Comorbidities, racial disparity found in homeless hospital COVID patients
Almost two thirds of homeless patients hospitalized for COVID-19 were of non-White descent and more than 80% had at least one comorbidity, according to a descriptive study in The Journal of Infectious Diseases yesterday.
The researchers analyzed 199 COVID-hospitalized adults who were experiencing homelessness out of the 2,872 (30.2%) patients in the COVID-NET database with homelessness status from Mar 1 to May 31, 2020. The cohort was 82.9% men, had a median age of 53 years, and were mostly non-White (63.3%).
When analyzing the patient data, the researchers used weighted percentages (WPs) to reflect what the population estimates would be if every medical record they pulled had homelessness information. For instance, in the cohort, almost 1 in 5 patients had a mental illness (38, 19.1%), but weighting changed the proportion to 1 in 12 (8.4%).
Most patients had at least one underlying health condition (155; WP, 83.0%), with the most common being high blood pressure (77; WP, 43.9%), cardiovascular disease (36; WP, 24.9%), obesity (59; WP, 23.6%), and chronic lung disease (43; WP, 22.3%). Most were also current smokers (105; WP, 45.9%), and 70 (WP, 33.7%) abused alcohol.
The median length of hospital stay was 4 days, and 37 were admitted to the intensive care unit (ICU; WP, 16.9%). Eighteen people needed invasive mechanical ventilation (WP, 11.3%), while 27 (WP, 15.0%) needed any type of respiratory support. Six patients died (WP, 1.1%).
Compared with a COVID-NET study of the general adult population in Clinical Infectious Diseases in July 2020, this study similarly shows a high prevalence of comorbidities. The current study group, however, had a younger median age (53 vs 62 years) and a higher proportion of minorities and current smokers.
Additionally, the 2020 study revealed that mechanical ventilation procedures did not vary by race and ethnicity and that White patients had a higher prevalence of in-hospital death. This study's results indicated that Hispanic and Black people accounted for most instances of mechanical ventilation or in-hospital death.
May 16 J Infect Dis study
COVID-19 reinfection found in 2% of university students
In the spring 2021 semester, 2.2% of Clemson University, South Carolina, students previously infected with COVID-19 were diagnosed as having been reinfected, according to a study published yesterday in Clinical Infectious Diseases.
The researchers looked at 16,101 students 17 to 24 years old from Aug 19 to Oct 5, 2020, as those after may have lingering viral RNA during weekly spring semester testing. Going into the spring semester, 12.6% of the cohort were considered to have a previous COVID-19 infection.
The university conducted mandatory weekly saliva tests during the spring 2021 semester, with a compliance rate of 83%. Overall, 44 students were reinfected (2.2% of the previously infected cohort), compared with 12.1% of students who had their first COVID-19 infection during the spring 2021 semester. The researchers estimate that protection from reinfection was 84% (95% confidence interval, 78% to 88%).
The reinfected students had a median age of 20.3 years. Most were female (51.4%) and didn't live in the dorms (66.2%) The median time to reinfection was 129 days, and the researchers say the Kaplan-Meier probability estimate of no reinfection for at least 8 months is 97.2%.
"Since 16% of this population remains susceptible to reinfection, precautions should still be employed by previously infected individuals (e.g., face coverings)," the researchers write. (The article was received by the journal Apr 17, 2021, before the CDC's revised mask guidelines May 13.) "As natural protection is not guaranteed, these findings strongly support vaccination of those previously infected with SARS-CoV-2. However, individuals without previous SARS-CoV-2 infections could be given prioritization when vaccines are in short supply."
May 16 Clin Infect Dis study