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1. Relative Risks of COVID-19–Associated Hospitalizations and Clinical Outcomes by Age and Race/Ethnicity—March 2020–March 2021

Author

Bozio, Catherine H, Butterfield, Kristen, Irving, Stephanie A, Vazquez-Benitez, Gabriela, Ong, Toan C, Zheng, Kai, Ball, Sarah W, Naleway, Allison L, Barron, Michelle, and Reed, Carrie

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Lung, Clinical Research, Prevention, Cardiovascular, Patient Safety, Respiratory, Good Health and Well Being, COVID-19, adults, hospitalization, race, ethnicity, race/ethnicity, Clinical sciences, Medical microbiology
Abstract

BackgroundLimited data exist on population-based risks and risk ratios (RRs) of coronavirus disease 2019 (COVID-19)-associated hospitalizations and clinical outcomes stratified by age and race/ethnicity.MethodsUsing data from electronic health records and claims from 4 US health systems for the period March 2020-March 2021, we calculated risk and RR by age and race/ethnicity for COVID-19-associated hospitalizations and clinical outcomes among adults (≥18 years). COVID-19-associated hospitalizations were defined based on COVID-19 discharge codes or a positive severe acute respiratory syndrome coronavirus 2 result. Proportions of acute exacerbations of underlying conditions were estimated among hospitalized patients with select underlying conditions, stratified by age and race/ethnicity.ResultsAmong 2.6 million adults included in the patient cohort, 6879 had COVID-19-associated hospitalizations during March 2020-March 2021 (risk: 264 per 100 000 population). Compared with younger, non-Hispanic White adults, non-Hispanic Black and Hispanic adults aged ≥65 years had the highest hospitalization risk ratios (RR, 8.6; 95% CI, 7.6-9.9; and RR, 9.3; 95% CI, 8.5-10.3, respectively). Among hospitalized adults with COVID-19 and renal disease or cardiovascular disease, the highest proportion of acute renal failure (55.5%) or congestive heart failure (43.9%) occurred in older, non-Hispanic Black patients. Among hospitalized adults with chronic lung disease or asthma, the highest proportion of respiratory failure (62.9%) or asthma exacerbation (66.7%) occurred in older, Hispanic patients.ConclusionsDuring the first year of the US COVID-19 pandemic in this cohort, older non-Hispanic Black and Hispanic adults had the highest relative risks of COVID-19-associated hospitalization and adverse outcomes and, among those with select underlying conditions, the highest occurrences of acute exacerbations of underlying conditions.

Published
2022

2. Interim Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19-Associated Hospitalization Among Adults Aged [greater than or equal to]18 Years with Immunocompromising Conditions--VISION Network, September 2023-February 2024

Author

Link-Gelles, Ruth, Rowley, Elizabeth A.K., DeSilva, Malini B., Dascomb, Kristin, Irving, Stephanie A., Klein, Nicola P., Grannis, Shaun J., Ong, Toan C., Weber, Zachary A., Fleming-Dutra, Katherine E., McEvoy, Charlene E., Akinsete, Omobosola, Bride, Daniel, Sheffield, Tamara, Naleway, Allison L., Zerbo, Ousseny, Fireman, Bruce, Hansen, John, Goddard, Kristin, Dixon, Brian E., Rogerson, Colin, Fadel, William F., Duszynski, Thomas, Rao, Suchitra, Barron, Michelle A., Reese, Sarah E., Ball, Sarah W., Dunne, Margaret M., Natarajan, Karthik, Okwuazi, Erica, Shah, Ami B., Wiegand, Ryan, Tenforde, Mark W., and Payne, Amanda B.

Subjects
Vaccination, Adults, Vaccines, Health
Abstract

Introduction On September 12, 2023, CDC's Advisory Committee on Immunization Practices recommended updated 2023-2024 COVID-19 vaccination with a monovalent XBB.1.5--derived vaccine for all persons aged [greater than or equal to]6 [...]

Published
2024

3. Interim Effectiveness of Updated 2023-2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalization Among Immunocompetent Adults Aged [greater than or equal to]18 Years--VISION and IVY Networks, September 2023- January 2024

Author

DeCuir, Jennifer, Payne, Amanda B., Self, Wesley H., Rowley, Elizabeth A.K., Dascomb, Kristin, DeSilva, Malini B., Irving, Stephanie A., Grannis, Shaun J., Ong, Toan C., Klein, Nicola P., Weber, Zachary A., Reese, Sarah E., Ball, Sarah W., Barron, Michelle A., Naleway, Allison L., Dixon, Brian E., Essien, Inih, Bride, Daniel, Natarajan, Karthik, Fireman, Bruce, Shah, Ami B., Okwuazi, Erica, Wiegand, Ryan, Zhu, Yuwei, Lauring, Adam S., Martin, Emily T., Gaglani, Manjusha, Peltan, Ithan D., Brown, Samuel M., Ginde, Adit A., Mohr, Nicholas M., Gibbs, Kevin W., Hager, David N., Prekker, Matthew, Mohamed, Amira, Srinivasan, Vasisht, Steingrub, Jay S., Khan, Akram, Busse, Laurence W., Duggal, Abhijit, Wilson, Jennifer G., Chang, Steven Y., Mallow, Christopher, Kwon, Jennie H., Exline, Matthew C., Columbus, Cristie, Vaughn, Ivana A., Safdar, Basmah, Mosier, Jarrod M., Harris, Estelle S., Casey, Jonathan D., Chappell, James D., Grijalva, Carlos G., Swan, Sydney A., Johnson, Cassandra, Lewis, Nathaniel M., Ellington, Sascha, Adams, Katherine, Tenforde, Mark W., Paden, Clinton R., Dawood, Fatimah S., Fleming-Dutra, Katherine E., Surie, Diya, and Link-Gelles, Ruth

Subjects
Vaccination, Medical research, Medicine, Experimental, Hospitals -- Emergency service, Emergency medicine, Adults, Vaccines, Health, Vanderbilt University. Medical Center
Abstract

Introduction On September 12, 2023, CDC's Advisory Committee on Immunization Practices recommended updated 2023-2024 COVID-19 vaccination with a monovalent XBB.1.5--derived vaccine for all persons aged [greater than or equal to]6 [...]

Published
2024

4. Effectiveness of COVID-19 mRNA Vaccines Against COVID-19-Associated Hospitalizations Among Immunocompromised Adults During SARS-CoV-2 Omicron Predominance--VISION Network, 10 States, December 2021-August 2022

Author

Britton, Amadea, Embi, Peter J., Levy, Matthew E., Gaglani, Manjusha, DeSilva, Malini B., Dixon, Brian E., Dascomb, Kristin, Patel, Palak, Schrader, Kristin E., Klein, Nicola P., Ong, Toan C., Natarajan, Karthik, Hartmann, Emily, Kharbanda, Anupam B., Irving, Stephanie A., Dickerson, Monica, Dunne, Margaret M., Raiyani, Chandni, Grannis, Shaun J., Stenehjem, Edward, Zerbo, Ousseny, Rao, Suchitra, Han, Jungmi, Sloan-Aagard, Chantel, Griggs, Eric P., Weber, Zachary A., Murthy, Kempapura, Fadel, William F., Grisel, Nancy, McEvoy, Charlene, Lewis, Ned, Barron, Michelle A., Nanez, Juan, Reese, Sarah E., Mamawala, Mufaddal, Valvi, Nimish R., Arndorfer, Julie, Goddard, Kristin, Yang, Duck- Hye, Fireman, Bruce, Ball, Sarah W., Link-Gelles, Ruth, Naleway, Allison L., and Tenforde, Mark W.

Subjects
Vaccination, Messenger RNA, Adults, Vaccines, Health
Abstract

Persons with moderate-to-severe immunocompromising conditions might have reduced protection after COVID-19 vaccination, compared with persons without immunocompromising conditions (1-3). On August 13, 2021, the Advisory Committee on Immunization Practices (ACIP) [...]

Published
2022

5. Effectiveness of 2, 3, and 4 COVID-19 mRNA Vaccine Doses Among Immunocompetent Adults During Periods when SARS-CoV-2 Omicron BA.1 and BA.2/BA.2.12.1 Sublineages Predominated--VISION Network, 10 States, December 2021-June 2022

Author

Link-Gelles, Ruth, Levy, Matthew E., Gaglani, Manjusha, Irving, Stephanie A., Stockwell, Melissa, Dascomb, Kristin, DeSilva, Malini B., Reese, Sarah E., Liao, I-Chia, Ong, Toan C., Grannis, Shaun J., McEvoy, Charlene, Patel, Palak, Klein, Nicola P., Hartmann, Emily, Stenehjem, Edward, Natarajan, Karthik, Naleway, Allison L., Murthy, Kempapura, Rao, Suchitra, Dixon, Brian E., Kharbanda, Anupam B., Akinseye, Akintunde, Dickerson, Monica, Lewis, Ned, Grisel, Nancy, Han, Jungmi, Barron, Michelle A., Fadel, William F., Dunne, Margaret M., Goddard, Kristin, Arndorfer, Julie, Konatham, Deepika, Valvi, Nimish R., Currey, J.C., Fireman, Bruce, Raiyani, Chandni, Zerbo, Ousseny, Sloan-Aagard, Chantel, Ball, Sarah W., Thompson, Mark G., and Tenforde, Mark W.

Subjects
Medical research, Medicine, Experimental, Messenger RNA, Infection, Adults, Vaccines, Health, University of Colorado
Abstract

On July 15, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). The Omicron variant (B.1.1.529) of SARS-CoV-2, the virus that causes COVID-19, was [...]

Published
2022

6. Waning 2-Dose and 3-Dose Effectiveness of mRNA Vaccines Against COVID-19-Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance--VISION Network, 10 States, August 2021-January 2022

Author

Ferdinands, Jill M., Rao, Suchitra, Dixon, Brian E., Mitchell, Patrick K., DeSilva, Malini B., Irving, Stephanie A., Lewis, Ned, Natarajan, Karthik, Stenehjem, Edward, Grannis, Shaun J., Han, Jungmi, McEvoy, Charlene, Ong, Toan C., Naleway, Allison L., Reese, Sarah E., Embi, Peter J., Dascomb, Kristin, Klein, Nicola P., Griggs, Eric P., Konatham, Deepika, Kharbanda, Anupam B., Yang, Duck-Hye, Fadel, William F., Grisel, Nancy, Goddard, Kristin, Patel, Palak, Liao, I-Chia, Birch, Rebecca, Valvi, Nimish R., Reynolds, Sue, Arndorfer, Julie, Zerbo, Ousseny, Murthy, Monica Dickerson Kempapura, Williams, Jeremiah, Bozio, Catherine H., Blanton, Lenee, Verani, Jennifer R., Schrag, Stephanie J., Dalton, Alexandra F., Wondimu, Mehiret H., Link-Gelles, Ruth, Azziz-Baumgartner, Eduardo, Barron, Michelle A., Gaglani, Manjusha, Thompson, Mark G., and Fireman, Bruce

Subjects
Pfizer Inc., Vaccination, Hospitals -- Emergency service, Messenger RNA, Emergency medicine, Adults, Vaccines, Pharmaceutical industry, Health
Abstract

On February 11, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). CDC recommends that all persons aged [greater than or equal to] 12 [...]

Published
2022

7. Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19--Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance--VISION Network, 10 States, August 2021-January 2022

Author

Thompson, Mark G., Natarajan, Karthik, Irving, Stephanie A., Rowley, Elizabeth A., Griggs, Eric P., Gaglani, Manjusha, Klein, Nicola P., Grannis, Shaun J., DeSilva, Malini B., Stenehjem, Edward, Reese, Sarah E., Dickerson, Monica, Naleway, Allison L., Han, Jungmi, Konatham, Deepika, McEvoy, Charlene, Rao, Suchitra, Dixon, Brian E., Dascomb, Kristin, Lewis, Ned, Levy, Matthew E., Patel, Palak, Liao, I-Chia, Kharbanda, Anupam B., Barron, Michelle A., Fadel, William F., Grisel, Nancy, Goddard, Kristin, Yang, Duck-Hye, Wondimu, Mehiret H., Murthy, Kempapura, Valvi, Nimish R., Arndorfer, Julie, Fireman, Bruce, Dunne, Margaret M., Embi, Peter, Azziz-Baumgartner, Eduardo, Zerbo, Ousseny, Bozio, Catherine H., Reynolds, Sue, Ferdinands, Jill, Williams, Jeremiah, Link-Gelles, Ruth, Schrag, Stephanie J., Verani, Jennifer R., Ball, Sarah, and Ong, Toan C.

Subjects
Pfizer Inc., Medical research, Medicine, Experimental, Hospitals -- Emergency service, Messenger RNA, Emergency medicine, Adults, Vaccines, Pharmaceutical industry, Health, University of Colorado, Comirnaty (Vaccine)
Abstract

On January 21, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Estimates of COVID-19 mRNA vaccine effectiveness (VE) have declined in recent months [...]

Published
2022

8. Effectiveness of 2-Dose Vaccination with mRNA COVID-19 Vaccines Against COVID-19-Associated Hospitalizations Among Immunocompromised Adults--Nine States, January-September 2021

Author

Embi, Peter J., Levy, Matthew E., Naleway, Allison L., Patel, Palak, Gaglani, Manjusha, Natarajan, Karthik, Dascomb, Kristin, Ong, Toan C., Klein, Nicola P., Liao, I.-Chia, Grannis, Shaun J., Han, Jungmi, Stenehjem, Edward, Dunne, Margaret M., Lewis, Ned, Irving, Stephanie A., Rao, Suchitra, McEvoy, Charlene, Bozio, Catherine H., Murthy, Kempapura, Dixon, Brian E., Grisel, Nancy, Yang, Duck-Hye, Goddard, Kristin, Kharbanda, Anupam B., Reynolds, Sue, Raiyani, Chandni, Fadel, William F., Arndorfer, Julie, Rowley, Elizabeth A., Fireman, Bruce, Ferdinands, Jill, Valvi, Nimish R., Ball, Sarah W., Zerbo, Ousseny, Griggs, Eric P., Mitchell, Patrick K., Porter, Rachael M., Kiduko, Salome A., Blanton, Lenee, Zhuang, Yan, Steffens, Andrea, Reese, Sarah E., Olson, Natalie, Williams, Jeremiah, Dickerson, Monica, McMorrow, Meredith, Schrag, Stephanie J., Verani, Jennifer R., Fry, Alicia M., Azziz-Baumgartner, Eduardo, Barron, Michelle A., Thompson, Mark G., and DeSilva, Malini B.

Subjects
Pfizer Inc., Vaccination, Messenger RNA, Adults, Pharmaceutical industry, Health
Abstract

On November 2, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Immunocompromised persons, defined as those with suppressed humoral or cellular immunity resulting [...]

Published
2021

9. The Emperor's New Clothes: PRospective Observational Evaluation of the Association Between Initial VancomycIn Exposure and Failure Rates Among ADult HospitalizEd Patients With Methicillin-resistant Staphylococcus aureus Bloodstream Infections (PROVIDE).

Author

Lodise, Thomas P, Rosenkranz, Susan L, Finnemeyer, Matthew, Evans, Scott, Sims, Matthew, Zervos, Marcus J, Creech, C Buddy, Patel, Pratish C, Keefer, Michael, Riska, Paul, Silveira, Fernanda P, Scheetz, Marc, Wunderink, Richard G, Rodriguez, Martin, Schrank, John, Bleasdale, Susan C, Schultz, Sara, Barron, Michelle, Stapleton, Ann, and Wray, Dannah

Subjects
ACUTE kidney failure, BACTEREMIA, BLOODBORNE infections, HOSPITAL care, LONGITUDINAL method, MEDICAL cooperation, MICROBIAL sensitivity tests, MORTALITY, SCIENTIFIC observation, RESEARCH, STAPHYLOCOCCAL diseases, VANCOMYCIN, TREATMENT effectiveness, METHICILLIN-resistant staphylococcus aureus, DESCRIPTIVE statistics, CATHETER-related infections, ADULTS
Abstract

Background Vancomycin is the most commonly administered antibiotic in hospitalized patients, but optimal exposure targets remain controversial. To clarify the therapeutic exposure range, this study evaluated the association between vancomycin exposure and outcomes in patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Methods This was a prospective, multicenter (n = 14), observational study of 265 hospitalized adults with MRSA bacteremia treated with vancomycin. The primary outcome was treatment failure (TF), defined as 30-day mortality or persistent bacteremia ≥7 days. Secondary outcomes included acute kidney injury (AKI). The study was powered to compare TF between patients who achieved or did not achieve day 2 area under the curve to minimum inhibitory concentration (AUC/MIC) thresholds previously found to be associated with lower incidences of TF. The thresholds, analyzed separately as co-primary endpoints, were AUC/MIC by broth microdilution ≥650 and AUC/MIC by Etest ≥320. Results Treatment failure and AKI occurred in 18% and 26% of patients, respectively. Achievement of the prespecified day 2 AUC/MIC thresholds was not associated with less TF. Alternative day 2 AUC/MIC thresholds associated with lower TF risks were not identified. A relationship between the day 2 AUC and AKI was observed. Patients with day 2 AUC ≤515 experienced the best global outcomes (no TF and no AKI). Conclusions Higher vancomycin exposures did not confer a lower TF risk but were associated with more AKI. The findings suggest that vancomycin dosing should be guided by the AUC and day 2 AUCs should be ≤515. As few patients had day 2 AUCs <400, further study is needed to define the lower bound of the therapeutic range. [ABSTRACT FROM AUTHOR]

Published
2020
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