COVID-19 Scan for Aug 12, 2022

Healthcare use after COVID-19
COVID vaccines and pregnancy

COVID-19 tied to 4% higher healthcare use in the 6 months post-infection

COVID-19 patients early in the pandemic had 4% higher healthcare use in the 6 months after illness onset than matched controls, most notably for infection-related conditions, hair loss, bronchitis, pulmonary embolism or deep vein thrombosis, and shortness of breath, finds a study today in JAMA Network Open.

Kaiser Permanente researchers led the study, which involved 127,859 COVID-19 patients of all ages from eight large US healthcare systems who tested positive for COVID-19 from Mar 1 to Nov 1, 2020, and the same number of matched controls with negative test results.

Average age was 41.2 years, 53.7% were female, 51.8% were Hispanic, 26.9% were White, 7.1% were Asian, and 6.2% were Black. Common underlying medical conditions included high blood pressure (18.2%), overweight or obesity (18.0%), and diabetes (12.3%). These conditions were more common among controls than COVID-19 patients, except for diabetes, overweight or obesity, and neurologic conditions. 

COVID-19 was tied to a 4% rise in healthcare use in the 6 months after infection (ratio of rate ratio [RRR], 1.04), mostly for virtual visits (RRR, 1.14) and emergency department visits (RRR, 1.08). Asian COVID-19 patients had the highest increase in use (RRR, 1.14).

Healthcare use for 18 COVID-linked conditions stayed elevated for 6 months, with the largest increase for infectious disease–related conditions (RRR, 86.00), COVID-19 (RRR, 19.47), hair loss (RRR, 2.52), bronchitis (RRR, 1.85), pulmonary embolism or deep-vein thrombosis (RRR, 1.74), and shortness of breath (RRR, 1.73). An estimated 27,217 additional COVID-related medical visits took place over 6 months (212.9 visits per 1,000 patients).

Children had lower healthcare use than adults (RRR, 0.88) but had significantly increased healthcare use for COVID-19 (RRR, 24.07), pulmonary embolism or deep vein thrombosis (RRR, 24.00), abnormal heart rhythms (RRR, 1.78), shortness of breath (RRR, 1.43), and ear, nose, and throat disorders (RRR, 1.25). 

"These findings suggest that health care systems should consider long-term strategic resource allocation in response to the expected elevated health care utilization experienced by patients with SARS-CoV-2 infection for at least 6 months following the acute stage of infection," the authors wrote.
Aug 12 JAMA Netw Open study


More evidence COVID-19 vaccines are safe in pregnancy

Yesterday The Lancet Infectious Diseases published a large study once again confirming the safety of mRNA COVID-19 vaccines in pregnancy.

The study was based on data from the Canadian National Vaccine Safety (CANVAS) Network, which tracked vaccine recipients and outcomes from December 2020 through November 2021.  Participants were asked to track any adverse events for the 7 days following both doses of vaccines. The results were compared with an unvaccinated control group, also asked to document any health events in the week prior to completing a health survey.

In total, 191,360 women aged 15 to 49 years with known pregnancy status completed the first dose survey and 94,937 completed the second dose survey.

Four percent (226/5,597) of mRNA-vaccinated pregnant participants reported a significant health event within 7 days after dose one of an mRNA vaccine, and 7.3% (227/3,108) after dose two. Among unvaccinated pregnant controls, 3.2% (11/339), participants reported similar events in the 7 days prior to survey completion.

Of note, there were no significant differences in rates of miscarriage or stillbirth for either revaccinated or unvaccinated participants. According to the authors, 2.1% (7/339) of unvaccinated pregnant women and 1.5% (83/5,597) of vaccinated pregnant women experienced a miscarriage or stillbirth within 7 days of either vaccine dose.

In a commentary on the study, researchers from the US Centers for Disease Control and Prevention wrote, "These findings are consistent with and add to the growing body of evidence that COVID-19 mRNA vaccines are safe during pregnancy. Given the risks of significant illness and adverse pregnancy outcomes, it is imperative that we continue to collect and disseminate data on the safety and effectiveness of COVID-19 vaccination in pregnancy and to encourage healthcare providers to promote vaccination during all trimesters of pregnancy."
Aug 11 Lancet Infect Dis study
Aug 11 Lancet Infect Dis commentary

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