Tag: JAMA

One-Year Adverse Outcomes Among US Adults With Post–COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama-health-forum/fullarticle/2802095

JAMA Health Forum. 2023;4(3):e230010. doi:10.1001/jamahealthforum.2023.0010

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Question  Do postacute sequelae of SARS-CoV-2 increase risks of 1-year adverse outcomes?

Findings  In this case-control study of 13 435 US adults with post–COVID-19 condition (PCC) and 26 870 matched adults without COVID-19, the adults with PCC experienced increased risks for a number of cardiovascular outcomes, such as ischemic stroke. During the 12-month follow-up period, 2.8% of the individuals with PCC vs 1.2% of the individuals without COVID-19 died, implying an excess death rate of 16.4 per 1000 individuals.

Meaning  Individuals with PCC may be at increased risk for adverse outcomes in the year following initial infection.

Author(s): Andrea DeVries, PhD1; Sonali Shambhu, BDS, MPH1; Sue Sloop, PhD1; et al

Publication Date:

Publication Site: JAMA Health Forum

Long COVID Correlates With High Mortality: Health Insurer

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2023/03/03/long-covid-correlates-with-high-mortality-health-insurer/

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A giant health insurer says health plan enrollees who suffered from long COVID-19 symptoms were more than twice as likely as other enrollees to die during a 12-month follow-up period.

Andrea DeVries, a researcher at Elevance Health, and three colleagues found that, during the year studied, 2.8% of the 13,435 enrollees classified as having “post-COVID-19 condition” died, according to a study published in the JAMA Health Forum, which is affiliated with the Journal of the American Medical Association.

That compares with a death rate of just 1.2% for similar enrollees without COVID-19 during the same period.

….

Elevance Health is the company formerly known as Anthem. The company provides or administers major medical coverage for about 48 million people.

The DeVries looked at claim records for 249,013 Elevance plan enrollees ages and older who were diagnosed with COVID-19 from April 1, 2020, through July 31, 2020 — before regulators had adopted a long COVID diagnosis code.

The team began by identifying enrollees with COVID-19 who had been enrolled in an Elevance plan for at least five months before being diagnosed with COVID-19 and who had survived for at least two months after the diagnosis date.

Because of the lack of a long COVID-19 diagnosis code, the team used claims for other conditions, such as loss of the sense of smell, brain fog, anxiety and heart rate problems, to come up with a list of enrollees with long COVID.

Author(s): Allison Bell

Publication Date: 3 March 2023

Publication Site: Think Advisor

More Americans 65 and Under Died from Alcohol-Related Causes Than Covid-19 in 2020, Study Finds

Mary Pat Campbell

Link: https://www.nationalreview.com/news/more-americans-65-and-under-died-from-alcohol-related-causes-than-covid-19-in-2020-study-finds/

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Alcohol-related deaths increased 25 percent from 2019 to 2020, with alcohol-related deaths among adults younger than 65 outnumbering deaths from Covid-19 in the same age group in 2020, a new study found.

Alcohol-related deaths, including from liver disease and accidents, increased to 99,017 in 2020, up from 78,927 the year prior, according to the study performed by researchers with the National Institute on Alcohol Abuse and Alcoholism, a division of the National Institutes of Health.

While 74,408 Americans ages 16 to 64 died of alcohol-related causes, 74,075 individuals under 65 died of Covid-19, the study found. The rate of increase for alcohol-related deaths in 2020 (25 percent) was greater than the rate of increase of deaths from all causes (16.6 percent).

The study shows just another unintended consequence of Covid-19 lockdowns and mitigation measures.

Author(s): Brittany Bernstein

Publication Date: 22 March 2022

Publication Site: National Review

‘We’re losing IQ points’: the lead poisoning crisis unfolding among US children

Mary Pat Campbell

Link:https://www.theguardian.com/us-news/2021/dec/08/lead-poisoning-crisis-us-children

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Turokk Dow is one of about 87,000 young children who are diagnosed with lead poisoning in the US each year, more than three decades after the neurotoxin was banned as an ingredient in paint, gasoline and water pipes. Today, lead lingers in houses and apartments, yards and water lines, and wherever states and communities ramp up testing, it becomes clear that the nation’s lead problem is worse than we realized, experts say.

A study published in JAMA Pediatrics this fall suggested that more than half of all US children have detectable levels of lead in their blood – and that elevated blood lead levels were closely associated with race, poverty and living in older housing. Black children are particularly at risk.

“Most American children are exposed to lead, a substance that is not safe at any level,” said co-author Dr Harvey Kaufman, a senior medical director at Quest Diagnostics, which led the study. According to the CDC, “[e]ven low levels of lead in blood have been shown to negatively affect a child’s intelligence, ability to pay attention, and academic achievement.”

….

In California, for example, a 2020 report found that 1.4 million low-income children who were supposed to receive testing never got checked for blood poisoning. In some states, like New York, testing of all children is required, but there is often insufficient followup. A study by the New York City comptroller found that 9,000 rental buildings where children tested positive for blood poisoning were never inspected for lead, resulting in additional children being poisoned.

Author(s): Erin McCormick in Rhode Island and Eric Lutz

Publication Date: 8 Dec 2021

Publication Site: The Guardian UK

Estimated US Infection- and Vaccine-Induced SARS-CoV-2 Seroprevalence Based on Blood Donations, July 2020-May 2021

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama/fullarticle/2784013

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Findings  In this repeated cross-sectional study that included 1 443 519 blood donation specimens from a catchment area representing 74% of the US population, estimated SARS-CoV-2 seroprevalence weighted for differences between the study sample and general population increased from 3.5% in July 2020 to 20.2% for infection-induced antibodies and 83.3% for combined infection- and vaccine-induced antibodies in May 2021. Seroprevalence differed by age, race and ethnicity, and geographic region of residence, but these differences changed over the course of the study.

Meaning  Based on a sample of blood donations in the US from July 2020 through May 2021, estimated SARS-CoV-2 seroprevalence increased over time and varied by age, race and ethnicity, and geographic region.

Author(s): Jefferson M. Jones, MD, MPH1; Mars Stone, PhD2; Hasan Sulaeman, MS2; et al

Publication Date: 2 September 2021

Publication Site: JAMA

Mortality From Falls Among US Adults Aged 75 Years or Older, 2000-2016

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama/fullarticle/2735063

Reference: JAMA. 2019;321(21):2131-2133. doi:10.1001/jama.2019.4185

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In the United States, an estimated 28.7% of adults aged 65 years or older fell in 2014.1 Falls result in increased morbidity, mortality, and health care costs.1,2 Risk factors for falls include age, medication use, poor balance, and chronic conditions (ie, depression, diabetes).1 Fall prevention strategies are typically recommended for adults older than 65 years. In several European countries, an increase in mortality from falls has been observed since 2000, particularly among adults older than 75 years.3,4 This age group has the highest fall risk and potential for cost-effective interventions. We report trends in mortality from falls for the US population aged 75 years or older from 2000 to 2016.

Author(s): Klaas A. Hartholt, MD, PhD1; Robin Lee, PhD, MPH2; Elizabeth R. Burns, MPH2; et al

Publication Date: 4 June 2019

Publication Site: JAMA

Study: U.S. had 23% more deaths than expected in 2020 due to pandemic

Mary Pat Campbell

Link: https://www.upi.com/Health_News/2021/04/02/coronavirus-excess-deaths-study/7781617369688/

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The United States saw 23% more deaths than expected between March 1, 2020, and the start of this year, due primarily to the effects of the COVID-19 pandemic, which suggests the official number of U.S. coronavirus deaths is an undercount, according to an analysis published Friday by JAMA found.

More than 2.8 million people died nationally between when the first confirmed cases of the coronavirus were identified and Jan. 2, the data showed.

That’s roughly 522,000 more than would be expected for the 10-month period, based on figures from 2014 through 2019.

These excess deaths were higher than the number of publicly reported COVID-19 deaths across the country, researchers said.

Author(s): Brian P. Dunleavy

Publication Date: 2 April 2021

Publication Site: UPI

Excess Deaths From COVID-19 and Other Causes in the US, March 1, 2020, to January 2, 2021

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama/fullarticle/2778361

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Between March 1, 2020, and January 2, 2021, the US experienced 2 801 439 deaths, 22.9% more than expected, representing 522 368 excess deaths (Table). The excess death rate was higher among non-Hispanic Black (208.4 deaths per 100 000) than non-Hispanic White or Hispanic populations (157.0 and 139.8 deaths per 100 000, respectively); these groups accounted for 16.9%, 61.1%, and 16.7% of excess deaths, respectively. The US experienced 4 surge patterns: in New England and the Northeast, excess deaths surged in the spring; in the Southeast and Southwest, in the summer and early winter; in the Plains, Rocky Mountain, and far West, primarily in early winter; and in the Great Lakes, bimodally, in the spring and early winter (Figure). Excess deaths were increasing in all regions at the end of 2020. The 10 states with the highest per capita rate of excess deaths were Mississippi, New Jersey, New York, Arizona, Alabama, Louisiana, South Dakota, New Mexico, North Dakota, and Ohio. New York experienced the largest relative increase in all-cause mortality (38.1%). Deaths attributed to COVID-19 accounted for 72.4% of US excess deaths.

Joinpoint analyses revealed an increase in weekly mortality from non–COVID-19 causes, including heart disease from March 15 to April 11, 2020 (APC, 4.9 [95% CI, 0.7-9.3]), and October 11, 2020, to January 2, 2021 (APC, 1.1 [95% CI, 0.8-1.4]); Alzheimer disease/dementia from March 15 to April 11, 2020 (APC, 7.1 [95% CI, 2.4-12.0]), May 31 to August 15, 2020 (APC, 1.2 [95% CI, 0.7-1.6]), and September 6, 2020, to January 2, 2021 (APC, 1.3 [95% CI, 1.1-1.5]); and diabetes from March 8 to April 11, 2020 (APC, 6.5 [95% CI, 2.8-10.3]), May 31 to July 11, 2020 (APC, 2.6 [95% CI, 0.2-5.0]), and October 18, 2020, to January 2, 2021 (APC, 2.2 [95% CI, 1.6-2.8]).

Author(s): Steven H. Woolf, MD, MPH1; Derek A. Chapman, PhD1; Roy T. Sabo, PhD2; et al

Publication Date: 2 April 2021

Publication Site: JAMA

The Leading Causes of Death in the US for 2020

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jama/fullarticle/2778234

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The provisional number of deaths occurring in the US among US residents in 2020 was 3 358 814, an increase of 503 976 (17.7%) from 2 854 838 in 2019 (Table). Historic trends in mortality show seasonality in the number of deaths throughout the year, with the number of deaths higher in the winter and lower in the summer. The eFigure in the Supplement shows that death counts by week from 2015 to 2019 followed a normal seasonal pattern, with higher average death counts in weeks 1 through 10 (n = 58 366) and weeks 35 through 52 (n = 52 892) than in weeks 25 through 34 (n = 50 227). In contrast, increased deaths in 2020 occurred in 3 distinct waves that peaked during weeks 15 (n = 78 917), 30 (n = 64 057), and 52 (n = 80 656), with only the latter wave aligning with historic seasonal patterns.

Author(s): Farida B. Ahmad, Robert N. Anderson

Publication Date: 31 March 2021

Publication Site: JAMA

The COVID-19 Pandemic—An Opportune Time to Update Medical Licensing

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2775345?guestAccessKey=759005fe-3396-4df8-b388-110fefb7e499&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=etoc&utm_term=030121

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Congress could regulate telemedicine across state lines as interstate commerce and establish the “place of service” of a telehealth visit as the location of the clinician, not the location of the patient.5 This definition would allow physicians to provide telehealth services if licensed by the state from which they would conduct telehealth visits. Such legislative action would not override state licensure or insurance regulations but would increase access to telehealth services by removing state licensing as a barrier.

State-based medical licensing is inherently linked to state-based consumer protection, including oversight by state licensing boards and the recourse of malpractice litigation in state courts. Therefore, if telemedicine were regulated as interstate commerce, Congress would need to provide a framework for consumer protections, in particular to guard against states protecting the interests of in-state physicians against claims from out-of-state telehealth patients. For example, Congress could decide that a physician’s home state medical board would be responsible for disciplinary investigations, while the state in which the patient lives would be the jurisdiction for malpractice litigation.

Author(s): Samyukta Mullangi, MD, MBA; Mohit Agrawal, MS, MBA; Kevin Schulman, MD

Publication Date: 13 January 2021

Publication Site: JAMA

Trends in Premature Deaths Among Adults in the United States and Latin America

Mary Pat Campbell

Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2760668

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Results  During 2001 to 2015, 22 million deaths (8 million women and 14 million men) occurred among individuals aged 20 to 64 years in the selected populations. Among women, US Latina individuals had the lowest premature mortality rates (ASMR for 2015, 144 deaths per 100 000 population) and US African American women had the highest premature mortality rate (ASMR for 2015, 340 deaths per 100 000 population) of the 16 populations studied. Rates among US white women shifted from the sixth lowest in 2001 (ASMR, 231 deaths per 100 000 population) to the 12th lowest in 2015 (ASMR, 235 deaths per 100 000 population). Among men, Peru had the lowest premature mortality rates (ASMR for 2015, 219 deaths per 100 000 population), and Belize had the highest premature mortality rates (ASMR for 2015, 702 deaths per 100 000 population). White men in the United States shifted from the fifth lowest rates in 2001 (ASMR, 396 deaths per 100 000 population) to the eighth lowest rates in 2015 (ASMR, 394 deaths per 100 000 population). Rates for both women and men decreased in all the populations studied from 2001 to 2015 (average annual percentage change range, 0.4% to 3.8% per year) except among US white populations, for which the rate plateaued (average annual percentage change, 0.02% per year [95% CI, −0.3% to 0.2% per year] for women; −0.2% per year [95% CI, −0.4% to 0.0% per year] for men) and among Nicaraguan men, for whom the rates increased (0.6% per year [95% CI, 0.2% to 1.0% per year]). The populations with the lowest mortality rates in 2015 had lower rates from all major causes, but rates were particularly lower for heart disease (21 deaths per 100 000 population) and cancer (50 deaths per 100 000 population).

Author(s): Yingxi Chen, MD, PhD; Neal D. Freedman, PhD; Erik J. Rodriquez, PhD; et al

Publication Date: 12 February 2021

Publication Site: JAMA

COVID-19: New Study Reveals Danger To Younger Americans, Who Are Dying At Historic Rate

Mary Pat Campbell

Link: https://dailyvoice.com/new-york/northsalem/news/covid-19-new-study-reveals-danger-to-younger-americans-who-are-dying-at-historic-rate/799940/

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Contrary to popular belief, COVID-19 is taking its toll on younger Americans, who are dying at a historic rate, according to a new study.

Research published this week in the Journal of American Medical Association found that Americans between the ages of 25 and 44 have died at a rate that has never been seen in history.

During the study, a total of 76,088 deaths were reported in adults between those ages, which was 11,899 more than the expected 64,189 fatalities during that stretch.

Author(s): Zak Failla

Publication Date: 19 December 2020

Publication Site: Daily Voice