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In March 2020, the American College of Surgeons1 and the U.S. Surgeon General2 recommended stopping all non-emergency surgical procedures. Recent news articles3,4 raised concern that pandemic-related reductions in non-emergency procedures may result in delayed diagnosis and treatment. We examined procedures to diagnose and treat solid organ tumors and heart disease (Table 1). When compared to 2018-2019 averages, our analysis found a dramatic–but temporary–decrease in procedures for cardiac arrhythmia and coronary artery disease, as well as procedures for all of the major organ cancers we examined. At their lowest point, these procedure volumes were 49-88% below their historical weekly averages.
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Life was so normal a few weeks ago. For me, and I imagine for many other health care workers, before the novel coronavirus etched its…
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Evidence from one large health system—NYU Langone Health—at an epicenter of the coronavirus disease 2019 outbreak in the United States shows possibility of sharp and…
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Story contributed by OCHIN. Recent EHR data show that while the rate of COVID-19 infection appears to be slowing in some parts of the country,…
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Physicians at Mount Sinai are exploring new avenues of clinical investigation, based on the beneficial response of patients to tPA in a small, preliminary case…
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To explore the association of liver abnormalities with COVID-19 outcomes, this study examined liver enzyme levels in a population of 37,420 adult patients who were admitted for COVID-19 and had either been discharged or died, as of July 8, 2020. Patients with severely elevated liver enzymes during admission for COVID-19 showed 2.5 times higher mortality rates when compared to patients with normal or moderately elevated levels.
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Early in the COVID-19 pandemic, experts expressed concerns that hypertensive patients taking RAAS inhibitors to control blood pressure might be at a higher risk of increased COVID-19 disease severity and mortality. However, analysis of EHR data suggests that COVID-19 patients treated with certain RAAS inhibitor medications, specifically ACE inhibitors and ARBs, have lower COVID-19 disease severity and mortality.
Delayed Cancer Screenings—A Second Look
The number of cancer screenings has recently begun to rise, but has not yet reached previously expected levels: June 16 weekly volumes remained 29%, 36%, and 35% lower than their pre-COVID-19 levels for breast, colon, and cervical cancer screenings. The gap between the expected screenings and the actual screenings created a sizable deficit of “missed” screenings…
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Using data from nearly 50,000 hospitalized COVID-19 positive patients across the United States, statistically significant geographic variations in supportive oxygen treatment were demonstrated and not explained by differences in age, sex, or severity.
follow-upReturn to Near Average Number of ED Visits for Acute MI and Strokes 12 Weeks Post COVID-19 Emergency Declaration
EHR data from ED visits occurring between the weeks of April 7, 2020 and May 31, 2020 show the weekly incidence of acute myocardial infarctions has returned to approximately 92% of the historical trend prior to March 13, 2020…
Acute Kidney Injury in Admitted COVID-19 Patients
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Fewer Patients Started on Medications for Opioid Use Disorder During COVID-19
The number of patients receiving first-time prescriptions for Medications for Opioid Use Disorder (MOUD) decreased by over 30% in the spring of 2020 when compared to trends observed in EHR data from January 2017 to May 2020. This finding suggests that patients at risk for opioid use disorder (OUD) and overdose are increasingly vulnerable during…
Mortality of COVID-19 Admitted Patients on Mechanical Ventilators
This brief was updated on June 26, 2020, with data as of June 18, 2020. Overall findings remain consistent, but the percentage of patients with an unknown outcome has decreased from 34% to 6%. Here we examine the mortality of patients who received invasive mechanical ventilation as treatment for acute respiratory failure due to COVID-19…
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For numerous reasons, some patients are tested for SARS-CoV-2 virus multiple times, and a small percentage of patients test positive more than once. We were interested in better understanding how often patients undergo multiple tests, and what the time frame is between the first and last positive results. We speculate that fewer days between repeat…
As Office Visits Fall, Telehealth Takes Hold
Recent data show that, while overall visit volumes have decreased dramatically since the beginning of the COVID-19 pandemic in the United States, telehealth visits overall have increased 300-fold.1 This brief describes the diagnoses and specialties that saw the largest visit volumes of telehealth, with the goal of informing future strategy around telehealth.
No Association Seen Between Vitamin D Deficiency and COVID-19 Infection, Hospitalization, or Mortality
A recent publication suggested patients’ vitamin D levels may impact the severity of their COVID-19 symptoms. EHR data for 28,185 patients for whom both COVID-19 disease status and vitamin D deficiency status were known show no statistically significant…
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There has been recent speculation surrounding whether famotidine, the active ingredient in a common heartburn medicine, Pepcid, could serve as an antiviral that may inhibit coronavirus replication. Our examination of EHR data did not show…
Effect of Comorbidities on Hospitalization and Death in COVID-19 Patients
Using data from 190,194 COVID-19 patients, the following conditions were found to be most strongly associated with a higher risk of hospitalization and death: Heart failure, diabetes, a weakened immune system, COPD, and a BMI of 40 or higher…
Pediatric Immunizations Drop in the Wake of COVID-19
Recent EHR data show that immunization administrations for pediatric patients have decreased by 42% in the spring of 2020 compared to prior years. It is estimated that 260,000 immunizations expected for March 8-May 9 were missed or delayed across all age groups at sampled organizations. Patients under 6 months of age showed the smallest reduction…
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Update: On July 7, we published an update to this article that found the weekly incidence of acute myocardial infarctions and stroke have returned to their near average historical trends. As the COVID-19 pandemic continues, there are growing concerns that patients with urgent conditions are not seeking the care they need for fear of exposure…
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As coronavirus cases mount, racial minorities appear to be disproportionately affected by the pandemic. Across a sample population of 23 million patients across 16 states, 12% were black and 65% were white, but among the 108,000 of those patients who are documented COVID-19 positive, 22% were black and 46% were white. The root causes of…
Obesity and COVID-19 Severity
Severe obesity, defined as having a body mass index (BMI) of 40 kg/m2 or higher, has been identified by the CDC as a risk factor for more severe COVID-19 illness. This brief examines the relationship between obesity and severity of illness for adult COVID-19 positive patients. In this sample of 119,582 COVID-19 positive patients, 79% have a BMI documented in their electronic medical record…
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There has been recent conversation about the role that smoking status may play in severity of COVID-19 disease. To investigate this role, we examined the relationship between smoking status, as documented in the electronic health record, and general outcome severity of COVID-19 in a large national cohort of adult COVID-19 positive patients…
Expansion of Telehealth During COVID-19 Pandemic
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Prevalence of Comorbidities in COVID-19 Related Hospitalizations and Deaths
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Learning from New Orleans’ COVID-19 Gene Sequence
Researchers from Ochsner and local lab BioInfoExperts have sequenced the genetic code of samples from their COVID-19 patients to learn more about the virus’s spread in Louisiana and how it continues to evolve. New Orleans has not only some of the highest per-capita rates of COVID-19 infection, but also a high rate of underlying health illness in the population…
Prior Outpatient Medications and Subsequent COVID-19 Positive Status
As the COVID-19 pandemic sweeps the globe, there is a rush to find medications that, if taken before COVID-19 is acquired, may be protective against infection. Clinical trials are currently examining drugs in many different classes. Figure 1 shows the percentage of patients who acquire COVID-19 after taking each medication chronically…
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Story contributed by Cleveland Clinic. Never before has the need to leverage technology for population health management been more apparent. With the outbreak of COVID-19, consistent outreach and prompt intervention are necessary to prevent negative outcomes. Although patients with COVID-19 often experience mild symptoms, deterioration can be rapid, even in patients considered low risk. That’s…
NYU Langone Scientists Track Evolution of Virus
Researchers at NYU Langone have sequenced the genetic code of samples from 91 COVID-19 patients in New York City, seeking clues to its origin and evolution in this region. Early data suggest that the virus has been spreading in the city for two months, before testing started. The findings also indicate the New York City…
COVID-19 Population Characteristics: Age and Sex
Investigators examined which patient populations are most likely to be tested for COVID-19, test positive for COVID-19, and have the most severe outcomes. The analysis below includes 165,359 patients tested for COVID-19 and 66,017 COVID-19 positive patients as of April 17, 2020. Data are pooled from 22 health systems that represent 140 hospitals, spanning 11…
Ibuprofen and COVID-19 Severity
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