Study finds long-haul COVID-19 common, in even those with mild disease
Long-haul COVID-19 was associated with severe or very severe symptoms, low income, and some age-groups, but was common even in those with mild symptoms, with a quarter of patients in that group having symptoms after 60 days, according to a Clinical Infectious Diseases study today that looked at adult Michigan patients.
The researchers surveyed 593 Michigan adults who had a symptomatic COVID-19 diagnosis through mid-April 2020. Most were female (56.1%), older than 45 years (68.2%), and either White (46.3%) or Black (34.8%). More than half reported 30-day COVID-19 symptoms (52.5%), and 35.0% said they had symptoms 60 days post-diagnosis. The most common symptoms among 60-day COVID-19 patients were fatigue (52.9%) and shortness of breath (43.9%).
Respondents with very severe symptoms were 2.25 and 1.71 times more likely to have 30- and 60-day COVID-19 symptoms, respectively, than those who had mild cases. Similarly, those who were hospitalized had about 40% higher crude increased odds of 30- or 60-day COVID-19 symptoms (crude odds ratio [OR], 1.37 and 1.40, respectively). Still, long-term COVID-19 also occurred in non-hospitalized patients (43.7% at 30 days and 26.9% at 60 days) and those with mild symptoms (29.2% at 30 days and 24.5% at 60 days).
While associations with race, some comorbidities, and multiple age-groups were found using unadjusted models, the researchers' adjusted models showed significant links only for psychological disorders (OR, 1.42 for 60-day symptoms), low household income (OR, 1.38 to 1.40 for income below $75,000 for 30-day symptoms), and people 35 to 44 years of age versus those 18 to 34 (OR not given).
The researchers add that although Hispanic adults had a 48% higher prevalence of 30-day COVID-19 and 67% higher prevalence of 60-day COVID-19 compared with non-hospitalized White adults, the adjusted models showed no statistical significance for any race or ethnicities.
May 19 Clin Infect Dis study
COVID racial disparities may persist independent of socioeconomic status
Non-White COVID-19 patients were more likely to be hospitalized compared with White people regardless of socioeconomic status, according to a study yesterday in the Journal of General Internal Medicine. The researchers also found that non-English speakers were more likely to require hospital care.
University of Minnesota researchers looked at 5,577 COVID-19 patient records from the M Fairview health system in Minnesota from Mar 4 to Aug 19, 2020. Of these, 15.5% were hospitalized within 45 days of diagnosis. Hospitalized patients were more likely to be male (49.1% vs 43.5%) and had more comorbidities (5.0 vs 1.0 on the Elixhauser Comorbidity Index).
Compared with White patients, Black, Asian, and Hispanic people were more likely to need hospitalization (odds ratios [ORs], 1.50, 2.39, and 3.80, respectively). The researchers also found that, while hospitalized patients were older than their outpatient counterparts in general (median 60.9 vs 40.4 years), racial differences in hospital patient age were noted: White patients were a median 69.6 years old; whereas Black patients were 55.4, Asians 58.9, and Hispanics 48.5.
Using the Area Deprivation Index for each patient's ZIP code, the researchers did not find any association between hospitalization outcomes and socioeconomic status, a common factor that is brought up when looking at COVID-19 racial disparities. "It supports concerns that other unidentified confounders (i.e., structural racism, testing, etc.) drive the association," the researchers write.
Conversely, language was independently associated. Regardless of race or ethnicity, the likelihood of hospitalization increased 1.91 times for patients who didn't speak English.
"Seeing an increased risk of severe COVID-19 disease in people of color and non-English speaking, independent of other known risk factors, these populations should be considered high priority for the continued vaccination rollout," lead author Nicholas Ingraham, MD, said in a University of Minnesota press release. The team also advocates for more multilingual COVID-19 information and implicit bias remediation among healthcare providers.
May 18 J Gen Intern Med study
May 18 University of Minnesota press release
Rapid test finds CWD at Minnesota deer carcass dump site
Using rapid testing technology, Minnesota investigators have detected evidence of chronic wasting disease (CWD) prions at a remote dumping site that a Minnesota deer farm used to dispose of white-tail deer carcasses, the University of Minnesota said yesterday in a press release.
Working at a site in Beltrami County in the northwestern part of the state, scientists from the Minnesota Center for Prion Research (MNPRO) used the RT-QuIC test on samples of bone, hides, soil, and plants that were collected on May 2. Their investigation, which focused on materials known to retain prions, turned up portions of at least 10 deer. One bone marrow sample was positive for CWD.
Peter Larsen, PhD, who led the team, said the rapidly evolving situation is concerning, because the area is frequented by wild white-tailed deer.
A herd at a nearby deer farm was depopulated last week and the US Department of Agriculture and MNPRO are testing samples from the depopulated animals. Scientists at MNPRO recently developed an assay for use in the field that is designed to reduce bottlenecks during deer hunting season. Called MN-QuIC, it generates a result within 24 hours, showing red for positive and blue for negative.
CWD is a fatal prion disease that affects deer, elk, reindeer, and moose, and has been confirmed in 26 US states and three Canadian provinces. No cases have yet been reported in people.
May 18 University of Minnesota press release