Race and Sex Differences in Vital Signs Associated with COVID-19 and Flu Diagnoses in Mississippi
Tóm tắt
Early detection of viral infections, such as COVID-19 and flu, have potential to reduce risk of morbidity, mortality, and disease transmission through earlier intervention strategies. For example, detecting changes in vital signs have the potential to more rapidly diagnose respiratory virus diseases. The objective of this study was to utilize the University of Mississippi Medical Center’s extensive clinical database (EPIC) to investigate associations between temperature, pulse rate, blood pressure (BP), and respiration rate in COVID-19 and flu diagnosed patients. Data from 1,363 COVID-19 (March 3, 2020, to February 27, 2021) and 507 flu (October 1, 2017, to September 30, 2018) diagnosed patients with reported demographic dimensions (age, first race, and sex) and office visit dimensions (BMI, diastolic BP, pulse rate, respiration rate, systolic BP, and temperature) was obtained, including day of diagnosis and additional encounter visits 60 days before and after first unique diagnosis. Patients with COVID-19 or flu were disproportionately obese, with 93% of COVID-19 and 79% of flu patients with BMI ≥ 30. Most striking, Black women 50–64 years of age disproportionately carried the burden of disease. At the time of diagnosis, temperature was significantly increased for all patients, yet pulse rate was only significantly increased for flu diagnosis, and BP was not significantly different in either. Our findings show the need for more complete demographic and office visit dimension data from patients during epidemic and pandemic events and support further studies needed to understand association between vital signs and predicting respiratory disease.
Tài liệu tham khảo
Jones CP, Ogbara T, Braveman P. Disparities in infectious diseases among women in developed countries. Emerg Infect Dis. 2004;10(11):e20–e20.
Vahidy FS, et al. Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population. BMJ Open. 2020;10(8):e039849.
Davido B, et al. Post–COVID-19 chronic symptoms: a postinfectious entity? Clin Microbiol Infect. 2020;26(11):1448–9.
Torjesen I. Covid-19: Middle aged women face greater risk of debilitating long term symptoms. BMJ. 2021;372:n829.
Evans RA et al. Physical, cognitive and mental health impacts of COVID-19 following hospitalisation – a multi-centre prospective cohort study. medRxiv. 2021: 2021.03.22.21254057.
MSDH. Mississippi State Department of Health: Coronavirus Disease 2019 (COVID-19). 2021.
Chaves SS, et al. The US influenza hospitalization surveillance network. Emerg Infect Dis. 2015;21(9):1543–50.
Malik VS, et al. Higher body mass index is an important risk factor in COVID-19 patients: a systematic review and meta-analysis. Environ Sci Pollut Res Int. 2020;27(33):42115–23.
Philipose Z et al. Obesity, old age, and frailty are the true risk factors for COVID-19 mortality and not chronic disease or ethnicity. medRxiv. 2020: 2020.08.12.20156257.
O’Hearn M, et al. Coronavirus disease 2019 hospitalizations attributable to cardiometabolic conditions in the United States: a comparative risk assessment analysis. J Am Heart Assoc. 2021;10(5):e019259.
Control, C.f.D. People with certain medical conditions. 2021 June 21, 2021; Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html.
Hendren NS, et al. Association of body mass index and age with morbidity and mortality in patients hospitalized with COVID-19. Circulation. 2021;143(2):135–44.
Moser J-AS, et al. Underweight, overweight, and obesity as independent risk factors for hospitalization in adults and children from influenza and other respiratory viruses. Influenza Other Respir Viruses. 2019;13(1):3–9.
Honce R, Schultz-Cherry S. Impact of obesity on influenza a virus pathogenesis, immune response, and evolution. Front Immunol. 2019;10:1071.
Han Y-Y, et al. Obesity and rhinitis in a nationwide study of children and adults in the United States. J Allergy Clin Immunol. 2016;137(5):1460–5.
Baik I, et al. A prospective study of age and lifestyle factors in relation to community-acquired pneumonia in US men and women. Arch Intern Med. 2000;160(20):3082–8.
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert panel on the identification, evaluation, and treatment of overweight in adults. Am J Clin Nutr. 1998;68(4):899–917.
Peckham H, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun. 2020;11(1):6317.
Karjalainen J, Viitasalo M. Fever and cardiac rhythm. Arch Intern Med. 1986;146(6):1169–71.
Quer G, et al. Wearable sensor data and self-reported symptoms for COVID-19 detection. Nat Med. 2021;27(1):73–7.
Radin JM, et al. Harnessing wearable device data to improve state-level real-time surveillance of influenza-like illness in the USA: a population-based study. Lancet Digit Health. 2020;2(2):e85–93.
University of Mississippi Medical Center, C.f.I.a.A., Patient cohort explorer. 2020.
Organization, W.H. International statistical classification of diseases and related health problems (10th ed.). 2016.
U.S. Census Bureau, P.D. Annual Estimates of the Resident Population for Selected Age Groups by Sex for Mississippi: April 1, 2010 to July 1, 2019 (SC-EST2019-AGESEX-28). 2020.
U.S. Census Bureau, P.D. Annual Estimates of the Resident Population by Sex, Race, and Hispanic Origin for Mississippi: April 1, 2010 to July 1, 2019 (SC-EST2019-SR11H-28). 2020.
CDC. Behavioral risk factor surveillance system. 2019.
Flegal KM, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303(3):235–41.
Gill JR, et al. Pulmonary pathologic findings of fatal 2009 pandemic influenza A/H1N1 viral infections. Arch Pathol Lab Med. 2010;134(2):235–43.
Morgan OW, et al. Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1) disease. PLoS One. 2010;5(3):e9694.
Thompson DL, et al. Risk factors for 2009 pandemic influenza A (H1N1)-related hospitalization and death among racial/ethnic groups in New Mexico. Am J Public Health. 2011;101(9):1776–84.
Vaillant L. et al. Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro Surveill. 2009;14(33).
Venkata C, Sampathkumar P, Afessa B. Hospitalized patients with 2009 H1N1 influenza infection: the Mayo Clinic experience. Mayo Clin Proc. 2010;85(9):798–805.
Louie JK, et al. Factors associated with death or hospitalization due to pandemic 2009 influenza A(H1N1) infection in California. JAMA. 2009;302(17):1896–902.
Cocoros NM, et al. Obesity as a risk factor for severe influenza-like illness. Influenza Other Respir Viruses. 2014;8(1):25–32.
Martín V, et al. High body mass index as a risk factor for hospitalization due to influenza: a case-control study. Arch Bronconeumol. 2016;52(6):299–307.
5050. G.H. COVID-19 sex disaggregated data tracker. 2020 June 23, 2021; Available from: https://globalhealth5050.org/covid19/sex-disaggregated-data-tracker.
Rushovich T, et al. Sex disparities in COVID-19 mortality vary across US racial groups. J Gen Intern Med. 2021;36(6):1696–701.
Chinn JJ, Martin IK, Redmond N. Health equity among Black women in the United States. J Womens Health. 2020;30(2):212–9.
Markel H, et al. Nonpharmaceutical interventions implemented by US cities during the 1918–1919 influenza pandemic. JAMA. 2007;298(6):644–54.
Control, C.f.D. Social Distancing. 2020 June 22, 2021; Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html#:~:text=Since%20people%20can%20spread%20the,severe%20illness%20from%20COVID%2D19.
CDC. How to protect yourself & others. 2021.
Glass RJ, et al. Targeted social distancing design for pandemic influenza. Emerg Infect Dis. 2006;12(11):1671–81.
Real FG, et al. Lung function, respiratory symptoms, and the menopausal transition. Journal of Allergy and Clinical Immunology. 2008;121(1):72-80.e3.
McKnight KK, et al. Racial and regional differences in age at menopause in the United States: findings from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Am J Obstet Gynecol. 2011;205(4):353.e1-353.e3538.
World Health Organization Writing, G., et al. Non-pharmaceutical interventions for pandemic influenza, international measures. Emerg Infect Dis. 2006;12(1):81–7.
Hayward AC, et al. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study. Lancet Respir Med. 2014;2(6):445–54.
Sah P, et al. Asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis. Proc Natl Acad Sci. 2021;118(34):e2109229118.
CDC. Influenza antiviral medications: summary for clinicians. 2021 November 11, 2021; Available from: https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm.
Radin JM, et al. Epidemiology of pathogen-specific respiratory infections among three US populations. PLOS ONE. 2015;9(12):e114871.
Williams DP, et al. Heart rate variability and inflammation: a meta-analysis of human studies. Brain Behav Immun. 2019;80:219–26.
Wong JY, et al. Case fatality risk of influenza A (H1N1pdm09): a systematic review. Epidemiology (Cambridge, Mass). 2013;24(6):830–41.
Elezkurtaj S, et al. Causes of death and comorbidities in hospitalized patients with COVID-19. Sci Rep. 2021;11(1):4263.
Faust JS, del Rio C. Assessment of deaths from COVID-19 and from seasonal influenza. JAMA Intern Med. 2020;180(8):1045–6.