboratory-confirmed SARS-CoV-2 infection by a real-time PCR test of a nasopharyngeal swab specimen detected between March 11, 2020, and January 21, 2021. Main outcome measures were critical care, in-hospital acquired disease and death. Patient demographics, comorbidities, vitals, and laboratory values were also collected. Findings: A total of 122,983 individuals were tested for SARS-CoV-2 infection, of which 12,659 tested positive. The second wave was characterized by a younger demographic, fewer comorbidities, less extreme laboratory values at presentation, and lower risk of adverse outcomes, including in-hospital mortality (adj. OR = 0·23, 99·5% CI = 0·17 to 0·30), hospitalization (adj. OR = 0·65, 99·5% CI = 0·58 to 0·74), invasive mechanical ventilation (adj. OR = 0·70, 99·5% CI = 0·56 to 0·89), acute kidney injury (adj. OR = 0·62, 99·5% CI = 0·54 to 0·71), and length of stay (adj. OR = 0·71, 99·5% CI = 0·60 to 0·85), with Black and Hispanic patients demonstrating most improvement in clinical outcomes. Interpretation: The second COVID-19 wave in the Bronx exhibits improved clinical outcomes compared to the first wave across all age, racial, and ethnic groups, with minority groups showing more improvement, which is encouraging news in the battle against health disparities.Wouter S. HoogenboomAntoine PhamHarnadar AnandRoman FleysherAlexandra BuczekSelvin SobyParsa MirhajiJudy YeeTim Q. DuongElsevierarticleCOVID-19SARS-CoV-2CoronavirusResurgenceRaceEthnicityPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Americas, Vol 3, Iss , Pp 100041- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV-2 Coronavirus Resurgence Race Ethnicity Public aspects of medicine RA1-1270
spellingShingle	COVID-19 SARS-CoV-2 Coronavirus Resurgence Race Ethnicity Public aspects of medicine RA1-1270 Wouter S. Hoogenboom Antoine Pham Harnadar Anand Roman Fleysher Alexandra Buczek Selvin Soby Parsa Mirhaji Judy Yee Tim Q. Duong Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study
description	Background: There is limited clinical patient data comparing the first and second waves of the coronavirus disease 2019 (COVID-19) in the United States and the effects of a COVID-19 resurgence on different age, racial and ethnic groups. We compared the first and second COVID-19 waves in the Bronx, New York, among a racially and ethnically diverse population. Methods: Patients in this retrospective cohort study were included if they had a laboratory-confirmed SARS-CoV-2 infection by a real-time PCR test of a nasopharyngeal swab specimen detected between March 11, 2020, and January 21, 2021. Main outcome measures were critical care, in-hospital acquired disease and death. Patient demographics, comorbidities, vitals, and laboratory values were also collected. Findings: A total of 122,983 individuals were tested for SARS-CoV-2 infection, of which 12,659 tested positive. The second wave was characterized by a younger demographic, fewer comorbidities, less extreme laboratory values at presentation, and lower risk of adverse outcomes, including in-hospital mortality (adj. OR = 0·23, 99·5% CI = 0·17 to 0·30), hospitalization (adj. OR = 0·65, 99·5% CI = 0·58 to 0·74), invasive mechanical ventilation (adj. OR = 0·70, 99·5% CI = 0·56 to 0·89), acute kidney injury (adj. OR = 0·62, 99·5% CI = 0·54 to 0·71), and length of stay (adj. OR = 0·71, 99·5% CI = 0·60 to 0·85), with Black and Hispanic patients demonstrating most improvement in clinical outcomes. Interpretation: The second COVID-19 wave in the Bronx exhibits improved clinical outcomes compared to the first wave across all age, racial, and ethnic groups, with minority groups showing more improvement, which is encouraging news in the battle against health disparities.
format	article
author	Wouter S. Hoogenboom Antoine Pham Harnadar Anand Roman Fleysher Alexandra Buczek Selvin Soby Parsa Mirhaji Judy Yee Tim Q. Duong
author_facet	Wouter S. Hoogenboom Antoine Pham Harnadar Anand Roman Fleysher Alexandra Buczek Selvin Soby Parsa Mirhaji Judy Yee Tim Q. Duong
author_sort	Wouter S. Hoogenboom
title	Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study
title_short	Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study
title_full	Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study
title_fullStr	Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study
title_full_unstemmed	Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study
title_sort	clinical characteristics of the first and second covid-19 waves in the bronx, new york: a retrospective cohort study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/fb19093f70574cb1b0ef97bea5e410e8
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Clinical characteristics of the first and second COVID-19 waves in the Bronx, New York: A retrospective cohort study

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